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CPT 36902: Dialysis Circuit Angiography with Balloon Angioplasty
CPT code 36902 represents combined diagnostic angiography and percutaneous transluminal balloon angioplasty of a dialysis access circuit performed under fluoroscopic guidance. This code captures both the imaging component—contrast injection and fluoroscopic visualization of the entire dialysis circuit—and the therapeutic balloon dilation of an identified obstructed segment, including radiological supervision, interpretation, image capture, and reporting. Nationally, procedures on dialysis access are critical to maintaining hemodialysis access patency and reducing complications and hospitalizations for patients with end-stage renal disease.
Key payers in this analysis include Aetna, Blue Cross Blue Shield, Cigna Health, United Healthcare, and Medicare. Readers will find a concise clinical and billing overview of the procedure, typical sites of service, common clinical indications, and the set of related CPT codes for comparable dialysis circuit interventions. The publication highlights how 36902 differs from purely diagnostic access angiography and from related codes that include stent placement or mechanical thrombectomy.
This summary provides clinicians, coders, and revenue cycle professionals with clear context on when 36902 is reported, what services it bundles, and which comparable codes to consider. Data not available in the input is noted where applicable.
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Billing Code Overview
CPT code 36902 describes a combined diagnostic and therapeutic endovascular procedure on a dialysis access circuit. The provider introduces a needle and/or catheter under fluoroscopic guidance, injects contrast to visualize and record the entire dialysis circuit, identifies an obstructed segment, and performs balloon angioplasty to dilate and restore vessel patency. Radiological supervision and interpretation for both angiography and the angioplasty, plus image capture and a report, are included in this code.
Service type: Image-guided diagnostic angiography with percutaneous transluminal balloon angioplasty of a dialysis access circuit.
Typical site of service: Hospital outpatient interventional radiology suite or ambulatory surgical center where fluoroscopic image guidance and endovascular intervention are performed.
National Reimbursement Benchmarks
Nationally, Medicare’s mean rate of $1,240.80 for CPT 36902 sits slightly above BUCA’s commercial average of $1,181.80, indicating Medicare reimbursement is modestly higher than this blended commercial benchmark. The proximity of those means suggests commercial arrangements captured by BUCA are competitive with public rates for this code, with differences on the order of roughly $59.00.
Dispersion varies across payers: Blue Cross Blue Shield shows a wide interquartile spread (P75–P25 = $1,274.00), and UnitedHealth Group is the widest with a spread of $1,568.00, indicating large variability in contracted rates. Aetna and Cigna are comparatively tighter, with spreads of $1,013.90 and $1,294.80 respectively, while BUCA’s spread is $1,109.50 and Medicare’s is narrow at $154.00, making Medicare the tightest and UnitedHealth Group the most dispersed.