CPT 36907 Dialysis Access Balloon Angioplasty Reimbursement | OpenPayer

Summary & Overview

CPT 36907: Dialysis Access Balloon Angioplasty, Central Segment

CPT code 36907 describes balloon angioplasty of an obstructed central segment identified during a primary procedure on a patient’s dialysis circuit. This endovascular intervention re-establishes flow through a central dialysis outflow or inflow channel by intraluminal balloon dilation; radiological supervision and interpretation for necessary imaging are bundled into the code. The code matters nationally because maintaining functional dialysis access is critical to ongoing renal replacement therapy and care coordination across outpatient and inpatient settings.

Key payers discussed include Aetna, Blue Cross Blue Shield, Cigna Health, UnitedHealthcare and Medicare. Readers will find a concise overview of clinical context and service setting, typical billing and coding considerations, and nationally oriented benchmarks where available. The publication also outlines common modifiers and related billing elements for claim submission and reimbursement workflows. Intended audiences include clinicians performing dialysis access interventions, interventional radiology teams, dialysis program administrators, and revenue cycle professionals who manage endovascular procedure coding and claims.

AetnaBlue Cross Blue ShieldCigna HealthUnitedHealthcareMedicareCPT 36907dialysis accessballoon angioplastyendovascular interventioninterventional radiologyambulatory surgical centervascular access maintenance

Billing Code Overview

CPT code 36907 describes a balloon angioplasty performed on an obstructed central segment of a patient's dialysis circuit that is identified during a primary procedure on the dialysis access. The procedure involves intravascular balloon dilation within the vessel lumen to reopen the occluded channel. Radiological supervision and interpretation for any imaging required to perform the balloon angioplasty are included with this code.

Service type: Endovascular intervention (balloon angioplasty) on dialysis access

Typical site of service: Ambulatory surgical center or hospital interventional radiology suite during dialysis access procedures

Clinical & Coding Specifications

Clinical Context

A 62-year-old patient with end-stage renal disease (ESRD) presents with difficulty achieving adequate blood flow through a tunneled hemodialysis arteriovenous graft. During the primary dialysis circuit procedure, the interventionalist identifies a central intragraft stenosis/occluded central segment that prevents effective dialysis. Under conscious sedation in an outpatient vascular access center or interventional radiology suite, the provider performs percutaneous transluminal balloon angioplasty of the obstructed central segment using fluoroscopic guidance. Radiological supervision and interpretation for imaging (angiography) are included. The typical workflow includes pre-procedure assessment and consent, sterile preparation of the access site, introduction of vascular sheaths and guidewires, diagnostic angiography to localize the lesion, balloon selection and inflation to dilate the stenosis, post-dilation angiography to confirm vessel patency, hemostasis, and post-procedure monitoring. This procedure is commonly performed in ambulatory surgery centers, hospital outpatient departments, or interventional radiology suites and is billed when balloon angioplasty is performed to reopen an obstructed central segment of a dialysis circuit during the primary procedure.

Coding Specifications

Modifier	Description	When to Use
`11`	Normal or routine service	Use when the service is the usual, expected service by the performing provider.

CPT 36905: Percutaneous Mechanical Thrombectomy for Dialysis Circuit

36902-INTRODUCTION-OF-NEEDLES-ANDOR-CATHETERS-DIALYSIS-CIRCUIT

CPT 36902: Angiography and Balloon Angioplasty of Dialysis Circuit

CPT-36901-DIALYSIS-CIRCUIT-CONTRAST-ANGIOGRAPHY-FLUOROSCOPIC-EVALUATION

CPT 36901: Fluoroscopic Dialysis Circuit Contrast Angiography

CPT-36903-DIALYSIS-ACCESS-ANGIOGRAPHY-WITH-STENT-PLACEMENT

CPT 36903: Dialysis Access Angiography with Intravascular Stent Placement

CPT-36904-DIALYSIS-CIRCUIT-THROMBECTOMY-THROMBOLYSIS

CPT 36904: Dialysis Circuit Thrombectomy and Pharmacologic Thrombolysis

CPT-36908-DIALYSIS-CIRCUIT-INTRAVASCULAR-STENT-PLACEMENT

CPT 36908: Intravascular Stent Placement for Dialysis Circuit

36906-TRANSLUMINAL-BALLOON-ANGIOPLASTY-PERIPHERAL-DIALYSIS

CPT 36906: Transluminal Balloon Angioplasty for Dialysis Access

CPT-36909-DIALYSIS-CIRCUIT-ENDOVASCULAR-OCCLUSION-EMBOLIZATION

CPT 36909: Permanent Endovascular Occlusion or Embolization of Dialysis Circuit

Taxonomy Code	Specialty	Notes
`208100000X`	Vascular Surgery	Common performing specialty for dialysis circuit interventions.
`208600000X`	Radiology — Diagnostic	Interprets imaging; may perform in interventional radiology settings.
`2086S0102X`	Interventional Radiology	Procedural specialty directly performing balloon angioplasty of dialysis access.
`363LF0000X`	Nephrology	Referring and co-managing specialty; may perform dialysis access procedures in some settings.
`208000000X`	General Surgery	Performs vascular access and angioplasty in some institutions.

Related Diagnoses

ICD-10 Code	Description	Clinical Relevance
`I77.6`	Arterial aneurysm of other sites	May be relevant if vascular abnormalities are identified during access evaluation (included as a less common association).
`T82.858A`	Other specified mechanical complication of vascular graft, initial encounter	Relevant for dysfunction of arteriovenous grafts causing obstruction requiring angioplasty.
`I65.29`	Occlusion and stenosis of other carotid artery	Less directly related but represents central vessel stenosis concepts; included when central vessel stenosis is the target.
`N18.6`	End stage renal disease	Primary underlying condition necessitating hemodialysis and creation/maintenance of dialysis circuit.
`I97.1`	Postprocedural hemorrhage and hematoma of a circulatory system organ or structure	Possible complication to monitor for after angioplasty procedures.

Related CPT Codes

CPT Code	Description	Relationship to This Procedure
`36000`	Introduction of needle or intracatheter, vein	Used for initial vascular access or venous puncture prior to sheath placement for angiography.
`36215`	Selective catheter placement, arterial system; each first order thoracic, abdominal, or pelvic branch	Used when selective catheterization is required for diagnostic angiography during access evaluation (note: arterial code example when arterial imaging is needed).
`37220`	Revascularization, endovascular, open or percutaneous, central or peripheral artery, including angioplasty	Sometimes reported for peripheral arterial interventions; not generally reported with `36907` but may be relevant when additional arterial interventions are performed.
`36908`	Transcatheter placement of intravascular stent(s), dialysis circuit (e.g., arteriovenous graft or fistula)	Performed if angioplasty alone (`36907`) is insufficient and stent placement is required.
`76937`	Ultrasound guidance for vascular access requiring imaging documentation	Used when ultrasound guidance is employed for vascular access or lesion localization prior to angioplasty.

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