CPT 36908 Intravascular Stent Reimbursement | OpenPayer

Summary & Overview

CPT 36908: Intravascular Stent Placement for Dialysis Circuit

CPT code 36908 represents intravascular stent placement performed during a primary procedure on a dialysis circuit to treat an obstructed central segment. The code includes radiological supervision and interpretation for any imaging necessary to complete the intravascular stent placement. This procedure is clinically significant because maintaining dialysis circuit patency reduces access failure, preserves dialysis adequacy, and can lower the need for additional interventions.

Key payers addressed in the analysis include Aetna, Blue Cross Blue Shield, Cigna Health, UnitedHealthcare, and Medicare. Readers will find a concise national overview of clinical context, common sites of service, typical application during dialysis access procedures, and the relevance of included radiology services. The publication summarizes benchmarking and reimbursement considerations, outlines common billing modifiers that may apply, and highlights policy or coding clarifications affecting coverage and claims processing. It also identifies areas where input data was not provided, such as associated taxonomies, ICD-10 diagnosis mappings, and related codes, so readers understand where additional clinical or administrative details may be needed.

AetnaBlue Cross Blue ShieldCigna HealthUnitedHealthcareMedicare36908CPTdialysis accessendovascular stentinterventional radiologyvascular accessstent placementradiology included

Billing Code Overview

CPT code 36908 describes intravascular stent placement performed during a primary procedure on a patient's dialysis circuit when an obstructed central segment is encountered. The provider dilates the obstructed segment and then places a stent through a catheter into the vessel lumen to maintain patency. Radiological supervision and interpretation for imaging required to perform the stent placement is included with this code.

Service type: Endovascular stent placement during dialysis circuit intervention
Typical site of service: Hospital-based interventional radiology suite or outpatient vascular access/interventional facility

Clinical & Coding Specifications

Clinical Context

A 62-year-old patient with end-stage renal disease presents for maintenance of a functioning arteriovenous dialysis circuit. During a primary dialysis circuit procedure for suspected circuit dysfunction the interventionalist identifies an obstructed central segment (e.g., central venous stenosis or occlusion) that impairs dialysis flow. Under conscious sedation in an interventional radiology or vascular access suite, the provider performs angiography to define the lesion, uses balloon angioplasty to dilate the stenotic segment, and deploys an intravascular stent through a catheter into the vessel lumen to maintain diameter and restore blood flow. Radiological supervision and interpretation for fluoroscopic imaging is used throughout the procedure and is included in the service. Typical sites of service include an outpatient interventional radiology suite, hospital-based interventional lab, or ambulatory surgical center. The clinical workflow includes pre-procedure evaluation, vascular access, intraprocedural imaging and intervention (angioplasty and stent placement), post-deployment angiographic confirmation of patency, hemostasis, recovery monitoring, and discharge with instructions for dialysis access surveillance.

Coding Specifications

Modifier	Description	When to Use
`11`	Service and procedure performed as billed (default)	Use when the procedure is performed without unusual circumstances or additional modifiers.

CPT 36902: Angiography and Balloon Angioplasty of Dialysis Circuit

CPT-36904-DIALYSIS-CIRCUIT-THROMBECTOMY-THROMBOLYSIS

CPT 36904: Dialysis Circuit Thrombectomy and Pharmacologic Thrombolysis

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

CPT-36907-DIALYSIS-ACCESS-BALLOON-ANGIOPLASTY-CENTRAL-SEGMENT

CPT 36907: Dialysis Access Balloon Angioplasty, Central Segment

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

CPT 36903: Dialysis Access Angiography with Intravascular Stent Placement

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

CPT 36901: Fluoroscopic Dialysis Circuit Contrast Angiography

36905-PERCUTANEOUS-TRANSLUMINAL-MECHANICAL-THROMBECTOMY-ANDOR

CPT 36905: Percutaneous Mechanical Thrombectomy for Dialysis Circuit

Taxonomy Code	Specialty	Notes
208000000X	Vascular Surgery	Commonly performs dialysis circuit interventions including stent placement.
208800000X	Interventional Radiology	Frequently performs angioplasty and stent deployment with fluoroscopic guidance.
207Q00000X	Interventional Cardiology	May perform central venous interventions in select institutions.
208600000X	General Surgery	May perform access and salvage procedures for dialysis circuits in some centers.
363L00000X	Nephrology (Vascular Access)	Nephrologists with procedural training may perform dialysis circuit interventions.

Related Diagnoses

ICD-10 Code	Description	Clinical Relevance
`I82.403`	Acute embolism and thrombosis of unspecified deep veins of lower extremity, unspecified leg	Central or peripheral venous thrombosis can obstruct dialysis circuit outflow requiring angioplasty and stent.
`I87.2`	Venous insufficiency (chronic) (peripheral)	Chronic venous pathology can contribute to access dysfunction and central vein stenosis.
`T82.858A`	Other mechanical complication of other vascular prosthetic devices, implants and grafts, initial encounter	Mechanical complications of prior grafts or devices can lead to central obstruction requiring stent placement.
`N18.6`	End stage renal disease	Underlying condition indicating chronic dialysis and need for maintenance of dialysis circuits.
`I77.3`	Embolism and thrombosis of arteries of the lower extremity	Arterial complications may coexist and influence vascular access planning and interventions.
`I82.409`	Acute embolism and thrombosis of unspecified deep veins of unspecified lower extremity	Venous thrombosis that may affect dialysis access function and require intervention.

Related CPT Codes

CPT Code	Description	Relationship to This Procedure
`36907`	Insertion of tunneled intravascular dialysis catheter, with subcutaneous port or pump, permanent; without subcutaneous port	Performed when establishing or revising long-term dialysis access prior to or after addressing central stenosis.
`36909`	Transluminal balloon angioplasty, dialysis circuit, peripheral or central, including radiological supervision and interpretation; with placement of drug-eluting stent	Alternative or adjunct procedure when a drug-eluting stent is indicated for dialysis circuit stenosis.
`75978`	Endovascular (catheter-based) diagnostic study, noncoronary, radiological supervision and interpretation	Commonly performed to document the lesion and assess flow before stent placement; included in many interventional coding bundles.
`36902`	Transcatheter placement of intravascular stent(s), dialysis circuit; initial central vein	Related code for stent placement in dialysis circuits when performed as a standalone service or when coding specifics differ from primary procedure context.
`76000`	Fluoroscopy, up to one hour physician supervision and interpretation	Ancillary imaging service sometimes reported separately depending on payer and coding guidance; typically imaging is included with primary code but listed here as related imaging service.

OpenPayer