2025 CPT code 36830
(Active) Effective Date: N/A Revision Date: N/A Surgery - Surgical Procedures on the Cardiovascular System Surgery Feed
Creation of an arteriovenous fistula using a non-autogenous graft (e.g., synthetic material).
Modifiers 59 (distinct procedural service), 78 (unplanned return to OR), and others as clinically indicated may be appended.
Medical necessity is established by the patient's need for vascular access for hemodialysis due to end-stage renal disease.Documentation should support the lack of alternative access options.
The surgeon's responsibilities include patient preparation, anesthesia administration (if applicable), incision, vessel identification and isolation, graft placement and anastomosis, hemostasis, and wound closure.Postoperative care and follow-up are not included.
In simple words: The doctor creates a connection between an artery and a vein using a special artificial tube, to make it easier to perform dialysis for kidney failure.
This CPT code, 36830, describes the surgical creation of an arteriovenous fistula, a connection between an artery and a vein, utilizing a non-autogenous graft.The procedure involves prepping the patient, making an incision, isolating the artery and vein, clamping blood flow, suturing a synthetic graft (e.g., biological collagen or thermoplastic material) to both vessels, creating a subcutaneous tunnel for the graft, removing the clamps to restore blood flow, and closing the wound. This procedure facilitates hemodialysis access for patients with end-stage renal disease.
Example 1: A patient with end-stage renal disease requires creation of a vascular access for hemodialysis. The surgeon performs a creation of arteriovenous fistula using a non-autogenous PTFE graft in the right forearm., A patient with chronic kidney failure needs hemodialysis access.Due to previous surgeries, the surgeon opts for a creation of arteriovenous fistula in the left upper arm using a biological collagen graft., A patient with ESRD and limited venous access requires a creation of arteriovenous fistula.The surgeon creates the fistula in the left forearm using a thermoplastic graft.
Preoperative assessment including renal function tests, vascular mapping, and patient consent. Intraoperative notes detailing vessel selection, graft type and size, surgical technique, and estimated blood loss.Postoperative imaging to confirm patency of the fistula.
** The selection of the graft material (e.g., biological collagen, thermoplastic) should be documented.Consideration should be given to the patient's anatomy and overall health when selecting the site for the fistula.
- Revenue Code: P2F (MAJOR PROCEDURE, CARDIOVASCULAR - OTHER)
- Payment Status: Active
- Specialties:Vascular Surgery, Nephrology
- Place of Service:Inpatient Hospital, Outpatient Hospital, Ambulatory Surgical Center