2025 CPT code 36825
(Active) Effective Date: N/A Revision Date: N/A Deletion Date: N/A Surgery - Surgical Procedures on the Cardiovascular System Surgery Feed
Creation of an arteriovenous fistula using an autogenous vein graft (separate procedure).
Modifiers may be applicable depending on the circumstances of the service.For example, modifier 59 (distinct procedural service) may be required if the procedure is performed as a separate and distinct service from other procedures performed on the same day.
The creation of an arteriovenous fistula is medically necessary for patients with end-stage renal disease requiring hemodialysis, as it provides long-term vascular access for efficient and reliable dialysis treatments.The medical necessity is supported by the patient's diagnosis of ESRD and need for hemodialysis.
The surgeon's responsibilities include patient preparation, anesthesia, incision, location and isolation of the artery and vein, harvesting of the autogenous vein graft, creation of a subcutaneous tunnel, anastomosis of the graft to the artery and vein, hemostasis, and wound closure.
In simple words: The doctor creates a connection between an artery and a vein using a piece of the patient's own vein to help with kidney dialysis treatments. This is a separate procedure from the actual connection of the artery and vein.
This CPT code, 36825, reports the creation of an arteriovenous fistula using an autogenous vein graft.The procedure involves surgical creation of a connection between an artery and a vein, utilizing a vein graft harvested from the patient's own body. This is distinct from direct arteriovenous anastomosis (36821).The creation of the graft itself is considered a separate procedure from any other procedures performed during the same operative session.These additional procedures are reported separately.The code does not include the creation of the arteriovenous anastomosis; this is a separate procedure.
Example 1: A patient with end-stage renal disease requires creation of an arteriovenous fistula for hemodialysis. The surgeon performs a 36825 procedure, harvesting a vein from the patient's leg to create the fistula in the forearm., A patient needs an arteriovenous fistula for chronic hemodialysis. The surgeon creates the fistula using a radial artery and cephalic vein.A separate autogenous vein graft is harvested and used for creating the fistula.The creation of the fistula with the autogenous graft is coded as 36825., A patient requires a fistula for hemodialysis access. The surgeon performs a 36825 procedure, creating the arteriovenous fistula in the upper arm using a brachial artery and basilic vein with an autogenous vein graft harvested from the leg.The creation of the graft itself is coded as 36825 while the connection between the artery and vein is a separate procedure.
Preoperative assessment, including patient history, physical examination, and imaging studies (e.g., ultrasound) to determine the suitability of vessels for fistula creation. Intraoperative documentation should specify the location of the vessels used, the technique used (including the source of the autogenous graft), the length and diameter of the graft, and the details of the anastomosis. Postoperative documentation should include confirmation of the patency of the fistula, and any complications encountered.
** Accurate documentation is crucial for appropriate coding and reimbursement.If there is any uncertainty about the technique used, query the physician for clarification.
- Revenue Code: P2F (MAJOR PROCEDURE, CARDIOVASCULAR - OTHER)
- RVU: Unknown
- Global Days: Unknown
- Payment Status: Active
- Modifier TC rule: No Technical Component (TC) modifier is applicable to this code.The code represents the entire procedure.
- Fee Schedule: Unknown
- Specialties:Vascular Surgery, Cardiothoracic Surgery, Nephrology
- Place of Service:Office, Ambulatory Surgical Center, Hospital (Inpatient or Outpatient)