2025 CPT code 36907
(Active) Effective Date: N/A Revision Date: N/A Deletion Date: N/A Surgery - Vascular Procedures Surgery Feed
Transluminal balloon angioplasty of the central dialysis segment, performed through the dialysis circuit.
Modifiers 52 (reduced services), 76 (repeat procedure), and 78 (unplanned return to OR) may be applicable depending on the circumstances.
Medical necessity for 36907 is established by the presence of hemodynamically significant stenosis or occlusion in the central segment of the dialysis access, resulting in compromised dialysis access function. Documentation should support the clinical indication and demonstrate that other less-invasive interventions have failed or are not feasible.
The interventional radiologist or vascular surgeon is typically responsible for performing this procedure. Their duties include obtaining informed consent, performing the angioplasty under imaging guidance, ensuring proper hemostasis, and post-procedure patient monitoring.
In simple words: This code describes a procedure to open a blocked blood vessel in a dialysis access line (a tube used for kidney dialysis).A tiny balloon is inflated inside the blocked area to widen it.This is done using a small tube inserted through the skin and includes all necessary imaging and doctor supervision.
This CPT code, 36907, represents an add-on code for transluminal balloon angioplasty performed within the central dialysis segment of an arteriovenous fistula (AVF) or arteriovenous graft (AVG).The procedure is done via percutaneous access to the existing dialysis circuit. The code includes all necessary imaging (angiography), fluoroscopic guidance, catheter manipulation, and radiological supervision and interpretation. It is bundled with the primary procedure code (36901-36906) and should not be reported separately.The angioplasty addresses narrowing or obstructions in the central segment, which extends from the axillary or cephalic veins (upper extremity) or the common femoral vein (lower extremity) to the vena cava.The service encompasses all angioplasty performed in the central segment during a single session, regardless of the number of lesions treated or the number of catheters/balloons used.
Example 1: A patient with a failing AV fistula presents with stenosis of the central venous segment.The interventional radiologist performs a transluminal balloon angioplasty of the central segment via percutaneous access to the AVF, utilizing code 36907 in conjunction with the appropriate primary procedure code., During a scheduled dialysis access maintenance, a thrombectomy is performed on a patient's AV graft.Post-thrombectomy angiography reveals a residual stenosis in the central venous segment. A balloon angioplasty is performed via the same access, and code 36907 is used with code 36904. , A patient with an AVG experiences thrombosis of the central segment.After successful thrombectomy and angioplasty of the peripheral segment (codes 36904 and 36905), a residual stenosis is identified in the central segment requiring an additional balloon angioplasty (code 36907).
Detailed medical history indicating the need for the procedure, pre-procedure and post-procedure imaging (angiograms), operative report detailing the technique, location and extent of angioplasty,catheter size and type used, balloon size and inflation pressure,and assessment of the results and complications.
** Careful documentation of the location of the stenosis, the number of lesions treated, and the results of the angioplasty is crucial for proper coding and reimbursement.
- Revenue Code: P9A (Dialysis Services)
- RVU: The RVUs for this code are determined by the specific payer and their associated fee schedule.They are dependent on geographic location and other factors.
- Global Days: Not applicable. This is an add-on code to a procedure with its own global period.
- Payment Status: Active
- Modifier TC rule: Not applicable. This is an add-on code and does not have a technical component.
- Fee Schedule: Fee schedules vary by payer and location and are not available here. Consult your specific payer’s fee schedule.
- Specialties:Interventional Radiology, Vascular Surgery, Nephrology
- Place of Service:Hospital (Inpatient or Outpatient), Ambulatory Surgical Center