{
    "code": "36903",
    "coding_system": "CPT",
    "canonical_url": "https://localishealth.com/cpt/36903/2019/A",
    "release_specific_url": "https://localishealth.com/cpt/36903/2019/A",
    "description": "Placement of a stent inside a narrowed dialysis fistula or graft to hold the channel open, done through a stick into the access. The circuit is imaged first, a balloon is generally used to prepare the narrowing, and then a metal or covered stent is deployed across it; the imaging and any balloon work in that same segment are part of the one procedure. This entry concerns the peripheral segment, meaning the access itself and its outflow veins up to roughly the level of the armpit, and it is chosen over the balloon-only code when a stent ends up being placed. It is used for narrowing without clot; separate codes apply when the access has clotted off.",
    "answer": {
        "question": "How much did Medicare pay for CPT 36903 in Q1 2019?",
        "text": "Medicare paid $5,485.51 for CPT 36903 in the office (non-facility) setting and $332.64 in a facility under the Q1 2019 Physician Fee Schedule, effective January 2019. These are the national allowed amounts before the ~2% sequestration cut and before locality (GPCI) adjustment. This is a 4.2% decrease from the previous quarter."
    },
    "release": {
        "schedule": "pfs",
        "year": 2019,
        "quarter": "A",
        "label": "Q1 2019",
        "effective": "January 1 – March 31, 2019",
        "revision": 1
    },
    "status": {
        "code": "A",
        "non_facility_payable": true,
        "facility_payable": true
    },
    "national_rates_usd": {
        "office_non_facility": 5485.51,
        "facility": 332.64,
        "sequestration_applied": false,
        "gpci": 1
    },
    "rvus": {
        "work": 6.39,
        "practice_expense_non_facility": 144.87,
        "practice_expense_facility": 1.89,
        "malpractice": 0.95
    },
    "formula": "(work_rvu × work_gpci + pe_rvu × pe_gpci + mp_rvu × mp_gpci) × conversion_factor",
    "conversion_factor": 36.0391,
    "source": {
        "label": "Physician relative value file (Q1 2019)",
        "cms_url": "https://www.cms.gov/medicare/medicare-fee-for-service-payment/physicianfeesched/downloads/rvu19a.zip",
        "local_source_url": "https://localishealth.com/sources/physician-fee-schedule/2019/A",
        "file": "PPRRVU19_V1213.csv",
        "row": 8705,
        "sha256": "027b1b615e25a1c68ccff88175acf40056bc59d858295f8e37b0c5a88a2e7d35"
    },
    "modified_at": "2026-08-04T03:08:45+00:00"
}