{
    "code": "36905",
    "coding_system": "CPT",
    "canonical_url": "https://localishealth.com/cpt/36905/2022/A",
    "release_specific_url": "https://localishealth.com/cpt/36905/2022/D",
    "description": "Rescue of a dialysis fistula or graft that has clotted off. Working through a sheath placed into the access, the operator breaks up and removes the clot, or dissolves it with a drug delivered into it, images the whole circuit, and then balloons open the underlying narrowing in the peripheral segment that caused the clot to form in the first place. This entry is the combination of clot removal plus balloon angioplasty in one sitting; neighbouring codes describe clot removal on its own or clot removal followed by a stent.",
    "answer": {
        "question": "How much did Medicare pay for CPT 36905 in Q4 2022?",
        "text": "Medicare paid $2,451.16 for CPT 36905 in the office (non-facility) setting and $447.11 in a facility under the Q4 2022 Physician Fee Schedule, effective October 2022. These are the national allowed amounts before the ~2% sequestration cut and before locality (GPCI) adjustment. This price has been unchanged since Q1 2022, when it decreased 4.0%."
    },
    "release": {
        "schedule": "pfs",
        "year": 2022,
        "quarter": "D",
        "label": "Q4 2022",
        "effective": "October 1 – December 31, 2022",
        "revision": 1
    },
    "status": {
        "code": "A",
        "non_facility_payable": true,
        "facility_payable": true
    },
    "national_rates_usd": {
        "office_non_facility": 2451.16,
        "facility": 447.11,
        "sequestration_applied": false,
        "gpci": 1
    },
    "rvus": {
        "work": 9,
        "practice_expense_non_facility": 60.63,
        "practice_expense_facility": 2.72,
        "malpractice": 1.2
    },
    "formula": "(work_rvu × work_gpci + pe_rvu × pe_gpci + mp_rvu × mp_gpci) × conversion_factor",
    "conversion_factor": 34.6062,
    "source": {
        "label": "Physician relative value file (Q4 2022)",
        "cms_url": "https://www.cms.gov/files/zip/rvu22d.zip",
        "local_source_url": "https://localishealth.com/sources/physician-fee-schedule/2022/D",
        "file": "PPRRVU22_OCT.csv",
        "row": 9338,
        "sha256": "f8774a019545e1fd71536837b20b74674c014b1acef3435d93456857885190ab"
    },
    "modified_at": "2026-08-04T03:12:03+00:00"
}