{
    "code": "36906",
    "coding_system": "CPT",
    "canonical_url": "https://localishealth.com/cpt/36906/2020/A",
    "release_specific_url": "https://localishealth.com/cpt/36906/2020/D",
    "description": "Rescue of a clotted dialysis fistula or graft in which a stent is placed as part of the same session. Clot is removed or dissolved through a sheath in the access, the circuit is imaged, and a stent is deployed across the narrowing in the peripheral segment that led to the clot, with any balloon work in that segment counted as part of the same procedure. What separates this entry from its neighbours is that a stent was needed, not just a balloon, on top of the clot removal.",
    "answer": {
        "question": "How much did Medicare pay for CPT 36906 in Q4 2020?",
        "text": "Medicare paid $6,556.04 for CPT 36906 in the office (non-facility) setting and $536.65 in a facility under the Q4 2020 Physician Fee Schedule, effective October 2020. These are the national allowed amounts before the ~2% sequestration cut and before locality (GPCI) adjustment. This price has been unchanged since Q1 2020, when it decreased 2.5%."
    },
    "release": {
        "schedule": "pfs",
        "year": 2020,
        "quarter": "D",
        "label": "Q4 2020",
        "effective": "October 1 – December 31, 2020",
        "revision": 1
    },
    "status": {
        "code": "A",
        "non_facility_payable": true,
        "facility_payable": true
    },
    "national_rates_usd": {
        "office_non_facility": 6556.04,
        "facility": 536.65,
        "sequestration_applied": false,
        "gpci": 1
    },
    "rvus": {
        "work": 10.42,
        "practice_expense_non_facility": 169.86,
        "practice_expense_facility": 3.07,
        "malpractice": 1.38
    },
    "formula": "(work_rvu × work_gpci + pe_rvu × pe_gpci + mp_rvu × mp_gpci) × conversion_factor",
    "conversion_factor": 36.0896,
    "source": {
        "label": "Physician relative value file (Q4 2020)",
        "cms_url": "https://www.cms.gov/files/zip/rvu20d-updated-11232020.zip",
        "local_source_url": "https://localishealth.com/sources/physician-fee-schedule/2020/D",
        "file": "PPRRVU20_OCT.csv",
        "row": 9048,
        "sha256": "504fd19a9bc1d2eeebb290adac2d7de6c56d4e86cde7532df1862fe42494d319"
    },
    "modified_at": "2026-08-04T03:10:00+00:00"
}