36904 Thrmbc/nfs dialysis circuit
What 36904 is
CMS fee schedule short descriptor: Thrmbc/nfs dialysis circuit.
Full CPT long descriptions are licensed by the American Medical Association and are not published on this site; the short descriptor above is the one CMS prints in its own fee schedule file. See About CPT.
Medicare payment for 36904 (CY2026)
| Work RVU | Practice expense RVU | Malpractice RVU | Total | Medicare rate | |
|---|---|---|---|---|---|
| Non-facility (office) | 7.31 | 43.68 | 1.13 | 52.12 | $1,740.85 |
| Facility (hospital, ASC) | 7.31 | 1.16 | 1.13 | 9.60 | $320.65 |
National rates: total RVUs x the CY2026 conversion factor of 33.4009 (non-QP), before geographic adjustment. Actual Medicare payment is 80% of the rate shown after the deductible; the patient or secondary payer owes the 20% coinsurance.
Status: Active - payable under the Physician Fee Schedule. Global period: Global concept does not apply (endoscopic or minor procedure: global period is the day of the procedure).
Medically Unlikely Edit (MUE)
Medicare caps 36904 at 1 unit per date of service for practitioner claims (MAI 3 - date of service edit (clinical): units above the MUE may pay with documentation on appeal), rationale: Nature of Service/Procedure. Units above the cap are denied unless the edit's adjudication rules allow an appeal with documentation.
Billed with 36904? These codes are bundled into it
36904 is a Column 1 code in 308 active NCCI PTP edits. When one of these Column 2 codes is reported on the same date of service, it is denied as bundled - unless the edit's modifier indicator is 1 and documentation supports a distinct service with an NCCI-associated modifier.
| Column 2 code | Short description | Modifier indicator | |
|---|---|---|---|
01844 | Anes vasc shunt/shunt revj | 0 - no modifier bypass | Check pair |
01916 | Anes dx arteriography/vngrph | 0 - no modifier bypass | Check pair |
01924 | Anes ther ivntl rad artl nos | 0 - no modifier bypass | Check pair |
01925 | Anes ivntl rad artl crtd/c | 0 - no modifier bypass | Check pair |
01926 | Anes ivntl rad icr icar/aort | 0 - no modifier bypass | Check pair |
01930 | Anes ther ivntl rad ven nos | 1 - modifier may bypass | Check pair |
0213T | Njx paravert w/us cer/thor | 0 - no modifier bypass | Check pair |
0216T | Njx paravert w/us lumb/sac | 0 - no modifier bypass | Check pair |
0596T | Temp fml iu vlv-pmp 1st insj | 1 - modifier may bypass | Check pair |
0597T | Temp fml iu valve-pmp rplcmt | 1 - modifier may bypass | Check pair |
0645T | Tcat impltj c sins rdctj dev | 1 - modifier may bypass | Check pair |
0708T | Id ca immntx prep & 1st njx | 1 - modifier may bypass | Check pair |
0709T | Id ca immntx each addl njx | 1 - modifier may bypass | Check pair |
0903T | Ecg alg 12 lead reduced i&r | 1 - modifier may bypass | Check pair |
0904T | Ecg alg 12 ld rdcd trcg only | 1 - modifier may bypass | Check pair |
0905T | Ecg alg 12 ld rdcd i&r only | 1 - modifier may bypass | Check pair |
11000 | Dbrdmt ecz/infected skin<10% | 1 - modifier may bypass | Check pair |
11001 | Dbrdmt ecz/infct skn ea addl | 1 - modifier may bypass | Check pair |
11004 | Dbrdmt skin xtrnl gent&per | 1 - modifier may bypass | Check pair |
11005 | Dbrdmt skin abdominal wall | 1 - modifier may bypass | Check pair |
11006 | Dbrdmt skin xtrnl gent per | 1 - modifier may bypass | Check pair |
11042 | Dbrdmt subq tis 1st 20sqcm/< | 1 - modifier may bypass | Check pair |
11043 | Dbrdmt musc&/fsca 1st 20/< | 1 - modifier may bypass | Check pair |
11044 | Dbrdmt bone 1st 20 sq cm/< | 1 - modifier may bypass | Check pair |
11045 | Dbrdmt subq tiss each addl | 1 - modifier may bypass | Check pair |
11046 | Dbrdmt musc&/fsca ea addl | 1 - modifier may bypass | Check pair |
11047 | Dbrdmt bone each addl | 1 - modifier may bypass | Check pair |
12001 | Rpr s/n/ax/gen/trnk 2.5cm/< | 1 - modifier may bypass | Check pair |
12002 | Rpr s/n/ax/gen/trnk2.6-7.5cm | 1 - modifier may bypass | Check pair |
12004 | Rpr s/n/ax/gen/trk7.6-12.5cm | 1 - modifier may bypass | Check pair |
Showing 30 of 308 column 2 codes. Use the pair checker for any specific combination.
36904 is bundled into these codes
36904 appears as a Column 2 code in 44 active edits. Reported with one of these Column 1 codes on the same date of service, 36904 is the code that denies.
| Column 1 code | Short description | Modifier indicator | |
|---|---|---|---|
33951 | Ecmo/ecls insj prph cannula | 1 | Check pair |
33952 | Ecmo/ecls insj prph cannula | 1 | Check pair |
33953 | Ecmo/ecls insj prph cannula | 1 | Check pair |
33954 | Ecmo/ecls insj prph cannula | 1 | Check pair |
33955 | Ecmo/ecls insj ctr cannula | 1 | Check pair |
33956 | Ecmo/ecls insj ctr cannula | 1 | Check pair |
34001 | Removal of artery clot | 1 | Check pair |
34101 | Removal of artery clot | 1 | Check pair |
34111 | Removal of arm artery clot | 1 | Check pair |
34201 | Removal of artery clot | 1 | Check pair |
34203 | Removal of leg artery clot | 1 | Check pair |
34421 | Removal of vein clot | 1 | Check pair |
34451 | Removal of vein clot | 1 | Check pair |
34490 | Removal of vein clot | 1 | Check pair |
35301 | Rechanneling of artery | 1 | Check pair |
Data: CMS CY2026 Physician Fee Schedule RVU file (October release, RVU26D) and Medicare NCCI PTP practitioner edits v32.3 (2026 Q4). Verify against the official files before billing or contracting decisions.