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Official Description

Revision, open, arteriovenous fistula; with thrombectomy, autogenous or nonautogenous dialysis graft (separate procedure)

© Copyright 2026 American Medical Association. All rights reserved.

Common Language Description

An open revision of an arteriovenous (AV) fistula is a surgical procedure aimed at correcting complications that may arise from the formation of stenosis, thrombus, or occlusion in an AV fistula, particularly those created using a graft. This procedure is necessary when the normal blood flow through the fistula is compromised, which can lead to inadequate dialysis treatment for patients with renal failure. The operation involves making an incision in the skin and soft tissue over the affected area, allowing the surgeon to access the graft, artery, and vein directly. Once exposed, the blood vessels and graft are carefully dissected from the surrounding tissue to facilitate further intervention. The use of vessel loops is critical in this procedure, as they help control blood flow by clamping the vessels both proximal and distal to the stenosed area. If a thrombus, or blood clot, is identified, it is removed through direct exposure, which may involve opening the affected artery, vein, or graft. The removal of the thrombus can be aided by applying arterial back pressure or using massage techniques to expel the clot effectively. Following the thrombus removal, the revision of the graft is performed, which may include the placement of a vein patch or the excision of the stenosed segment, followed by the attachment of a new segment of either autogenous vein or nonautogenous graft material. If a patch graft is utilized, a segment of vein, often harvested from the saphenous vein, is tailored to fit over the stenosed area, enhancing the diameter and improving blood flow. Alternatively, if excision is necessary, a new tubular segment of vein or a nonautogenous graft is prepared and sutured to the remaining segments of the graft or blood vessels. The procedure concludes with the release of vessel loops, checking for hemostasis, and performing completion angiography to confirm that the revised AV fistula is patent and functioning properly.

© Copyright 2026 Coding Ahead. All rights reserved.

1. Indications

The open revision of an arteriovenous (AV) fistula with thrombectomy is indicated for the following conditions:

  • Stenosis - A narrowing of the blood vessel within the AV fistula that impedes normal blood flow.
  • Thrombus Formation - The presence of a blood clot within the AV fistula that obstructs blood flow and may require surgical intervention to restore patency.
  • Occlusion - A complete blockage of the AV fistula, necessitating operative treatment to re-establish adequate blood flow for dialysis.

2. Procedure

The procedure for the open revision of an arteriovenous fistula with thrombectomy involves several critical steps:

  • Incision - An incision is made in the skin and soft tissue over the area of stenosis to gain access to the underlying structures.
  • Exposure - The graft, artery, and vein are carefully exposed by dissecting them free from surrounding tissue, allowing for direct visualization and intervention.
  • Control of Blood Flow - Vessel loops are placed both proximal and distal to the stenosed area to control blood flow during the procedure, ensuring a clear working field.
  • Thrombus Removal - If a thrombus is present, it is removed through direct exposure. The artery, vein, and/or graft are opened, and the thrombus is expelled using arterial back pressure or massage techniques.
  • Revision of the Graft - The graft is revised, which may involve either the placement of a vein patch or the excision of the stenosed area. If a patch graft is used, a segment of vein, typically harvested from the saphenous vein, is tailored to fit over the stenosed segment and sutured into place.
  • Excision of Stenosed Segment - Alternatively, if excision is necessary, a tubular segment of new vein is harvested or a nonautogenous graft is prepared and sutured to the remaining proximal and distal segments of the graft or blood vessels.
  • Completion - After the revision, vessel loops are released, hemostasis is checked to ensure there is no bleeding, and completion angiography is performed to confirm that the revised AV fistula is patent and functioning correctly.

3. Post-Procedure

Post-procedure care following the open revision of an arteriovenous fistula includes monitoring for any signs of complications such as bleeding, infection, or re-thrombosis. Patients may require follow-up imaging studies to assess the patency of the revised fistula. Additionally, healthcare providers will typically provide instructions regarding activity restrictions and signs to watch for that may indicate complications. Regular follow-up appointments are essential to ensure the AV fistula remains functional for dialysis access.

Short Descr AV FISTULA REVISION
Medium Descr REVJ OPN ARVEN FSTL W/THRMBC DIAL GRF
Long Descr Revision, open, arteriovenous fistula; with thrombectomy, autogenous or nonautogenous dialysis graft (separate procedure)
Status Code Active Code
Global Days 090 - Major Surgery
PC/TC Indicator (26, TC) 0 - Physician Service Code
Multiple Procedures (51) 2 - Standard payment adjustment rules for multiple procedures apply.
Bilateral Surgery (50) 0 - 150% payment adjustment for bilateral procedures does NOT apply.
Physician Supervisions 09 - Concept does not apply.
Assistant Surgeon (80, 82) 2 - Payment restriction for assistants at surgery does not apply to this procedure...
Co-Surgeons (62) 1 - Co-surgeons could be paid, though supporting documentation is required...
Team Surgery (66) 0 - Team surgeons not permitted for this procedure.
Diagnostic Imaging Family 99 - Concept Does Not Apply
APC Status Indicator Hospital Part B services paid through a comprehensive APC
ASC Payment Indicator Surgical procedure on ASC list in CY 2007; payment based on OPPS relative payment weight.
Type of Service (TOS) 2 - Surgery
Berenson-Eggers TOS (BETOS) P2F - Major procedure, cardiovascular-Other
MUE 1
CCS Clinical Classification 57 - Creation, revision and removal of arteriovenous fistula or vessel-to-vessel cannula for dialysis

This is a primary code that can be used with these additional add-on codes.

36907 CPT Add On MPFS Status: Active Code APC N ASC N1 Transluminal balloon angioplasty, central dialysis segment, performed through dialysis circuit, including all imaging and radiological supervision and interpretation required to perform the angioplasty (List separately in addition to code for primary procedure)
36908 CPT Add On MPFS Status: Active Code APC N ASC N1 Transcatheter placement of intravascular stent(s), central dialysis segment, performed through dialysis circuit, including all imaging and radiological supervision and interpretation required to perform the stenting, and all angioplasty in the central dialysis segment (List separately in addition to code for primary procedure)
LT Left side (used to identify procedures performed on the left side of the body)
AS Physician assistant, nurse practitioner, or clinical nurse specialist services for assistant at surgery
GC This service has been performed in part by a resident under the direction of a teaching physician
78 Unplanned return to the operating/procedure room by the same physician or other qualified health care professional following initial procedure for a related procedure during the postoperative period: it may be necessary to indicate that another procedure was performed during the postoperative period of the initial procedure (unplanned procedure following initial procedure). when this procedure is related to the first, and requires the use of an operating/procedure room, it may be reported by adding modifier 78 to the related procedure. (for repeat procedures, see modifier 76.)
RT Right side (used to identify procedures performed on the right side of the body)
80 Assistant surgeon: surgical assistant services may be identified by adding modifier 80 to the usual procedure number(s).
XE Separate encounter, a service that is distinct because it occurred during a separate encounter
22 Increased procedural services: when the work required to provide a service is substantially greater than typically required, it may be identified by adding modifier 22 to the usual procedure code. documentation must support the substantial additional work and the reason for the additional work (ie, increased intensity, time, technical difficulty of procedure, severity of patient's condition, physical and mental effort required). note: this modifier should not be appended to an e/m service.
51 Multiple procedures: when multiple procedures, other than e/m services, physical medicine and rehabilitation services or provision of supplies (eg, vaccines), are performed at the same session by the same individual, the primary procedure or service may be reported as listed. the additional procedure(s) or service(s) may be identified by appending modifier 51 to the additional procedure or service code(s). note: this modifier should not be appended to designated "add-on" codes (see appendix d).
52 Reduced services: under certain circumstances a service or procedure is partially reduced or eliminated at the discretion of the physician or other qualified health care professional. under these circumstances the service provided can be identified by its usual procedure number and the addition of modifier 52, signifying that the service is reduced. this provides a means of reporting reduced services without disturbing the identification of the basic service. note: for hospital outpatient reporting of a previously scheduled procedure/service that is partially reduced or cancelled as a result of extenuating circumstances or those that threaten the well-being of the patient prior to or after administration of anesthesia, see modifiers 73 and 74 (see modifiers approved for asc hospital outpatient use).
57 Decision for surgery: an evaluation and management service that resulted in the initial decision to perform the surgery may be identified by adding modifier 57 to the appropriate level of e/m service.
58 Staged or related procedure or service by the same physician or other qualified health care professional during the postoperative period: it may be necessary to indicate that the performance of a procedure or service during the postoperative period was: (a) planned or anticipated (staged); (b) more extensive than the original procedure; or (c) for therapy following a surgical procedure. this circumstance may be reported by adding modifier 58 to the staged or related procedure. note: for treatment of a problem that requires a return to the operating/procedure room (eg, unanticipated clinical condition), see modifier 78.
59 Distinct procedural service: under certain circumstances, it may be necessary to indicate that a procedure or service was distinct or independent from other non-e/m services performed on the same day. modifier 59 is used to identify procedures/services, other than e/m services, that are not normally reported together, but are appropriate under the circumstances. documentation must support a different session, different procedure or surgery, different site or organ system, separate incision/excision, separate lesion, or separate injury (or area of injury in extensive injuries) not ordinarily encountered or performed on the same day by the same individual. however, when another already established modifier is appropriate it should be used rather than modifier 59. only if no more descriptive modifier is available, and the use of modifier 59 best explains the circumstances, should modifier 59 be used. note: modifier 59 should not be appended to an e/m service. to report a separate and distinct e/m service with a non-e/m service performed on the same date, see modifier 25.
62 Two surgeons: when 2 surgeons work together as primary surgeons performing distinct part(s) of a procedure, each surgeon should report his/her distinct operative work by adding modifier 62 to the procedure code and any associated add-on code(s) for that procedure as long as both surgeons continue to work together as primary surgeons. each surgeon should report the co-surgery once using the same procedure code. if additional procedure(s) (including add-on procedure(s) are performed during the same surgical session, separate code(s) may also be reported with modifier 62 added. note: if a co-surgeon acts as an assistant in the performance of additional procedure(s), other than those reported with the modifier 62, during the same surgical session, those services may be reported using separate procedure code(s) with modifier 80 or modifier 82 added, as appropriate.
74 Discontinued out-patient hospital/ambulatory surgery center (asc) procedure after administration of anesthesia: due to extenuating circumstances or those that threaten the well being of the patient, the physician may terminate a surgical or diagnostic procedure after the administration of anesthesia (local, regional block(s), general) or after the procedure was started (incision made, intubation started, scope inserted, etc). under these circumstances, the procedure started but terminated can be reported by its usual procedure number and the addition of modifier 74. note: the elective cancellation of a service prior to the administration of anesthesia and/or surgical preparation of the patient should not be reported. for physician reporting of a discontinued procedure, see modifier 53.
76 Repeat procedure or service by same physician or other qualified health care professional: it may be necessary to indicate that a procedure or service was repeated by the same physician or other qualified health care professional subsequent to the original procedure or service. this circumstance may be reported by adding modifier 76 to the repeated procedure or service. note: this modifier should not be appended to an e/m service.
77 Repeat procedure by another physician or other qualified health care professional: it may be necessary to indicate that a basic procedure or service was repeated by another physician or other qualified health care professional subsequent to the original procedure or service. this circumstance may be reported by adding modifier 77 to the repeated procedure or service. note: this modifier should not be appended to an e/m service.
79 Unrelated procedure or service by the same physician or other qualified health care professional during the postoperative period: the individual may need to indicate that the performance of a procedure or service during the postoperative period was unrelated to the original procedure. this circumstance may be reported by using modifier 79. (for repeat procedures on the same day, see modifier 76.)
82 Assistant surgeon (when qualified resident surgeon not available): the unavailability of a qualified resident surgeon is a prerequisite for use of modifier 82 appended to the usual procedure code number(s).
AG Primary physician
AQ Physician providing a service in an unlisted health professional shortage area (hpsa)
CC Procedure code change (use 'cc' when the procedure code submitted was changed either for administrative reasons or because an incorrect code was filed)
CR Catastrophe/disaster related
ET Emergency services
GV Attending physician not employed or paid under arrangement by the patient's hospice provider
GW Service not related to the hospice patient's terminal condition
Q1 Routine clinical service provided in a clinical research study that is in an approved clinical research study
Q6 Service furnished under a fee-for-time compensation arrangement by a substitute physician or by a substitute physical therapist furnishing outpatient physical therapy services in a health professional shortage area, a medically underserved area, or a rural area
SG Ambulatory surgical center (asc) facility service
X5 Diagnostic services requested by another clinician: for reporting services by a clinician who furnishes care to the patient only as requested by another clinician or subsequent and related services requested by another clinician; this modifier is reported for patient relationships that may not be adequately captured by the above alternative categories; reporting clinician service examples include but are not limited to, the radiologist's interpretation of an imaging study requested by another clinician
XS Separate structure, a service that is distinct because it was performed on a separate organ/structure
XU Unusual non-overlapping service, the use of a service that is distinct because it does not overlap usual components of the main service
Date
Action
Notes
2001-01-01 Changed Code description changed.
1999-01-01 Added First appearance in code book in 1999.
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