CPT 36903
Global 000 ActiveIntro cath dialysis circuit
CPT 36903 Billing & Documentation Guide
CPT code 36903 (Intro cath dialysis circuit) is classified under Surgery (Respiratory/Cardiovascular) with a global period indicator of 000. The 2026 Medicare Physician Fee Schedule assigns a work RVU of 6.23, a non-facility practice expense RVU of 136.52, and a malpractice RVU of 1.03, a total non-facility RVU of 143.78 and facility RVU of 8.31. With the current conversion factor of $33.4009, the national average non-facility reimbursement is approximately $5000.64, though rates vary from $4142.75 to $6824.78 based on MAC locality and Geographic Practice Cost Indices (GPCIs).
When billing 36903, ensure documentation supports medical necessity and the specific components required for the code's level of service. For E/M codes, document MDM (medical decision-making) elements: problems addressed, data reviewed, and risk. For procedural codes, document the indication, technique, and any complications. Always verify NCCI edits before bundling 36903 with related codes; this code has 10 PTP bundling relationships on file (see table below).
Payment Status & Global Period
Active code (paid under MPFS)
Endoscopic or minor procedure with related preoperative and postoperative work performed on the same day
MUE Limit (Medically Unlikely Edits)
Submitting more than 1 units of 36903 for the same patient on the same date triggers automatic line denial unless an appropriate modifier and supporting documentation justify the higher quantity.
RVU Breakdown, CPT 36903
| Component | Non-Facility | Facility |
|---|---|---|
| Work RVU | 6.23 | 6.23 |
| Practice Expense RVU | 136.52 | 1.05 |
| Malpractice RVU | 1.03 | 1.03 |
| Total RVU | 143.78 | 8.31 |
| Conversion Factor | $33.4009 | |
2026 Medicare Reimbursement by State, CPT 36903
State-level averages across all MAC localities. Non-facility rates typically apply to office-based services; facility rates apply to hospital outpatient / inpatient.
| State | Non-Facility | Facility | Range (Non-Fac) | Localities |
|---|---|---|---|---|
| California | $5629.81 | $275.7 | $5227.71 - $6824.78 | 29 |
| Florida | $4850.15 | $310.24 | $4619.05 - $5041.94 | 3 |
| Georgia | $4599.7 | $283.02 | $4316.52 - $4882.88 | 2 |
| Illinois | $4680.55 | $308.45 | $4425.04 - $4953.51 | 4 |
| Michigan | $4538.25 | $289.44 | $4410.11 - $4666.39 | 2 |
| North Carolina | $4484.45 | $262.79 | $4484.45 - $4484.45 | 1 |
| New York | $5351.74 | $303.85 | $4564.17 - $5707 | 5 |
| Ohio | $4405.95 | $274.79 | $4405.95 - $4405.95 | 1 |
| Pennsylvania | $4713.15 | $281.09 | $4426.58 - $4999.72 | 2 |
| Texas | $4730.4 | $275.72 | $4389.55 - $5063.35 | 8 |
Source: CMS PFSRVU 2026 · Updated 2026-04-01. Full locality-level detail available for all 53 states, contact us for custom reports.
NCCI Bundling Edits, CPT 36903
Procedure-to-procedure (PTP) edits. If you bill any of these codes with 36903 on the same date of service, review the modifier indicator and payer policy before submission.
| Partner Code | Relationship | Modifier Allowed | Rationale |
|---|---|---|---|
| 01916 | Column 1 (primary), can be billed with modifier | No | Anesthesia service included in surgical procedure |
| 01924 | Column 1 (primary), can be billed with modifier | No | Anesthesia service included in surgical procedure |
| 01925 | Column 1 (primary), can be billed with modifier | No | Anesthesia service included in surgical procedure |
| 01926 | Column 1 (primary), can be billed with modifier | No | Anesthesia service included in surgical procedure |
| 01930 | Column 1 (primary), can be billed with modifier | Yes | Anesthesia service included in surgical procedure |
| 0213T | Column 1 (primary), can be billed with modifier | No | Misuse of Column Two code with Column One code |
| 0216T | Column 1 (primary), can be billed with modifier | No | Misuse of Column Two code with Column One code |
| 0228T | Column 1 (primary), can be billed with modifier | No | Misuse of Column Two code with Column One code |
| 0230T | Column 1 (primary), can be billed with modifier | No | Misuse of Column Two code with Column One code |
| 0596T | Column 1 (primary), can be billed with modifier | Yes | Misuse of Column Two code with Column One code |
Frequently Asked Questions, CPT 36903
What does CPT code 36903 mean? +
CPT code 36903 represents: Intro cath dialysis circuit. It's in the Surgery (Respiratory/Cardiovascular) category with a global period of 000.
What is the Medicare reimbursement for CPT 36903? +
The 2026 Medicare national average non-facility payment for CPT 36903 is $5000.64. Rates range from $4142.75 to $6824.78 across 53 states depending on MAC locality and GPCIs.
What modifiers can I use with CPT 36903? +
Surgery codes commonly use modifier 22 (increased procedural services), 50 (bilateral), 51 (multiple procedures), 52 (reduced services), 58/78/79 (staged, unplanned return, unrelated within global), 62 (co-surgeons), 80/82 (assistant surgeon), and 59 or the X{EPSU} subset for distinct procedural service.
What bundling edits apply to CPT 36903? +
This code has 10 NCCI PTP bundling relationships. See the NCCI Bundling section below for full list.
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Reviewed by the PayerReady Medical Coding Team
Verified against the CMS 2026 code set on June 2, 2026.
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