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CPT®
36870

CPT® Code 36870

Official Description

Thrombectomy, percutaneous, arteriovenous fistula, autogenous or nonautogenous graft (includes mechanical thrombus extraction and intra-graft thrombolysis)

© Copyright 2026 American Medical Association. All rights reserved.

Common Language Description

The CPT® Code 36870 refers to a percutaneous thrombectomy procedure specifically targeting an arteriovenous fistula, which can involve either autogenous or nonautogenous grafts. This procedure is designed to remove thrombus, or blood clots, that may obstruct blood flow within the fistula. The term 'thrombectomy' indicates the surgical removal of a thrombus, and in this context, it is performed using a catheter-based approach. The procedure incorporates mechanical thrombus extraction techniques, which may include the use of specialized devices that either fragment the thrombus or retrieve it entirely. The use of intra-graft thrombolysis may also be involved, where thrombolytic agents are administered to dissolve the clot. The percutaneous nature of this procedure means that it is performed through the skin, minimizing the need for larger incisions and allowing for a less invasive approach to treating clot-related complications in vascular access sites. The overall goal of the procedure is to restore patency to the arteriovenous fistula, thereby ensuring adequate blood flow for dialysis or other medical needs.

© Copyright 2026 Coding Ahead. All rights reserved.

1. Indications

The procedure described by CPT® Code 36870 is indicated for the treatment of thrombus formation within an arteriovenous fistula. The following conditions may warrant the performance of this thrombectomy:

  • Thrombus Formation - The presence of a blood clot obstructing the flow within the arteriovenous fistula, which can lead to complications such as reduced blood flow for dialysis.
  • Access Complications - Issues arising from the use of the fistula for hemodialysis, necessitating intervention to restore function.
  • Graft Dysfunction - Dysfunctional grafts, whether autogenous or nonautogenous, that require intervention to maintain patency and ensure effective vascular access.

2. Procedure

The thrombectomy procedure as described by CPT® Code 36870 involves several key steps to effectively remove the thrombus from the arteriovenous fistula:

  • Step 1: Skin Puncture and Sheath Placement - The procedure begins with the physician puncturing the skin over the arteriovenous fistula. A sheath is then placed to facilitate access to the vascular system.
  • Step 2: Introduction of Guiding Catheter - Under fluoroscopic guidance, a guiding catheter is introduced into the vascular access site. This step is crucial for navigating to the site of the thrombus.
  • Step 3: Advancement of Microcatheter - A microcatheter is advanced over a microguidewire through the guiding catheter and passed through the thrombus. This allows for precise targeting of the clot.
  • Step 4: Mechanical Thrombectomy Device Activation - Once the microcatheter is in place, the guidewire is removed, and a mechanical thrombectomy device is advanced through the microcatheter to the thrombus. Depending on the device used, various techniques are employed to fragment or retrieve the thrombus.
  • Step 5: Thrombus Fragmentation or Retrieval - If a rotating wire or brush device is utilized, it is activated to fragment the thrombus. Alternatively, if hydrodynamic forces are employed, a rapid stream of fluid is delivered to break up the clot, which is then aspirated. For retriever devices, the device is passed beyond the clot, deployed, and used to capture and remove the thrombus.
  • Step 6: Multiple Passes - It may be necessary to perform several passes with the mechanical device to ensure complete fragmentation and removal of the clot.
  • Step 7: Thrombolytic Agent Administration - During the procedure, a thrombolytic agent may be injected to assist in dissolving any residual clot material.
  • Step 8: Removal of Devices - Once the thrombectomy is complete, the mechanical device, microcatheter, and guiding catheter are carefully removed from the site.

3. Post-Procedure

After the completion of the thrombectomy procedure, the patient may require monitoring for any potential complications, such as bleeding or re-thrombosis. The site of the puncture should be assessed for hemostasis, and appropriate post-procedure care should be provided. Patients may also need follow-up evaluations to ensure the patency of the arteriovenous fistula and to monitor for any signs of complications. The recovery process may vary depending on the individual patient's condition and the extent of the procedure performed.
Short Descr PERCUT THROMBECT AV FISTULA
Medium Descr THRMBC PRQ ARVEN FSTL AUTOG/NONAUTOG GRF
Long Descr Thrombectomy, percutaneous, arteriovenous fistula, autogenous or nonautogenous graft (includes mechanical thrombus extraction and intra-graft thrombolysis)
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) 1 - 150% payment adjustment for bilateral procedures applies.
Physician Supervisions 9 - Concept does not apply.
Assistant Surgeon (80, 82) 1 - Statutory payment restriction for assistants at surgery applies to this procedure...
Co-Surgeons (62) 2 - Co-surgeons permitted and no documentation required if the two- specialty requirement is met.
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
Type of Service (TOS) 2 - Surgery
Berenson-Eggers TOS (BETOS) P2F - Major procedure, cardiovascular-Other
MUE Not applicable/unspecified.
CCS Clinical Classification 61 - Other OR procedures on vessels other than head and neck
Date
Action
Notes
2017-01-01 Changed Moderate (Conscious) Sedation flag removed. See new Moderate Sedation category.
2016-12-31 Deleted Code deleted. See 36904, 36905, 36906.
2001-01-01 Added First appearance in code book in 2001.
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