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Procedure price report · Creation, revision and removal of arteriovenous fistula or vessel-to-vessel cannula for dialysis

Dialysis fistula by direct artery-to-vein connection

CPT 36821the billing code this page is about

Open surgery joining an artery directly to a nearby vein at any site to create a fistula for dialysis access, without moving or transposing the vein.

Hospitals typically charge $4,246 cash for this outpatient procedure — the median across 756 hospitals that filed a usable cash price; the average of the middle 60% is $4,727. Most fall between $1,522 and $9,600 (20th–80th percentile).

Hospitals
756
States
49
Filings dated
Jun 2024 – Sep 2026
Computed
September 25, 2026
Prices checked
through September 24, 2026

Median: half of hospitals filed less, half more — and it is a price some hospital actually filed. Average of the middle 60%: the mean of the prices between the 20th and 80th percentiles. We never publish the plain average, the lowest or the highest price: the extremes in hospital price files are chargemaster artefacts, not prices anyone pays.

What hospitals charge, from cheapest to most expensive

Cash price percentiles, outpatient, across 756 hospitals. Each figure is a price a hospital filed. 10th: one in ten hospitals charges less; 25th: a quarter charge less; Median: half charge less; 75th: three quarters charge less; 90th: nine in ten charge less.
10th25thMedian75th90th
$977$1,919$4,246$8,580$14,426

The most expensive tenth of hospitals charges at least 15× what the cheapest tenth charges ($977 vs $14,426).

How the prices are spread

$720 – $1,004: 43 hospitals$720$1,004 – $1,400: 56 hospitals$1,400 – $1,953: 61 hospitals$1,400$1,953 – $2,724: 39 hospitals$2,724 – $3,800: 107 hospitals$2,724$3,800 – $5,301: 102 hospitals$5,301 – $7,394: 84 hospitals$5,301$7,394 – $10,315: 86 hospitals$10,315 – $14,388: 65 hospitals$10,315$14,388 – $20,071: 40 hospitals$14,388median $4,246price bands are equal on a log scale
Hospitals per price band (683 of 756 — the bands cover the 5th to 95th percentile)
FromToHospitals
$720$1,00443
$1,004$1,40056
$1,400$1,95361
$1,953$2,72439
$2,724$3,800107
$3,800$5,301102
$5,301$7,39484
$7,394$10,31586
$10,315$14,38865
$14,388$20,07140

Against Medicare

Medicare pays (OPPS 2026, national rate)$3,226
Median cash price$4,246
Cash as a multiple of Medicare1.32×

The Medicare figure is the national unadjusted OPPS rate for this code — what Medicare itself pays a hospital before local wage adjustment. It is a benchmark, not a price anyone is charged.

By state

The median cash price in each state, against the national median of $4,246.

Alaska: 4 hospitals filed a usable price — fewer than 10, so no figureAKMaine: 1 hospital filed a usable price — fewer than 10, so no figureMEVermont: 3 hospitals filed a usable price — fewer than 10, so no figureVTNew Hampshire: 6 hospitals filed a usable price — fewer than 10, so no figureNHWashington: median $7,611 across 17 hospitalsWA$7,611Idaho: median $7,280 across 10 hospitalsID$7,280Montana: 5 hospitals filed a usable price — fewer than 10, so no figureMTNorth Dakota: 1 hospital filed a usable price — fewer than 10, so no figureNDMinnesota: median $4,246 across 21 hospitalsMN$4,246Illinois: median $3,164 across 29 hospitalsIL$3,164Wisconsin: median $3,668 across 30 hospitalsWI$3,668Michigan: median $1,844 across 33 hospitalsMI$1,844New York: median $3,941 across 63 hospitalsNY$3,941Massachusetts: median $9,486 across 18 hospitalsMA$9,486Oregon: median $1,180 across 10 hospitalsOR$1,180Nevada: 6 hospitals filed a usable price — fewer than 10, so no figureNVWyoming: 4 hospitals filed a usable price — fewer than 10, so no figureWYSouth Dakota: 7 hospitals filed a usable price — fewer than 10, so no figureSDIowa: median $1,622 across 22 hospitalsIA$1,622Indiana: median $4,846 across 21 hospitalsIN$4,846Ohio: median $5,784 across 40 hospitalsOH$5,784Pennsylvania: median $3,690 across 31 hospitalsPA$3,690New Jersey: median $4,085 across 36 hospitalsNJ$4,085Connecticut: 7 hospitals filed a usable price — fewer than 10, so no figureCTRhode Island: 1 hospital filed a usable price — fewer than 10, so no figureRICalifornia: median $8,674 across 58 hospitalsCA$8,674Utah: no hospital in the corpus filed a usable priceUTColorado: 4 hospitals filed a usable price — fewer than 10, so no figureCONebraska: median $2,138 across 10 hospitalsNE$2,138Missouri: median $4,097 across 21 hospitalsMO$4,097Kentucky: 6 hospitals filed a usable price — fewer than 10, so no figureKYWest Virginia: median $1,194 across 18 hospitalsWV$1,194Virginia: median $5,023 across 22 hospitalsVA$5,023Maryland: 2 hospitals filed a usable price — fewer than 10, so no figureMDDelaware: 3 hospitals filed a usable price — fewer than 10, so no figureDEArizona: 6 hospitals filed a usable price — fewer than 10, so no figureAZNew Mexico: 6 hospitals filed a usable price — fewer than 10, so no figureNMKansas: 9 hospitals filed a usable price — fewer than 10, so no figureKSArkansas: median $3,525 across 10 hospitalsAR$3,525Tennessee: median $1,429 across 12 hospitalsTN$1,429North Carolina: 6 hospitals filed a usable price — fewer than 10, so no figureNCSouth Carolina: median $8,580 across 10 hospitalsSC$8,580Oklahoma: median $1,069 across 14 hospitalsOK$1,069Louisiana: median $4,318 across 12 hospitalsLA$4,318Mississippi: 8 hospitals filed a usable price — fewer than 10, so no figureMSAlabama: 9 hospitals filed a usable price — fewer than 10, so no figureALGeorgia: median $4,045 across 22 hospitalsGA$4,045Hawaii: 6 hospitals filed a usable price — fewer than 10, so no figureHITexas: median $7,740 across 37 hospitalsTX$7,740Florida: median $8,568 across 19 hospitalsFL$8,568
Cash price by state, most expensive first. National median $4,246. A state needs at least 10 hospitals with a usable price to show a figure.
StateHospitalsMedianvs national20th–80th
Massachusetts MA18$9,486+123%$5,685 – $11,214
California CA58$8,674+104%$2,037 – $13,507
South Carolina SC10$8,580+102%$5,362 – $16,132
Florida FL19$8,568+102%$3,094 – $14,380
Texas TX37$7,740+82%$3,156 – $8,540
Washington WA17$7,611+79%$1,301 – $9,929
Idaho ID10$7,280+71%$5,193 – $8,600
Ohio OH40$5,784+36%$1,323 – $17,001
Virginia VA22$5,023+18%$4,804 – $13,945
Indiana IN21$4,846+14%$907 – $10,628
Louisiana LA12$4,318+2%$2,153 – $10,336
Minnesota MN21$4,2460%$3,233 – $6,133
Missouri MO21$4,097−4%$1,083 – $15,004
New Jersey NJ36$4,085−4%$3,487 – $5,741
Georgia GA22$4,045−5%$4,045 – $5,208
New York NY63$3,941−7%$2,423 – $6,543
Pennsylvania PA31$3,690−13%$421 – $11,292
Wisconsin WI30$3,668−14%$3,493 – $5,894
Arkansas AR10$3,525−17%$1,595 – $6,219
Illinois IL29$3,164−25%$907 – $24,492
Nebraska NE10$2,138−50%$1,269 – $2,580
Michigan MI33$1,844−57%$1,522 – $4,342
Iowa IA22$1,622−62%$1,622 – $2,030
Tennessee TN12$1,429−66%$768 – $6,189
West Virginia WV18$1,194−72%$713 – $8,680
Oregon OR10$1,180−72%$1,180 – $7,817
Oklahoma OK14$1,069−75%$1,069 – $6,417
Alabama AL9not enough hospitals filed a usable price
Kansas KS9not enough hospitals filed a usable price
Mississippi MS8not enough hospitals filed a usable price
Connecticut CT7not enough hospitals filed a usable price
South Dakota SD7not enough hospitals filed a usable price
Arizona AZ6not enough hospitals filed a usable price
Hawaii HI6not enough hospitals filed a usable price
Kentucky KY6not enough hospitals filed a usable price
North Carolina NC6not enough hospitals filed a usable price
New Hampshire NH6not enough hospitals filed a usable price
New Mexico NM6not enough hospitals filed a usable price
Nevada NV6not enough hospitals filed a usable price
Montana MT5not enough hospitals filed a usable price
Alaska AK4not enough hospitals filed a usable price
Colorado CO4not enough hospitals filed a usable price
Wyoming WY4not enough hospitals filed a usable price
Delaware DE3not enough hospitals filed a usable price
Vermont VT3not enough hospitals filed a usable price
Maryland MD2not enough hospitals filed a usable price
Maine ME1not enough hospitals filed a usable price
North Dakota ND1not enough hospitals filed a usable price
Rhode Island RI1not enough hospitals filed a usable price

Hospitals like yours

The same distribution cut by the kind of hospital. Hospital type and ownership come from CMS; a hospital counts as part of a system when its price file is shared with at least one other hospital under the same brand. The national median is $4,246.

Cash price by hospital segment. A segment needs at least 20 hospitals to show a figure.
SegmentHospitalsMedian20th–80th
Hospital type
Acute care652$4,595$1,622 – $11,214
Children’s8fewer than 20 hospitals
Critical access94$2,856$1,054 – $5,784
Ownership
For-profit78$5,383$2,123 – $12,344
Government105$3,462$1,421 – $7,274
Non-profit571$4,342$1,522 – $10,059
System affiliation
Part of a system605$4,595$1,622 – $10,034
Independent151$2,856$1,211 – $8,777

Cash price vs list price

Median list price (chargemaster)$7,620
Median cash price$4,246
Cash as a share of list, median hospital60%

At the typical hospital, asking for the cash price cuts the list price by about 40%. The share is the median of each hospital’s own cash ÷ list ratio, over hospitals that filed both — not the ratio of the two medians above.

The same procedure, inpatient

392 hospitals filed a usable inpatient cash price for this code. The median is $3,493 and the average of the middle 60% is $3,841; most fall between $1,092 and $7,740.

Cash price percentiles, inpatient, across 392 hospitals. Each figure is a price a hospital filed. 10th: one in ten hospitals charges less; 25th: a quarter charge less; Median: half charge less; 75th: three quarters charge less; 90th: nine in ten charge less.
10th25thMedian75th90th
$763$1,271$3,493$7,280$11,214

The most expensive tenth of hospitals charges at least 15× what the cheapest tenth charges ($763 vs $11,214).

Of the 439 hospitals that filed this code inpatient, 392 gave a usable cash price; 25 carried a plausibility flag, 0 filed a number their own filing marks as not a price, 0 gave an estimate, and 22 a list price only.

How complete is this

756 of the 3,956 hospitals with a price file in our corpus (19%) filed a usable outpatient cash price for this code, and those are the hospitals every figure on this page is computed from.

What the 834 hospitals that filed this code at all gave us
Usable cash price — counted756
Cash price carrying a plausibility flag — shown on the compare tool, excluded here52
A number the filing itself marks as not a price (a placeholder, a ratio) — excluded0
An estimate rather than a filed cash price — excluded6
A list price only, no cash figure — excluded20
Hospitals that filed this code834

Sections not shown for this setting

  • Since our last snapshot: there is no earlier snapshot at least 90 days older than this one yet.

We last checked these hospitals’ price files for changes between September 4, 2026 and September 24, 2026; the figures were computed September 25, 2026 from filings loaded through September 24, 2026. The percentiles and averages use only the “counted” row.

Related procedures

Part of the Creation, revision and removal of arteriovenous fistula or vessel-to-vessel cannula for dialysis family.

Hospitals file this code under descriptions such as Arteriovenous Anastomosis Open Direct.

Method

Source
The machine-readable price files every U.S. hospital is required by CMS to publish, parsed per hospital. Nothing is surveyed, sampled or modelled.
What counts
One cash (self-pay) price per hospital for this code and setting. A hospital’s own filing can rule its number out — a placeholder, a “not applicable” note, a list price standing in for cash — and our plausibility checks can flag a price far below what every other hospital files. Both kinds are disclosed above and excluded from the statistics; on the compare tool a flagged price is still shown.
Statistics
Percentiles are discrete: each is a price some hospital filed. The average is the mean of the prices between the 20th and 80th percentiles. We never publish the plain mean, the minimum or the maximum. A state needs 10 hospitals and a segment 20 to show a figure; otherwise the row shows its count and no number. Medicare is the national unadjusted OPPS rate where one exists.
Names
Procedure names on these pages are our own plain-language titles, not the AMA’s copyrighted CPT descriptors. The code is the identity.

The full rules — sources, statistics, thresholds, limitations — are on the methodology page.

Download this page’s figures: JSON · CSV. Aggregates only — the per-hospital prices are on the compare tool.

Cite: HospitalRates.com, “Dialysis fistula by direct artery-to-vein connection (CPT 36821) — cash price report,” computed September 25, 2026. https://hospitalrates.com/procedures/cpt-36821-dialysis-fistula-by-direct-artery-to-vein-connection