DRIL Procedure

Question:

The surgeon said he did a DRIL procedure on an AC fistula. I’m not sure how to code this. Is it an unlisted code?

Answer:

The DRIL procedure (Distal Revascularization with Interval Ligation) is a surgical intervention to treat complications related to hemodialysis access. It is performed to address complications arising from hemodialysis access, such as ischemia (reduced blood flow) or steal syndrome (where blood flow is diverted away from the limb) in the affected extremity. It involves restoring blood flow to a limb while also addressing issues like high flow or steal syndrome by ligating (tying off) a portion of the access. This procedure aims to reduce pain, improve tissue viability, and prevent further complications in the affected limb. This procedure has an existing CPT code and is reported as 36838. 

*This response is based on the best information available as of 7/31/25.