A common AV fistula creation for dialysis at surgery center facility in Massachusetts includes
| |
Units |
Avg Cash price |
Provider |
Vascular surgeon visit provider fee
First time visit
Standard
|
1 |
$151 |
Provider fee to relocate arm vein and connect with an arm artery, open procedure
Standard
Standard
|
1 |
$1,059 |
Facility |
Surgery center fee to relocate arm vein and connect with an arm artery, open procedure
Standard
Standard
|
1 |
$1,922 |
Anesthesia |
Anesthesiologist fee to be "put under" for procedure
Level 3
Standard
|
1 |
$231 |
Anesthesiologist time to be "put under" for procedure
Per minute
Standard
|
233 |
$534 |
Total average cash price |
|
A common AV fistula creation for dialysis at outpatient hospital facility in Massachusetts includes
| |
Units |
Avg Cash price |
Provider |
Vascular surgeon visit provider fee
First time visit
Standard
|
1 |
$151 |
Provider fee to relocate arm vein and connect with an arm artery, open procedure
Standard
Standard
|
1 |
$1,059 |
Facility |
Outpatient Hospital fee to relocate arm vein with connection to arm artery, open procedure
level 3
Standard
|
1 |
$3,970 |
Anesthesia |
Anesthesiologist fee to be "put under" for procedure
Level 3
Standard
|
1 |
$231 |
Anesthesiologist time to be "put under" for procedure
Per minute
Standard
|
233 |
$534 |
Total average cash price |
|
An AV or arteriovenous fistula is a surgically created connection of an artery to a vein. The fistula causes the vein to become larger and stronger because of extra blood flow from the artery that has been connected. The creation of the AV fistula for patients undergoing dialysis provides easier and reliable access to blood vessels. Typically veins would not withstand repeated needle insertion required for dialysis procedures and may even collapse. The AV fistula forms preferred access for dialysis. An AV fistula is often placed in the non-dominant arm, but can be created in a leg.
AV fistulas are the preferred access for dialysis because they provide good blood flow for dialysis, last longer, and are less likely to become infected or clotted than other types of access. An AV fistula is considered when dialysis will be needed long term.
To create an AV fistula, your surgeon will perform ultrasound mapping to locate a large enough vein for a fistula. AV fistulas can be made under local, regional, or general anesthesia. Your surgeon will decide which type of anesthesia is best for your procedure. During the surgery, an incision is made in the chosen arm or leg, and the vessels are connected. The connection may be made by dividing the vein and sewing one end to the side of the artery, or the two vessels may be joined side by side without dividing the vein.
The surgery to create an AV fistula is most often performed outpatient, and you’ll be able to go home the same day of your surgery. However, in some cases, you might need to stay overnight.
Once the AV fistula is created, it must “mature” before it can be used. This will take two to three months after the surgery. During this time, the vein will enlarge, and you will feel a vibration or “thrill” when you touch the area.
To access an AV fistula, two needles are inserted into the vascular access. One needle carries blood from the body to the dialyzer while the second carries filtered blood back to the body. The dialysis staff connects the needles to tubing that circulates the blood through the dialysis machine, where it is filtered.
Fistulas for dialysis are usually not painful. You may have some minor discomfort at the site of the incision when the fistula is created, but this will resolve quickly. Once the incision heals, you should no longer have any discomfort. If you do notice ongoing pain or problems, let your surgeon know so they can evaluate.
An AV fistula can last for many years and even decades. AV fistula is the preferred access for dialysis and is the least prone to complications of infection or blood clots.
The most common complications of AV fistula include:
- Lymphedema
- Infection
- Aneurysm
- Stenosis
- Congestive heart failure
- Steal syndrome
- Ischemic neuropathy
- Thrombosis
About the AV fistula creation for dialysis Average Cash Prices
This procedure is most commonly performed at either a surgery center or an outpatient hospital.
Surgery centers, also known as ambulatory surgery centers (ASCs), are independent, licensed medical
facilities that are governed by distinct regulatory requirements compared with a hospital. Procedures
performed at an ASCs are often less expensive than when they are performed at an outpatient hospital,
but they typically offer fewer complimentary services, and may not have the full-range of support
services that a hospital provides.
Outpatient facilities are outpatient departments or clinics that may be within or next to a hospital,
but is owned and run by the affiliated hospital. These facilities can perform surgical treatments and
procedures that do not require an overnight stay. Procedures performed at an outpatient hospital are
often more expensive than when they are performed in an ambulatory surgery center, but outpatient
hospitals may offer more complimentary and support services for patients because they are connected to
the hospital system.
