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Operative note states: "Fistulogram with angioplasty and revision of fistula with ligation of tributary. The patient has poorly functioning right radiocephalic fistula. Fistulogram was found to have stenosis just distal to the anastomosis up beyond a large tributary. This was angioplasited with 4 x 80 and 6 x 80 balloon, and large tribrutary was then ligated through separate incision. Wire was manipulated using a Bern catheter down into the radial artery. Angioplasty was performed of the stenotic area with good results. A large tributary was located and marked and the vein dissected free from surrounding tissue up to level of the fistula and ligated with 2-0 silk and divided." I am not sure if the ligation of tributary would be reported with code 37607, as it is not the fistula itself. Also, I do not believe this is a revision of the fistula. I am reading this as fistulogram (36147), angioplasty (35476, 75978), and the ligation. There really was no revision of the fistula. Your help is appreciated.