CPT code 33946: ECMO initiation, venovenous, age six and older2026 Medicare rate & RVUs in Minnesota
Reports physician work to initiate venovenous ECMO/ECLS in patients age six and older when respiratory support is needed through extracorporeal gas exchange.
In Minnesota, Medicare pays $251.16 for 33946 in a facility. There’s no office rate.
Check a contract rate as a % of Medicare · 33946 nationwide
Medicare allowed amount for participating (non-QP) physicians, before deductible, coinsurance and claim adjustments. Not a patient’s bill or a hospital charge.
On this page 11 sections
What 33946 covers
This service covers starting venovenous extracorporeal membrane oxygenation or extracorporeal life support in a patient age six or older. Venous blood is routed through an extracorporeal circuit for gas exchange and returned to the venous circulation, supporting patients with severe respiratory failure when conventional respiratory support is inadequate. The physician directing initiation may be a critical care specialist, cardiothoracic surgeon, or another clinician experienced in ECMO, typically in an intensive care setting.
Report 33946 for the initiation phase, not for ongoing daily ECMO management or an arterial-return configuration. The record should establish the patient’s age, the venovenous support configuration, the clinical need for ECMO, and the physician’s work initiating the service. Cannula insertion has separate codes in the ECMO/ECLS code family when that work is performed.
This summary was written with AI assistance from CMS physician fee schedule data and checked against the CMS billing rules shown here. Rates on this page come directly from CMS files.
How Minnesota compares for 33946
Across 109 of 109 payment localities, the facility rate for 33946 runs from $248.68 in Wisconsin to $361.10 in Alaska. Minnesota pays $251.16. The RVUs are the same everywhere; the geographic indexes change the dollars.
- Minnesota · this page$251.16
- Los Angeles, CA · California$281.14+$29.98
- Washington, DC area · District of Columbia$302.36+$51.20
- Miami, FL · Florida$345.64+$94.48
- Chicago, IL · Illinois$335.64+$84.48
- Manhattan, NY · New York$323.55+$72.39
- Alaska · Alaska$361.10+$109.94
Other areas in Minnesota first, then benchmark localities. Bars start at $0.
Every other payment area
| Payment locality | Office | Facility |
|---|---|---|
| AlabamaAlabama | — | $256.04 |
| ArkansasArkansas | — | $253.22 |
| ArizonaArizona | — | $272.20 |
| Bakersfield, CACalifornia | — | $270.86 |
| Chico, CACalifornia | — | $267.40 |
| El Centro, CACalifornia | — | $267.61 |
| Fresno, CACalifornia | — | $267.40 |
| Hanford, CACalifornia | — | $267.40 |
| Madera, CACalifornia | — | $267.40 |
| Merced, CACalifornia | — | $267.40 |
| Modesto, CACalifornia | — | $267.40 |
| Napa, CACalifornia | — | $284.55 |
| Oxnard, CACalifornia | — | $276.83 |
| Redding, CACalifornia | — | $267.40 |
| Rest of CaliforniaCalifornia | — | $267.40 |
| Riverside, CACalifornia | — | $280.94 |
| Sacramento, CACalifornia | — | $273.93 |
| Salinas, CACalifornia | — | $272.79 |
| San Diego, CACalifornia | — | $274.40 |
| Marin County, CACalifornia | — | $292.61 |
| San Francisco, CACalifornia | — | $291.18 |
| San Benito County, CACalifornia | — | $300.13 |
| Santa Clara County, CACalifornia | — | $294.28 |
| San Luis Obispo, CACalifornia | — | $269.21 |
| Santa Cruz, CACalifornia | — | $273.19 |
| Santa Maria, CACalifornia | — | $272.50 |
| Santa Rosa, CACalifornia | — | $275.50 |
| Stockton, CACalifornia | — | $267.40 |
| Vallejo, CACalifornia | — | $282.49 |
| Visalia, CACalifornia | — | $267.40 |
| Yuba City, CACalifornia | — | $267.40 |
| ColoradoColorado | — | $275.39 |
| ConnecticutConnecticut | — | $295.55 |
| DelawareDelaware | — | $275.79 |
| Fort Lauderdale, FLFlorida | — | $314.12 |
| Rest of FloridaFlorida | — | $298.88 |
| Atlanta, GAGeorgia | — | $289.28 |
| Rest of GeorgiaGeorgia | — | $283.10 |
| Hawaii, Guam, HIHawaii | — | $267.61 |
| IowaIowa | — | $250.61 |
| IdahoIdaho | — | $254.02 |
| East St. Louis, ILIllinois | — | $318.87 |
| Rest of IllinoisIllinois | — | $299.60 |
| Suburban Chicago, ILIllinois | — | $314.56 |
| IndianaIndiana | — | $254.86 |
| KansasKansas | — | $254.65 |
| KentuckyKentucky | — | $271.32 |
| New Orleans, LALouisiana | — | $282.81 |
| Rest of LouisianaLouisiana | — | $272.96 |
| Metropolitan Boston, MAMassachusetts | — | $291.11 |
| Rest of MassachusettsMassachusetts | — | $276.38 |
| Baltimore area, MDMaryland | — | $295.74 |
| Rest of MarylandMaryland | — | $278.57 |
| Rest of MaineMaine | — | $260.29 |
| Southern Maine, MEMaine | — | $263.66 |
| Detroit, MIMichigan | — | $306.96 |
| Rest of MichiganMichigan | — | $281.33 |
| Metropolitan Kansas City, MOMissouri | — | $276.03 |
| Metropolitan St. Louis, MOMissouri | — | $277.63 |
| Rest of MissouriMissouri | — | $272.66 |
| MississippiMississippi | — | $262.73 |
| MontanaMontana | — | $279.48 |
| North CarolinaNorth Carolina | — | $261.55 |
| North DakotaNorth Dakota | — | $254.57 |
| NebraskaNebraska | — | $250.15 |
| New HampshireNew Hampshire | — | $276.03 |
| Northern New JerseyNew Jersey | — | $301.47 |
| Rest of New JerseyNew Jersey | — | $295.34 |
| New MexicoNew Mexico | — | $284.53 |
| NevadaNevada | — | $272.58 |
| NYC suburbs and Long Island, NYNew York | — | $336.09 |
| Poughkeepsie and northern NYC suburbs, NYNew York | — | $301.19 |
| Queens, NYNew York | — | $318.33 |
| Rest of New YorkNew York | — | $264.96 |
| OhioOhio | — | $276.24 |
| OklahomaOklahoma | — | $265.68 |
| Portland, OROregon | — | $276.59 |
| Rest of OregonOregon | — | $266.90 |
| Metropolitan Philadelphia, PAPennsylvania | — | $292.93 |
| Rest of PennsylvaniaPennsylvania | — | $273.80 |
| Puerto RicoPuerto Rico | — | $279.40 |
| Rhode IslandRhode Island | — | $280.12 |
| South CarolinaSouth Carolina | — | $270.05 |
| South DakotaSouth Dakota | — | $251.62 |
| TennesseeTennessee | — | $256.25 |
| Austin, TXTexas | — | $277.60 |
| Beaumont, TXTexas | — | $272.79 |
| Brazoria, TXTexas | — | $271.49 |
| Dallas, TXTexas | — | $275.18 |
| Fort Worth, TXTexas | — | $275.31 |
| Galveston, TXTexas | — | $273.60 |
| Houston, TXTexas | — | $296.66 |
| Rest of TexasTexas | — | $273.34 |
| UtahUtah | — | $272.75 |
| VirginiaVirginia | — | $266.48 |
| Virgin Islands, VIUnited States Virgin Islands | — | $279.40 |
| VermontVermont | — | $258.35 |
| Rest of WashingtonWashington | — | $274.28 |
| King County, WAWashington | — | $291.19 |
| WisconsinWisconsin | — | $248.68 |
| West VirginiaWest Virginia | — | $292.19 |
| WyomingWyoming | — | $268.62 |
33946 rates by state
Office rate range in each state. Select a state to see its payment localities.
Explore a state
Local rates. Clear comparisons.
Hover or focus a tile to see its rate range. Select it to open the state’s fee schedule.
View every state and territory as a table
| State / territory | Office rate range | Localities |
|---|---|---|
| AK | No published base rate | 1 |
| AL | No published base rate | 1 |
| AR | No published base rate | 1 |
| AZ | No published base rate | 1 |
| CA | No published base rate | 29 |
| CO | No published base rate | 1 |
| CT | No published base rate | 1 |
| DC | No published base rate | 1 |
| DE | No published base rate | 1 |
| FL | No published base rate | 3 |
| GA | No published base rate | 2 |
| GU | No published base rate | 1 |
| HI | No published base rate | 1 |
| IA | No published base rate | 1 |
| ID | No published base rate | 1 |
| IL | No published base rate | 4 |
| IN | No published base rate | 1 |
| KS | No published base rate | 1 |
| KY | No published base rate | 1 |
| LA | No published base rate | 2 |
| MA | No published base rate | 2 |
| MD | No published base rate | 3 |
| ME | No published base rate | 2 |
| MI | No published base rate | 2 |
| MN | No published base rate | 1 |
| MO | No published base rate | 3 |
| MS | No published base rate | 1 |
| MT | No published base rate | 1 |
| NC | No published base rate | 1 |
| ND | No published base rate | 1 |
| NE | No published base rate | 1 |
| NH | No published base rate | 1 |
| NJ | No published base rate | 2 |
| NM | No published base rate | 1 |
| NV | No published base rate | 1 |
| NY | No published base rate | 5 |
| OH | No published base rate | 1 |
| OK | No published base rate | 1 |
| OR | No published base rate | 2 |
| PA | No published base rate | 2 |
| PR | No published base rate | 1 |
| RI | No published base rate | 1 |
| SC | No published base rate | 1 |
| SD | No published base rate | 1 |
| TN | No published base rate | 1 |
| TX | No published base rate | 8 |
| UT | No published base rate | 1 |
| VA | No published base rate | 2 |
| VI | No published base rate | 1 |
| VT | No published base rate | 1 |
| WA | No published base rate | 2 |
| WI | No published base rate | 1 |
| WV | No published base rate | 1 |
| WY | No published base rate | 1 |
How the 33946 rate is calculated
Each of 33946’s three RVUs is multiplied by a geographic index (GPCI) for the payment locality, added up, and multiplied by the conversion factor. Drag the indexes or enter a ZIP to see what moves the rate.
How the rate is built · 33946
RVUs × geographic indexes × conversion factor
Work5.85
5.85 RVUs× 1.000 GPCI
Practice expense1.26
1.26 RVUs× 1.000 GPCI
Malpractice1.26
1.26 RVUs× 1.000 GPCI
Adjusted RVUs
8.3700
Conversion factor
$33.4009
Medicare rate
$279.57
Every GPCI starts at 1.000, the national rate. Enter a ZIP or drag a slider.
The exact Minnesota inputs and CMS source lines
PPRRVU2026_Oct_nonQPP.csv
4,132
- Code
- 33946
- Physician work
- 5.85
- Practice expense
- 1.26
- Malpractice
- 1.26
GPCI2026.csv
66
- Locality
- Minnesota
- Physician work
- 1.000
- Practice expense
- 1.029
- Malpractice
- 0.296
| Component | RVU | Locality factor | Adjusted |
|---|---|---|---|
| Physician work | 5.85 | × 1.000 | 5.8500 |
| Practice expense | 1.26 | × 1.029 | 1.2965 |
| Malpractice | 1.26 | × 0.296 | 0.3730 |
| Total RVUs | 7.5195 | ||
| Conversion factor | × 33.4009 | ||
Facility rate, Minnesota$251.16
Facility: (5.85 × 1 + 1.26 × 1.029 + 1.26 × 0.296) × $33.4009 = $251.16
Payment rules and modifiers for 33946
33946 has no global surgery period, no multiple-procedure, bilateral or assistant-at-surgery adjustment, and no professional/technical split. What changes the payment is where the service happens: the place of service on the claim decides whether Medicare pays the office or the facility rate.
Place of service · 33946
Which rate does Medicare pay?
The POS code on the claim line (CMS-1500 box 24B).
POS 11 · non-facility rate · national
—
33946 isn’t priced in this setting.
How 33946 has changed in Minnesota
33946 · Office / nonfacility
Rate unavailable
Effective 2026-10-01
A rate is unavailable in one of these releases, so a change cannot be calculated.
One bar per available release, ordered by effective date. Missing rates remain gaps. These comparisons hold the code, setting and locality identifiers constant; they do not isolate which policy or input caused a change.
What changed, release by release
January 1, 2015
RVU15A
No ratechanged toNo rate
Held through RVU15B, RVU15C, RVU15D, RVU16A, RVU16B, RVU16C, RVU16D, RVU17A, RVU17B, RVU17C, RVU17D, RVU18AR1, RVU18B, RVU18C, RVU18D, RVU19A, RVU19B, RVU19C, RVU19D, RVU20A, RVU20B, RVU20C, RVU20D, RVU21A, RVU21B, RVU21C, RVU21D, RVU22A, RVU22B, RVU22C, RVU22D, RVU23A, RVU23B, RVU23C, RVU23D, RVU24A, RVU24AR, RVU24B, RVU24C, RVU24D, RVU25A, RVU25B, RVU25C, RVU25D, RVU26A, RVU26B, RVU26C, RVU26D.
January 1, 2013
RVU13AR
Earliest loaded release: No rate
Held through RVU13B, RVU13C, RVU13D, RVU14A, RVU14B, RVU14C, RVU14D.
| Effective from | Office | Facility | CMS release |
|---|---|---|---|
| 2026-10-01 | Not available in this setting | $251.16 | RVU26D |
| 2026-07-01 | Not available in this setting | $251.16 | RVU26C |
| 2026-04-01 | Not available in this setting | $251.16 | RVU26B |
| 2026-01-01 | Not available in this setting | $251.16 | RVU26A |
| 2025-10-01 | Not available in this setting | $267.08 | RVU25D |
| 2025-07-01 | Not available in this setting | $267.08 | RVU25C |
| 2025-04-01 | Not available in this setting | $267.08 | RVU25B |
| 2025-01-01 | Not available in this setting | $267.08 | RVU25A |
| 2024-10-01 | Not available in this setting | $273.34 | RVU24D |
| 2024-07-01 | Not available in this setting | $273.34 | RVU24C |
| 2024-04-01 | Not available in this setting | $273.34 | RVU24B |
| 2024-03-09 | Not available in this setting | $273.34 | RVU24AR |
| 2024-01-01 | Not available in this setting | $268.88 | RVU24A |
| 2023-10-01 | Not available in this setting | $279.52 | RVU23D |
| 2023-07-01 | Not available in this setting | $279.52 | RVU23C |
| 2023-04-01 | Not available in this setting | $279.52 | RVU23B |
| 2023-01-01 | Not available in this setting | $279.52 | RVU23A |
| 2022-10-01 | Not available in this setting | $287.06 | RVU22D |
| 2022-07-01 | Not available in this setting | $287.06 | RVU22C |
| 2022-04-01 | Not available in this setting | $287.06 | RVU22B |
| 2022-01-01 | Not available in this setting | $287.06 | RVU22A |
| 2021-10-01 | Not available in this setting | $288.59 | RVU21D |
| 2021-07-01 | Not available in this setting | $288.59 | RVU21C |
| 2021-04-01 | Not available in this setting | $288.59 | RVU21B |
| 2021-01-01 | Not available in this setting | $288.59 | RVU21A |
| 2020-10-01 | Not available in this setting | $296.15 | RVU20D |
| 2020-07-01 | Not available in this setting | $296.15 | RVU20C |
| 2020-04-01 | Not available in this setting | $296.15 | RVU20B |
| 2020-01-01 | Not available in this setting | $296.15 | RVU20A |
| 2019-10-01 | Not available in this setting | $296.41 | RVU19D |
| 2019-07-01 | Not available in this setting | $296.41 | RVU19C |
| 2019-04-01 | Not available in this setting | $296.41 | RVU19B |
| 2019-01-01 | Not available in this setting | $296.41 | RVU19A |
| 2018-10-01 | Not available in this setting | $295.69 | RVU18D |
| 2018-07-01 | Not available in this setting | $295.69 | RVU18C |
| 2018-04-01 | Not available in this setting | $295.69 | RVU18B |
| 2018-01-01 | Not available in this setting | $295.69 | RVU18AR1 |
| 2017-10-01 | Not available in this setting | $295.04 | RVU17D |
| 2017-07-01 | Not available in this setting | $295.04 | RVU17C |
| 2017-04-01 | Not available in this setting | $295.04 | RVU17B |
| 2017-01-01 | Not available in this setting | $295.04 | RVU17A |
| 2016-10-01 | Not available in this setting | $292.99 | RVU16D |
| 2016-07-01 | Not available in this setting | $292.99 | RVU16C |
| 2016-04-01 | Not available in this setting | $292.99 | RVU16B |
| 2016-01-01 | Not available in this setting | $292.99 | RVU16A |
| 2015-10-01 | Not available in this setting | $296.73 | RVU15D |
| 2015-07-01 | Not available in this setting | $296.73 | RVU15C |
| 2015-04-01 | Not available in this setting | $295.25 | RVU15B |
| 2015-01-01 | Not available in this setting | $295.25 | RVU15A |
| 2014-10-01 | Not in this release | Not in this release | RVU14D |
| 2014-07-01 | Not in this release | Not in this release | RVU14C |
| 2014-04-01 | Not in this release | Not in this release | RVU14B |
| 2014-01-01 | Not in this release | Not in this release | RVU14A |
| 2013-10-01 | Not in this release | Not in this release | RVU13D |
| 2013-07-01 | Not in this release | Not in this release | RVU13C |
| 2013-04-01 | Not in this release | Not in this release | RVU13B |
| 2013-01-01 | Not in this release | Not in this release | RVU13AR |
Where the Minnesota rate applies
Minnesota is a Medicare payment area, not a city. Our Census mapping connects it to 916 cities and communities in Minnesota. Some span more than one payment area; confirm with the service ZIP.
- Ada
- Adams
- Adrian
- Afton
- Aitkin
- Akeley
- Albany
- Albert Lea
33946 billing questions
When is 33946 chosen instead of 33947?
Use 33946 for venovenous support, with blood returned to the venous circulation. Code 33947 describes initiation of a venoarterial configuration.
Can 33946 be used for daily ECMO management?
No. It represents initiation; 33948 describes daily management of venovenous ECMO/ECLS.
Does 33946 include cannula insertion?
Cannula insertion is represented by separate codes in the ECMO/ECLS family when that work is performed. Document the insertion separately from the physician’s initiation work.
What age range does 33946 cover?
This initiation code applies to patients age six and older. Check the applicable age-specific code when the patient is younger.
What documentation supports reporting 33946?
Document the respiratory indication, venovenous circuit configuration, initiation work, and patient age. The record should distinguish initiation from subsequent daily management.
Where these rates come from
FeeBase calculates base physician payments from CMS work, practice-expense and malpractice RVUs, adjusted by each locality’s geographic indexes and the conversion factor. Services without a published rate are labeled, never given a made-up amount. Amounts are Medicare allowed amounts before claim adjustments: not a patient’s bill or a commercial rate.
CMS RVU26D · effective Oct 1, 2026 through the day before Jan 1, 2027
Show the CMS file lines behind this rate
Fee sheets
Put 33946 and the rest of your codes on one sheet
Your codes at your locality, with payer contracts beside Medicare.
Build my fee sheet