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CPT code 33949: ECMO management, venoarterial support2026 Medicare rate & RVUs

Reports a physician’s daily management of venoarterial ECMO or ECLS, including clinical oversight of the patient and extracorporeal support circuit.

CMS RVU26DEffective Oct 1, 2026109 payment localities7.2K Medicare services in 2024

Medicare pays $209.09 for 33949 nationally in a facility.

Medicare rate · 33949

ECMO management, venoarterial support

Office or facility?

Work RVUs
4.49
Total RVUs
6.26
Global days
XXX

National rate · 2026

$209.09

Facility setting, before claim adjustments.

See every locality for 33949 →Billed by an NP, PA or therapist? →

Medicare allowed amount for participating (non-QP) physicians, before deductible, coinsurance and claim adjustments. Not a patient’s bill or a hospital charge.

Your location

Medicare pays by the payment locality where the service is performed.

On this page 10 sections
  1. Medicare rate
  2. What 33949 covers
  3. By payment locality
  4. Rate map
  5. How it’s calculated
  6. Payment rules
  7. Similar codes
  8. Related codes
  9. Billing questions
  10. Sources

What 33949 covers

Code 33949 represents a physician’s daily management of venoarterial extracorporeal membrane oxygenation or extracorporeal life support. This support configuration returns oxygenated blood to the arterial circulation and may be used for severe cardiac or combined cardiopulmonary failure. Management typically occurs in an intensive care setting while the patient remains on support, with physician involvement from specialties such as critical care or cardiothoracic surgery.

Report the service for each date on which the physician provides the daily management, rather than for ECMO initiation or a cannula procedure. The record should support the physician’s assessment of the patient and circuit, management decisions, and any adjustments made to the support plan. Select this code for venoarterial support; the parallel daily-management code 33948 is for venovenous support.

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.

Where 33949 pays more and less

The same RVUs, adjusted for each area’s costs. Open a locality for its calculation, history and nearby areas.

109 of 109 payment localities

33949 office and facility rates by payment locality
Payment localityOfficeFacility
AlabamaUnavailable$193.96
AlaskaUnavailable$275.04
ArizonaUnavailable$204.43
ArkansasUnavailable$192.14
Atlanta, GAUnavailable$215.12
Austin, TXUnavailable$208.51
Bakersfield, CAUnavailable$205.41
Baltimore area, MDUnavailable$219.91
Beaumont, TXUnavailable$204.24
Brazoria, TXUnavailable$204.47

33949 rates by state

Office rate range in each state. Select a state to see its payment localities.

MEWIVTNHMTNDMNMINYMARIWAIDWYSDIAILINOHPANJCTORNVUTCONEMOKYWVVAMDDECAAZNMKSOKARTNNCSCDCTXLAMSALGAFLAKHI

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
33949 office rate range by state
State / territoryOffice rate rangeLocalities
AKNo published base rate1
ALNo published base rate1
ARNo published base rate1
AZNo published base rate1
CANo published base rate29
CONo published base rate1
CTNo published base rate1
DCNo published base rate1
DENo published base rate1
FLNo published base rate3
GANo published base rate2
GUNo published base rate1
HINo published base rate1
IANo published base rate1
IDNo published base rate1
ILNo published base rate4
INNo published base rate1
KSNo published base rate1
KYNo published base rate1
LANo published base rate2
MANo published base rate2
MDNo published base rate3
MENo published base rate2
MINo published base rate2
MNNo published base rate1
MONo published base rate3
MSNo published base rate1
MTNo published base rate1
NCNo published base rate1
NDNo published base rate1
NENo published base rate1
NHNo published base rate1
NJNo published base rate2
NMNo published base rate1
NVNo published base rate1
NYNo published base rate5
OHNo published base rate1
OKNo published base rate1
ORNo published base rate2
PANo published base rate2
PRNo published base rate1
RINo published base rate1
SCNo published base rate1
SDNo published base rate1
TNNo published base rate1
TXNo published base rate8
UTNo published base rate1
VANo published base rate2
VINo published base rate1
VTNo published base rate1
WANo published base rate2
WINo published base rate1
WVNo published base rate1
WYNo published base rate1

How the 33949 rate is calculated

Each of 33949’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 · 33949

RVUs × geographic indexes × conversion factor

Office or facility?

Work4.49

4.49 RVUs× 1.000 GPCI

Practice expense1.02

1.02 RVUs× 1.000 GPCI

Malpractice0.75

0.75 RVUs× 1.000 GPCI

Adjusted RVUs

6.2600

Conversion factor

$33.4009

Medicare rate

$209.09

Every GPCI starts at 1.000, the national rate. Enter a ZIP or drag a slider.

Payment rules and modifiers for 33949

33949 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 · 33949

Which rate does Medicare pay?

The POS code on the claim line (CMS-1500 box 24B).

POS 11 · non-facility rate · national

—

33949 isn’t priced in this setting.

33949 compared with similar codes

Compare codes · National

4 codes, side by side

Office or facility?

  • 33949

    ECMO management, venoarterial support4.49 wRVU

    Not priced

  • 33948

    ECMO management, venovenous support4.61 wRVU

    Not priced

  • 33947

    ECMO initiation, venoarterial configuration6.46 wRVU

    Not priced

  • 33946

    ECMO initiation, venovenous, age six and older5.85 wRVU

    Not priced

How to choose

33948ECMO managementVenovenous support
Choose 33948 for daily management of venovenous ECMO/ECLS; choose 33949 when support is venoarterial.
33947ECMO initiationVenoarterial configuration
Code 33947 represents initiation of venoarterial ECMO/ECLS. Code 33949 represents its daily management.
33946ECMO initiationVenovenous, age six and older
Code 33946 is for venovenous ECMO/ECLS initiation. Code 33949 is for daily management of venoarterial support.

Codes related to 33949

Related codes aren’t interchangeable: bill the code that matches the service performed.

Codes related to 33949
CodeHow it relatesNational office range
Same family
33948ECMO management, venovenous supportDaily management counterpart for venovenous ECMO/ECLS.No office rate
33947ECMO initiation, venoarterial configurationVenoarterial ECMO/ECLS initiation, rather than ongoing daily management.No office rate
33946ECMO initiation, venovenous, age six and olderVenovenous ECMO/ECLS initiation; distinguishes support type and service phase.No office rate

33949 billing questions

How does 33949 differ from 33948?

Use 33949 for venoarterial ECMO/ECLS daily management. Code 33948 is the corresponding daily-management service for venovenous support.

Is 33949 the code for starting ECMO?

No. It describes daily management after support is in use; 33947 describes initiation of venoarterial ECMO/ECLS.

Can 33949 be reported for cannula insertion or repositioning?

No. It represents daily management, not a cannula procedure. Use the applicable procedure code when insertion or repositioning is performed and documented.

How often is 33949 reported?

It represents daily management, so report it for each date the physician provides that service. Documentation should establish the physician’s work on that date.

What documentation supports 33949?

Document that the patient is receiving venoarterial ECMO/ECLS and the physician’s daily assessment and management of the patient and support circuit.

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
RVUs for 33949PPRRVU2026_Oct_nonQPP.csv, line 4,135 (RVU26D)

Open CMS sourceHow we calculate rates

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