CPT code 33949: ECMO management, venoarterial support2026 Medicare rate & RVUs in Texas
Reports a physician’s daily management of venoarterial ECMO or ECLS, including clinical oversight of the patient and extracorporeal support circuit.
CMS doesn’t publish an office rate for 33949 in Texas.
Medicare allowed amount for participating (non-QP) physicians, before deductible, coinsurance and claim adjustments. Not a patient’s bill or a hospital charge.
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On this page 9 sections
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 in Texas
The same RVUs, adjusted for each area’s costs. Open a locality for its calculation, history and nearby areas.
8 of 8 payment localities
| Payment locality | Office | Facility |
|---|---|---|
| Austin, TX | Unavailable | $208.51 |
| Beaumont, TX | Unavailable | $204.24 |
| Brazoria, TX | Unavailable | $204.47 |
| Dallas, TX | Unavailable | $206.75 |
| Fort Worth, TX | Unavailable | $206.73 |
| Galveston, TX | Unavailable | $205.74 |
| Houston, TX | Unavailable | $219.47 |
| Rest of Texas | Unavailable | $204.92 |
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
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
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33949 isn’t priced in this setting.
33949 compared with similar codes
Compare codes · National
4 codes, side by side
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.
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
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