CPT code 33954: ECMO cannulation, percutaneous, age 6 and older2026 Medicare rate & RVUs in Montana
Reports percutaneous placement of peripheral cannulae for ECMO or ECLS in a patient age six or older as part of extracorporeal support.
In Montana, Medicare pays $431.73 for 33954 in a facility. There’s no office rate.
Check a contract rate as a % of Medicare · 33954 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 33954 covers
This service covers percutaneous placement of peripheral cannulae to establish extracorporeal membrane oxygenation or extracorporeal life support in patients age six and older. A cardiothoracic or vascular surgeon, or another physician qualified to perform the access, places cannulae through peripheral vessels; femoral vessels are common access sites. The service is performed in settings such as an operating room or intensive care unit when urgent circulatory or respiratory support is needed.
Select this code for percutaneous peripheral cannulation in the specified age group; use the applicable sibling code when the age group or insertion approach differs. Document the patient’s age, peripheral access site, percutaneous technique, and cannula placement. The 0-day global period includes same-day preoperative and postoperative care. When multiple procedures occur in the same session, the highest-valued procedure is paid in full and other procedures are subject to the standard 50% reduction. Modifier 50 is inappropriate. Assistant-at-surgery payment requires documented medical necessity; co-surgeons and team surgery are not permitted.
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 Montana compares for 33954
Across 109 of 109 payment localities, the facility rate for 33954 runs from $380.60 in Wisconsin to $552.91 in Alaska. Montana pays $431.73. The RVUs are the same everywhere; the geographic indexes change the dollars.
- Montana · this page$431.73
- Los Angeles, CA · California$432.39+$0.66
- Washington, DC area · District of Columbia$467.41+$35.68
- Miami, FL · Florida$541.79+$110.06
- Chicago, IL · Illinois$525.11+$93.38
- Manhattan, NY · New York$502.51+$70.78
- Alaska · Alaska$552.91+$121.18
Other areas in Montana first, then benchmark localities. Bars start at $0.
Every other payment area
| Payment locality | Office | Facility |
|---|---|---|
| AlabamaAlabama | — | $393.29 |
| ArkansasArkansas | — | $388.67 |
| ArizonaArizona | — | $419.75 |
| Bakersfield, CACalifornia | — | $416.34 |
| Chico, CACalifornia | — | $410.62 |
| El Centro, CACalifornia | — | $410.97 |
| Fresno, CACalifornia | — | $410.62 |
| Hanford, CACalifornia | — | $410.62 |
| Madera, CACalifornia | — | $410.62 |
| Merced, CACalifornia | — | $410.62 |
| Modesto, CACalifornia | — | $410.62 |
| Napa, CACalifornia | — | $436.76 |
| Oxnard, CACalifornia | — | $425.59 |
| Redding, CACalifornia | — | $410.62 |
| Rest of CaliforniaCalifornia | — | $410.62 |
| Riverside, CACalifornia | — | $433.15 |
| Sacramento, CACalifornia | — | $420.62 |
| Salinas, CACalifornia | — | $418.88 |
| San Diego, CACalifornia | — | $421.41 |
| Marin County, CACalifornia | — | $448.81 |
| San Francisco, CACalifornia | — | $446.42 |
| San Benito County, CACalifornia | — | $460.74 |
| Santa Clara County, CACalifornia | — | $450.99 |
| San Luis Obispo, CACalifornia | — | $413.42 |
| Santa Cruz, CACalifornia | — | $419.56 |
| Santa Maria, CACalifornia | — | $418.44 |
| Santa Rosa, CACalifornia | — | $423.08 |
| Stockton, CACalifornia | — | $410.62 |
| Vallejo, CACalifornia | — | $433.32 |
| Visalia, CACalifornia | — | $410.62 |
| Yuba City, CACalifornia | — | $410.62 |
| ColoradoColorado | — | $424.24 |
| ConnecticutConnecticut | — | $457.55 |
| DelawareDelaware | — | $425.49 |
| Fort Lauderdale, FLFlorida | — | $489.39 |
| Rest of FloridaFlorida | — | $464.29 |
| Atlanta, GAGeorgia | — | $447.90 |
| Rest of GeorgiaGeorgia | — | $438.31 |
| Hawaii, Guam, HIHawaii | — | $411.27 |
| IowaIowa | — | $384.04 |
| IdahoIdaho | — | $389.70 |
| East St. Louis, ILIllinois | — | $497.79 |
| Rest of IllinoisIllinois | — | $465.70 |
| Suburban Chicago, ILIllinois | — | $489.86 |
| IndianaIndiana | — | $391.07 |
| KansasKansas | — | $390.83 |
| KentuckyKentucky | — | $418.68 |
| New Orleans, LALouisiana | — | $437.57 |
| Rest of LouisianaLouisiana | — | $421.44 |
| Metropolitan Boston, MAMassachusetts | — | $448.95 |
| Rest of MassachusettsMassachusetts | — | $425.83 |
| Baltimore area, MDMaryland | — | $458.00 |
| Rest of MarylandMaryland | — | $429.87 |
| Rest of MaineMaine | — | $400.15 |
| Southern Maine, MEMaine | — | $405.41 |
| Detroit, MIMichigan | — | $477.71 |
| Rest of MichiganMichigan | — | $435.26 |
| MinnesotaMinnesota | — | $384.38 |
| Metropolitan Kansas City, MOMissouri | — | $426.29 |
| Metropolitan St. Louis, MOMissouri | — | $428.89 |
| Rest of MissouriMissouri | — | $421.06 |
| MississippiMississippi | — | $404.51 |
| North CarolinaNorth Carolina | — | $402.19 |
| North DakotaNorth Dakota | — | $390.21 |
| NebraskaNebraska | — | $383.23 |
| New HampshireNew Hampshire | — | $425.78 |
| Northern New JerseyNew Jersey | — | $465.75 |
| Rest of New JerseyNew Jersey | — | $456.53 |
| New MexicoNew Mexico | — | $440.57 |
| NevadaNevada | — | $420.23 |
| NYC suburbs and Long Island, NYNew York | — | $523.28 |
| Poughkeepsie and northern NYC suburbs, NYNew York | — | $466.14 |
| Queens, NYNew York | — | $493.71 |
| Rest of New YorkNew York | — | $407.78 |
| OhioOhio | — | $426.77 |
| OklahomaOklahoma | — | $409.26 |
| Portland, OROregon | — | $425.89 |
| Rest of OregonOregon | — | $410.78 |
| Metropolitan Philadelphia, PAPennsylvania | — | $453.42 |
| Rest of PennsylvaniaPennsylvania | — | $422.68 |
| Puerto RicoPuerto Rico | — | $431.54 |
| Rhode IslandRhode Island | — | $432.08 |
| South CarolinaSouth Carolina | — | $416.40 |
| South DakotaSouth Dakota | — | $385.30 |
| TennesseeTennessee | — | $393.47 |
| Austin, TXTexas | — | $428.25 |
| Beaumont, TXTexas | — | $421.03 |
| Brazoria, TXTexas | — | $418.23 |
| Dallas, TXTexas | — | $424.32 |
| Fort Worth, TXTexas | — | $424.58 |
| Galveston, TXTexas | — | $421.73 |
| Houston, TXTexas | — | $460.16 |
| Rest of TexasTexas | — | $421.75 |
| UtahUtah | — | $420.81 |
| VirginiaVirginia | — | $410.14 |
| Virgin Islands, VIUnited States Virgin Islands | — | $431.54 |
| VermontVermont | — | $396.57 |
| Rest of WashingtonWashington | — | $422.42 |
| King County, WAWashington | — | $448.65 |
| WisconsinWisconsin | — | $380.60 |
| West VirginiaWest Virginia | — | $453.57 |
| WyomingWyoming | — | $413.64 |
33954 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 33954 rate is calculated
Each of 33954’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 · 33954
RVUs × geographic indexes × conversion factor
Work8.88
8.88 RVUs× 1.000 GPCI
Practice expense1.95
1.95 RVUs× 1.000 GPCI
Malpractice2.10
2.10 RVUs× 1.000 GPCI
Adjusted RVUs
12.9300
Conversion factor
$33.4009
Medicare rate
$431.87
Every GPCI starts at 1.000, the national rate. Enter a ZIP or drag a slider.
The exact Montana inputs and CMS source lines
PPRRVU2026_Oct_nonQPP.csv
4,140
- Code
- 33954
- Physician work
- 8.88
- Practice expense
- 1.95
- Malpractice
- 2.10
GPCI2026.csv
71
- Locality
- Montana
- Physician work
- 1.000
- Practice expense
- 1.000
- Malpractice
- 0.998
| Component | RVU | Locality factor | Adjusted |
|---|---|---|---|
| Physician work | 8.88 | × 1.000 | 8.8800 |
| Practice expense | 1.95 | × 1.000 | 1.9500 |
| Malpractice | 2.10 | × 0.998 | 2.0958 |
| Total RVUs | 12.9258 | ||
| Conversion factor | × 33.4009 | ||
Facility rate, Montana$431.73
Facility: (8.88 × 1 + 1.95 × 1 + 2.1 × 0.998) × $33.4009 = $431.73
Payment rules and modifiers for 33954
The CMS indicators that decide how 33954 is paid alongside other services.
CMS payment indicators · 33954
ECMO cannulation, percutaneous, age 6 and older
| Rule | CMS value | What it means |
|---|---|---|
| Global period | 000 | Same-day global: pre- and post-op care on the day of the procedure is included. |
| Multiple procedures | 2 | Standard reduction: highest-valued procedure at 100%, others at 50%. |
| Bilateral (modifier 50) | 0 | The 150% bilateral adjustment doesn’t apply. |
| Assistant at surgery (80/81/82/AS) | 0 | Not paid without supporting documentation. |
| Co-surgeons (62) | 0 | Not permitted. |
| Team surgery (66) | 0 | Not permitted. |
| Professional/technical | 0 | Physician service: no professional/technical split. |
What modifiers do to the payment
Modifier 51 · payment effect
With and without the modifier
33954 without 51 · national facility
$431.87
ECMO cannulation, percutaneous, age 6 and older
33954-51 · Second procedure: 50%
$215.94
When this isn’t the highest-valued procedure in the session, Medicare pays 50% of its fee schedule amount (the highest is paid at 100%).
How 33954 has changed in Montana
33954 · 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 | $431.73 | RVU26D |
| 2026-07-01 | Not available in this setting | $431.73 | RVU26C |
| 2026-04-01 | Not available in this setting | $431.73 | RVU26B |
| 2026-01-01 | Not available in this setting | $431.73 | RVU26A |
| 2025-10-01 | Not available in this setting | $450.69 | RVU25D |
| 2025-07-01 | Not available in this setting | $450.69 | RVU25C |
| 2025-04-01 | Not available in this setting | $450.69 | RVU25B |
| 2025-01-01 | Not available in this setting | $450.69 | RVU25A |
| 2024-10-01 | Not available in this setting | $461.77 | RVU24D |
| 2024-07-01 | Not available in this setting | $461.77 | RVU24C |
| 2024-04-01 | Not available in this setting | $461.77 | RVU24B |
| 2024-03-09 | Not available in this setting | $461.77 | RVU24AR |
| 2024-01-01 | Not available in this setting | $454.24 | RVU24A |
| 2023-10-01 | Not available in this setting | $468.80 | RVU23D |
| 2023-07-01 | Not available in this setting | $468.80 | RVU23C |
| 2023-04-01 | Not available in this setting | $468.80 | RVU23B |
| 2023-01-01 | Not available in this setting | $468.80 | RVU23A |
| 2022-10-01 | Not available in this setting | $482.44 | RVU22D |
| 2022-07-01 | Not available in this setting | $482.44 | RVU22C |
| 2022-04-01 | Not available in this setting | $482.44 | RVU22B |
| 2022-01-01 | Not available in this setting | $482.44 | RVU22A |
| 2021-10-01 | Not available in this setting | $483.03 | RVU21D |
| 2021-07-01 | Not available in this setting | $483.03 | RVU21C |
| 2021-04-01 | Not available in this setting | $483.03 | RVU21B |
| 2021-01-01 | Not available in this setting | $483.03 | RVU21A |
| 2020-10-01 | Not available in this setting | $521.03 | RVU20D |
| 2020-07-01 | Not available in this setting | $521.03 | RVU20C |
| 2020-04-01 | Not available in this setting | $521.03 | RVU20B |
| 2020-01-01 | Not available in this setting | $521.03 | RVU20A |
| 2019-10-01 | Not available in this setting | $547.75 | RVU19D |
| 2019-07-01 | Not available in this setting | $547.75 | RVU19C |
| 2019-04-01 | Not available in this setting | $547.75 | RVU19B |
| 2019-01-01 | Not available in this setting | $547.75 | RVU19A |
| 2018-10-01 | Not available in this setting | $546.83 | RVU18D |
| 2018-07-01 | Not available in this setting | $546.83 | RVU18C |
| 2018-04-01 | Not available in this setting | $546.83 | RVU18B |
| 2018-01-01 | Not available in this setting | $546.83 | RVU18AR1 |
| 2017-10-01 | Not available in this setting | $531.44 | RVU17D |
| 2017-07-01 | Not available in this setting | $531.44 | RVU17C |
| 2017-04-01 | Not available in this setting | $531.44 | RVU17B |
| 2017-01-01 | Not available in this setting | $531.44 | RVU17A |
| 2016-10-01 | Not available in this setting | $518.85 | RVU16D |
| 2016-07-01 | Not available in this setting | $518.85 | RVU16C |
| 2016-04-01 | Not available in this setting | $518.85 | RVU16B |
| 2016-01-01 | Not available in this setting | $518.85 | RVU16A |
| 2015-10-01 | Not available in this setting | $520.64 | RVU15D |
| 2015-07-01 | Not available in this setting | $520.64 | RVU15C |
| 2015-04-01 | Not available in this setting | $518.05 | RVU15B |
| 2015-01-01 | Not available in this setting | $518.05 | 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 Montana rate applies
Montana is a Medicare payment area, not a city. Our Census mapping connects it to 497 cities and communities in Montana. Some span more than one payment area; confirm with the service ZIP.
- Absarokee
- Acton
- Alberton
- Alder
- Alzada
- Amsterdam
- Anaconda-Deer Lodge County
- Antelope
33954 billing questions
How does 33954 differ from 33951?
33954 is for percutaneous peripheral cannula insertion in a patient age six or older. Choose 33951 when the insertion approach and the patient’s age match that code’s criteria instead.
When should a central cannula insertion code be used instead?
Use the central cannula insertion family when cannulae are placed centrally rather than through peripheral vessels. Code 33954 describes percutaneous peripheral access.
Can this be reported with an ECMO/ECLS initiation code?
Peripheral cannula placement may be reported with the applicable initiation service when both services are performed and documented. Select the initiation code for the veno-venous or veno-arterial circuit.
Can modifier 50 be appended for cannulation on both sides?
No. The CMS bilateral adjustment does not apply, and modifier 50 is inappropriate for this code.
What documentation supports 33954?
Record the patient’s age, the peripheral vessel access site, the percutaneous approach, and the cannula placement performed for ECMO/ECLS.
May an assistant surgeon or co-surgeon be reported?
Assistant-at-surgery payment requires documentation of medical necessity. Co-surgeons and team surgery are not permitted.
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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