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CPT code 33963: ECMO cannula repositioning, peripheral cannula2026 Medicare rate & RVUs

Report this procedure when a physician repositions an existing peripheral ECMO or ECLS cannula to address a documented positioning problem.

CMS RVU26DEffective Oct 1, 2026109 payment localities

Medicare pays $428.53 for 33963 nationally in a facility.

Medicare rate · 33963

ECMO cannula repositioning, peripheral cannula

Office or facility?

Work RVUs
8.78
Total RVUs
12.83
Global days
000

National rate · 2026

$428.53

Facility setting, before claim adjustments.

See every locality for 33963 →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 33963 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 33963 covers

This procedure addresses the position of a peripheral cannula already in use for extracorporeal membrane oxygenation (ECMO) or extracorporeal life support (ECLS). A physician adjusts an arterial or venous cannula, such as one placed through femoral or jugular vessels, when its position interferes with support or creates another documented concern. The work may occur in an intensive care unit or operating room and is distinct from placing a new cannula or removing one at the end of support.

Report 33963 for the documented peripheral cannula repositioning procedure, not for routine monitoring or circuit management alone. The procedure note should identify the cannula and access site, the reason for adjustment, and the repositioning performed. CMS assigns a 0-day global period, so routine preoperative and postoperative care on the procedure date is included. When multiple procedures occur in one session, CMS pays the highest-valued procedure in full and other procedures at 50%. Modifier 50 is inappropriate. Payment for an assistant at surgery, co-surgeons, or a surgical team requires supporting documentation.

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 33963 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

33963 office and facility rates by payment locality
Payment localityOfficeFacility
AlabamaUnavailable$389.95
AlaskaUnavailable$547.90
ArizonaUnavailable$416.41
ArkansasUnavailable$385.33
Atlanta, GAUnavailable$444.55
Austin, TXUnavailable$424.90
Bakersfield, CAUnavailable$412.93
Baltimore area, MDUnavailable$454.60
Beaumont, TXUnavailable$417.69
Brazoria, TXUnavailable$414.86

33963 rates by state

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

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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
33963 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 33963 rate is calculated

Each of 33963’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 · 33963

RVUs × geographic indexes × conversion factor

Office or facility?

Work8.78

8.78 RVUs× 1.000 GPCI

Practice expense1.95

1.95 RVUs× 1.000 GPCI

Malpractice2.10

2.10 RVUs× 1.000 GPCI

Adjusted RVUs

12.8300

Conversion factor

$33.4009

Medicare rate

$428.53

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

Payment rules and modifiers for 33963

The CMS indicators that decide how 33963 is paid alongside other services.

CMS payment indicators · 33963

ECMO cannula repositioning, peripheral cannula

RuleCMS valueWhat it means
Global period000Same-day global: pre- and post-op care on the day of the procedure is included.
Multiple procedures2Standard reduction: highest-valued procedure at 100%, others at 50%.
Bilateral (modifier 50)0The 150% bilateral adjustment doesn’t apply.
Assistant at surgery (80/81/82/AS)0Not paid without supporting documentation.
Co-surgeons (62)1Permitted with supporting documentation.
Team surgery (66)1Permitted with supporting documentation.
Professional/technical0Physician service: no professional/technical split.

What modifiers do to the payment

Modifier 51 · payment effect

With and without the modifier

33963 without 51 · national facility

$428.53

ECMO cannula repositioning, peripheral cannula

33963-51 · Second procedure: 50%

$214.27

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%).

When to use modifier 51

33963 compared with similar codes

Compare codes · National

4 codes, side by side

Office or facility?

  • 33963

    ECMO cannula repositioning, peripheral cannula8.78 wRVU

    Not priced

  • 33951

    ECMO cannulation, percutaneous, age 5 or older7.95 wRVU

    Not priced

  • 33965

    ECMO cannula removal, percutaneous, age five and older3.42 wRVU

    Not priced

  • 33949

    ECMO management, venoarterial support4.49 wRVU

    Not priced

How to choose

33951ECMO cannulationPercutaneous, age 5 or older
33951 concerns insertion of a peripheral ECMO or ECLS cannula. Report 33963 when the documented work repositions an existing peripheral cannula rather than places one.
33965ECMO cannula removalPercutaneous, age five and older
33965 concerns removal of a peripheral ECMO or ECLS cannula. Report 33963 when the cannula is adjusted for continued use.
33949ECMO managementVenoarterial support
33949 describes daily management of arterial ECMO or ECLS support. It does not describe the hands-on peripheral cannula repositioning reported with 33963.

Codes related to 33963

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

Codes related to 33963
CodeHow it relatesNational office range
Same family
33957ECMO cannula repositioning, percutaneous, venovenousAnother peripheral ECMO or ECLS cannula repositioning code; verify the documented procedure details.No office rate
33958Cannula repositioning, open, younger than six yearsA related peripheral cannula repositioning entry with different code-selection details.No office rate
33962ECMO cannula, peripheral repositioningA neighboring peripheral cannula repositioning entry; select from the documented procedure details.No office rate
33964Cannula repositioning, open approach, ages 5–17Another peripheral cannula repositioning entry in the ECMO or ECLS series.No office rate

33963 billing questions

When is 33963 reported instead of a peripheral cannula insertion code?

Use 33963 for repositioning an existing peripheral ECMO or ECLS cannula. Codes such as 33951 describe insertion rather than adjustment of a cannula already in place.

Does routine ECMO management support reporting 33963?

No. The record must describe a procedure that repositions the peripheral cannula; monitoring circuit performance alone does not establish that work.

Is same-day care separately included with 33963?

CMS assigns a 0-day global period, which includes routine preoperative and postoperative care on the procedure date.

Should modifier 50 be used if more than one peripheral cannula is adjusted?

No. CMS does not apply a bilateral adjustment to 33963, and modifier 50 is inappropriate.

What supports payment for additional surgeons on 33963?

An assistant at surgery requires documentation of medical necessity. Co-surgeons and team surgery also require supporting documentation.

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 33963PPRRVU2026_Oct_nonQPP.csv, line 4,148 (RVU26D)

Open CMS sourceHow we calculate rates

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