CPT code 33963: ECMO cannula repositioning, peripheral cannula2026 Medicare rate & RVUs in Texas
Report this procedure when a physician repositions an existing peripheral ECMO or ECLS cannula to address a documented positioning problem.
CMS doesn’t publish an office rate for 33963 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 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 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 | $424.90 |
| Beaumont, TX | Unavailable | $417.69 |
| Brazoria, TX | Unavailable | $414.86 |
| Dallas, TX | Unavailable | $420.95 |
| Fort Worth, TX | Unavailable | $421.21 |
| Galveston, TX | Unavailable | $418.36 |
| Houston, TX | Unavailable | $456.80 |
| Rest of Texas | Unavailable | $418.41 |
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
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
| 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) | 1 | Permitted with supporting documentation. |
| Team surgery (66) | 1 | Permitted with supporting documentation. |
| Professional/technical | 0 | Physician 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%).
33963 compared with similar codes
Compare codes · National
4 codes, side by side
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.
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
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