CPT code 33965: ECMO cannula removal, percutaneous, age five and older2026 Medicare rate & RVUs

Reports percutaneous removal of peripheral ECMO or ECLS cannulae in patients age five and older when extracorporeal support is discontinued.

CMS RVU26DEffective Oct 1, 2026109 payment localities

Medicare pays $170.01 for 33965 nationally in a facility.

Medicare rate · 33965

ECMO cannula removal, percutaneous, age five and older

Office or facility?

Work RVUs
3.42
Total RVUs
5.09
Global days
000

National rate · 2026

$170.01

Facility setting, before claim adjustments.

See every locality for 33965 →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 33965 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 33965 covers

This service covers percutaneous removal of peripheral cannulae used for extracorporeal membrane oxygenation or extracorporeal life support in a patient age five or older. It is performed when the patient no longer needs extracorporeal support, often in an intensive care unit or procedure setting. The physician removes the cannulae through the percutaneous access sites and manages hemostasis. Cardiovascular and vascular surgeons, along with other physicians involved in ECMO care, may perform the procedure.

Select this code for percutaneous removal in the specified age group; document the patient’s age, the ECMO/ECLS indication, the peripheral cannulae removed, and the percutaneous approach. The code has a 0-day global period, so same-day preoperative and postoperative care is included. 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% multiple-procedure reduction. Modifier 50 is inappropriate for this service. An assistant at surgery is payable only when medical necessity is documented; 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.

Where 33965 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

33965 office and facility rates by payment locality
Payment localityOfficeFacility
AlabamaUnavailable$154.58
AlaskaUnavailable$216.67
ArizonaUnavailable$165.19
ArkansasUnavailable$152.72
Atlanta, GAUnavailable$176.31
Austin, TXUnavailable$168.76
Bakersfield, CAUnavailable$164.20
Baltimore area, MDUnavailable$180.40
Beaumont, TXUnavailable$165.51
Brazoria, TXUnavailable$164.64

33965 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.

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33965 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 33965 rate is calculated

Each of 33965’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 · 33965

RVUs × geographic indexes × conversion factor

Office or facility?

Work3.42

3.42 RVUs× 1.000 GPCI

Practice expense0.85

0.85 RVUs× 1.000 GPCI

Malpractice0.82

0.82 RVUs× 1.000 GPCI

Adjusted RVUs

5.0900

Conversion factor

$33.4009

Medicare rate

$170.01

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

Payment rules and modifiers for 33965

The CMS indicators that decide how 33965 is paid alongside other services.

CMS payment indicators · 33965

ECMO cannula removal, percutaneous, age five and older

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)0Not permitted.
Team surgery (66)0Not permitted.
Professional/technical0Physician service: no professional/technical split.

What modifiers do to the payment

Modifier 51 · payment effect

With and without the modifier

33965 without 51 · national facility

$170.01

ECMO cannula removal, percutaneous, age five and older

33965-51 · Second procedure: 50%

$85.01

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

33965 compared with similar codes

Compare codes · National

5 codes, side by side

Office or facility?

  • 33965

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

    Not priced

  • 33966

    ECMO cannula removal, peripheral, open approach4.39 wRVU

    Not priced

  • 33969

    ECMO cannula removal, peripheral, percutaneous5.09 wRVU

    Not priced

  • 33951

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

    Not priced

  • 33957

    ECMO cannula repositioning, percutaneous, venovenous3.42 wRVU

    Not priced

How to choose

33966ECMO cannula removalPeripheral, open approach
Both describe percutaneous peripheral ECMO/ECLS cannula removal; choose 33965 for patients age five and older and 33966 for younger patients.
33969ECMO cannula removalPeripheral, percutaneous
This code represents percutaneous removal. Code 33969 is the open approach to peripheral ECMO/ECLS cannula removal.
33951ECMO cannulationPercutaneous, age 5 or older
Code 33951 covers percutaneous insertion of peripheral ECMO/ECLS cannulae, not their removal after support ends.
33957ECMO cannula repositioningPercutaneous, venovenous
Code 33957 describes percutaneous repositioning of peripheral cannulae that remain in use; 33965 describes their removal.

33965 billing questions

How does this code differ from 33966?

This code is for percutaneous removal in patients age five and older. Code 33966 is the corresponding percutaneous removal code for patients younger than five.

When is removal reported instead of repositioning?

Report removal when the peripheral ECMO/ECLS cannulae are taken out after support ends. Repositioning codes describe changing cannula position while the cannulae remain in use.

What documentation supports the percutaneous approach?

Record the ECMO/ECLS indication, the peripheral cannulae removed, the patient's age, and that removal was performed percutaneously.

Can an assistant surgeon be reported?

An assistant at surgery is payable only when the record supports medical necessity. Co-surgeons and team surgery are not permitted for this code.

How does the 0-day global period affect same-day care?

Same-day preoperative and postoperative care is included in the procedure. The 0-day global period does not include care on later dates.

How are other procedures in the same session paid?

The highest-valued procedure is paid in full, and other procedures in the session are subject to the standard 50% multiple-procedure reduction.

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 33965PPRRVU2026_Oct_nonQPP.csv, line 4,150 (RVU26D)

Open CMS sourceHow we calculate rates

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