CPT code 33966: ECMO cannula removal, peripheral, open approach2026 Medicare rate & RVUs in Texas
Reports open surgical removal of peripheral ECMO or ECLS cannulae when extracorporeal support ends and the cannula is removed through an operative approach.
CMS doesn’t publish an office rate for 33966 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 33966 covers
This service covers surgical removal of peripheral cannulae used for extracorporeal membrane oxygenation or extracorporeal life support. A surgeon, commonly a cardiothoracic or vascular surgeon, removes the cannula through an open approach, typically in a hospital operating room or intensive care setting when a patient is ready to come off extracorporeal support. The service concerns removal of the cannula, not its initial placement or repositioning.
Select this code when the documented removal uses an open approach and matches the code’s cannula and patient criteria; distinguish it from the percutaneous removal variant. The operative note should identify the peripheral cannula removed and describe the open removal. CMS assigns 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. 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.
Where 33966 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 | $214.16 |
| Beaumont, TX | Unavailable | $210.20 |
| Brazoria, TX | Unavailable | $209.06 |
| Dallas, TX | Unavailable | $212.07 |
| Fort Worth, TX | Unavailable | $212.17 |
| Galveston, TX | Unavailable | $210.78 |
| Houston, TX | Unavailable | $229.64 |
| Rest of Texas | Unavailable | $210.66 |
How the 33966 rate is calculated
Each of 33966’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 · 33966
RVUs × geographic indexes × conversion factor
Work4.39
4.39 RVUs× 1.000 GPCI
Practice expense1.04
1.04 RVUs× 1.000 GPCI
Malpractice1.03
1.03 RVUs× 1.000 GPCI
Adjusted RVUs
6.4600
Conversion factor
$33.4009
Medicare rate
$215.77
Every GPCI starts at 1.000, the national rate. Enter a ZIP or drag a slider.
Payment rules and modifiers for 33966
The CMS indicators that decide how 33966 is paid alongside other services.
CMS payment indicators · 33966
ECMO cannula removal, peripheral, open approach
| 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
33966 without 51 · national facility
$215.77
ECMO cannula removal, peripheral, open approach
33966-51 · Second procedure: 50%
$107.89
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%).
33966 compared with similar codes
Compare codes · National
5 codes, side by side
How to choose
- 33965ECMO cannula removalPercutaneous, age five and older
- Use 33965 for percutaneous peripheral cannula removal. This code describes removal through an open approach.
- 33969ECMO cannula removalPeripheral, percutaneous
- Both are peripheral cannula-removal codes. Apply the specific cannula and patient criteria in the applicable descriptor to select between them.
- 33957ECMO cannula repositioningPercutaneous, venovenous
- 33957 represents repositioning a peripheral ECMO/ECLS cannula, not removing it from the patient.
- 33952ECMO cannulationPeripheral, percutaneous, younger than five
- 33952 is a peripheral cannula insertion code. Choose it for placement, not decannulation.
33966 billing questions
How is this code distinguished from 33965?
This code is for open removal of peripheral ECMO/ECLS cannulae; 33965 is the percutaneous removal counterpart. Use the approach documented in the operative report.
Does this code include initial cannula placement or repositioning?
No. It represents cannula removal. Placement and repositioning are separate services with their own codes and documentation requirements.
What does the 0-day global period include?
Same-day preoperative and postoperative care is included. The global period does not extend beyond the day of the procedure.
Can an assistant surgeon be reported?
Assistant-at-surgery payment is allowed only when medical necessity is documented. Co-surgeons and team surgery are not permitted under the CMS rules for this code.
Can modifier 50 be used for bilateral removal?
No. The CMS bilateral adjustment does not apply, and modifier 50 is inappropriate for this descriptor and anatomy.
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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