CPT code 33947: ECMO initiation2026 Medicare rate & RVUs

Medicare pays $308.29 for 33947 nationally in a facility.

Medicare allowed amount for participating (non-QP) physicians, before deductible, coinsurance and claim adjustments. Not a patient’s bill or a hospital charge.

What 33947 covers

This service covers starting venoarterial extracorporeal membrane oxygenation or extracorporeal life support, which returns oxygenated blood to the arterial circulation while supporting cardiac and respiratory function. Cardiothoracic or vascular surgeons and other physicians involved in ECMO care may perform the initiation in an intensive care unit, operating room, or emergency setting. Typical circumstances include cardiogenic shock, cardiac arrest, or inability to separate from cardiopulmonary bypass when temporary extracorporeal support is needed.

Report 33947 for the initiation phase, not for ongoing daily management. The record should establish the clinical need for support, the venoarterial configuration, and the physician’s role in starting the circuit. Cannula insertion has its own codes when that work is performed and separately reportable; identify the cannula site and procedure in the documentation. CMS rules supplied for this code list no specific add-on, global-period, component, or reduction rule, so the code-specific facts here do not establish a separate payment adjustment or bundling instruction.

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 33947 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

33947 rates by state

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

How the 33947 rate is calculated

Each of 33947’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.

Payment rules and modifiers for 33947

33947 has no global surgery period, no multiple-procedure, bilateral or assistant-at-surgery adjustment, and no professional/technical split. What changes the payment is where the service happens: the place of service on the claim decides whether Medicare pays the office or the facility rate.

33947 compared with similar codes

How to choose

33946ECMO initiation

Both codes report ECMO/ECLS initiation; 33947 is for venoarterial support, while 33946 is for venovenous support.

33949ECMO management

33949 is for daily management of venoarterial ECMO/ECLS, not starting the circuit.

33951ECMO cannulation

33951 represents peripheral cannula insertion. It describes cannulation work rather than the initiation service reported by 33947.

33955Central cannulation

33955 represents central cannula insertion, whereas 33947 reports initiation of venoarterial ECMO/ECLS.

Codes related to 33947

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

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

Open CMS sourceHow we calculate rates