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Billing code 33948: ECMO managementMedicare rate & RVUs

Report this service for a physician’s ongoing daily management of venovenous ECMO supporting a patient with severe respiratory failure.

CMS RVU26DEffective Oct 1, 2026109 payment localities5.9K Medicare services in 2024

Medicare pays $217.11 for 33948 nationally in a facility.

Medicare rate · 33948

ECMO management

Work RVUs
4.61
Total RVUs
6.50
Global days
XXX

National rate · 2026

$217.11

Facility setting, before claim adjustments.

See every locality for 33948 →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.

On this page 10 sections
  1. Medicare rate
  2. What 33948 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 33948 covers

This service covers a physician’s ongoing management of venovenous extracorporeal membrane oxygenation or extracorporeal life support. Venovenous support drains blood from and returns it to the venous circulation, typically to provide oxygenation and carbon dioxide removal in severe respiratory failure. Intensivists, cardiothoracic surgeons, and other physicians directing ECMO care may perform this work in an intensive care setting. Management may include assessing the patient’s response, reviewing circuit function and relevant clinical data, and directing changes to support settings or treatment.

Report 33948 for a date on which the physician provides daily management while venovenous support is ongoing; it is not the code for starting support or placing cannulas. Documentation should identify the venovenous configuration and date, and describe the physician’s management work, such as assessment of the patient and circuit and decisions about continued support or adjustments. The service is distinct in purpose from the initial setup and cannulation procedures.

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 33948 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

33948 office and facility rates by payment locality
Payment localityOfficeFacility
AlabamaUnavailable$200.85
Alaska*Unavailable$284.29
ArizonaUnavailable$212.09
ArkansasUnavailable$198.90
AtlantaUnavailable$223.58
AustinUnavailable$216.42
BakersfieldUnavailable$212.92
Baltimore/Surr. CntysUnavailable$228.61
BeaumontUnavailable$211.94
BrazoriaUnavailable$212.06

33948 rates by state

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

MEWIVTNHMTNDMNMINYMARIWAIDWYSDIAILINOHPANJCTORNVUTCONEMOKYWVVAMDDECAAZNMKSOKARTNNCSCDCTXLAMSALGAFLAKHI

Explore a state

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
33948 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 33948 rate is calculated

Each of 33948’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 · 33948

RVUs × geographic indexes × conversion factor

Work4.61

4.61 RVUs× 1.000 GPCI

Practice expense1.08

1.08 RVUs× 1.000 GPCI

Malpractice0.81

0.81 RVUs× 1.000 GPCI

Adjusted RVUs

6.5000

Conversion factor

$33.4009

Medicare rate

$217.11

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

Payment rules and modifiers for 33948

33948 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.

Place of service · 33948

Which rate does Medicare pay?

The POS code on the claim line (CMS-1500 box 24B).

POS 11 · non-facility rate · national

—

33948 isn’t priced in this setting.

33948 compared with similar codes

Compare codes · National

4 codes, side by side

  • 33948

    ECMO management4.61 wRVU

    Not priced

  • 33946

    ECMO initiation5.85 wRVU

    Not priced

  • 33949

    ECMO management4.49 wRVU

    Not priced

  • 33947

    ECMO initiation6.46 wRVU

    Not priced

How to choose

33946ECMO initiation
33946 describes initiating venovenous support; 33948 describes subsequent daily physician management while that support continues.
33949ECMO management
Both codes describe daily ECMO/ECLS management, but 33948 is for venovenous support and 33949 is for arterial support.
33947ECMO initiation
33947 describes initiation of arterial support. It is not the daily management code for venovenous ECMO.

Codes related to 33948

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

Codes related to 33948
CodeHow it relatesNational office range
Same family
33946ECMO initiationInitiation of venovenous ECMO/ECLS, rather than ongoing daily management.No office rate
33949ECMO managementDaily management for arterial ECMO/ECLS.No office rate
33947ECMO initiationInitiation of arterial ECMO/ECLS.No office rate
Often billed with
33951ECMO cannulationPeripheral cannula insertion is a separate procedure when performed during ECMO setup.No office rate
33955Central cannulationCentral cannula insertion is a separate procedure when performed during ECMO setup.No office rate

33948 billing questions

How does 33948 differ from 33946?

33946 describes initiation of venovenous ECMO/ECLS. Use 33948 for the physician’s ongoing daily management after support has been initiated.

When should 33949 be used instead?

33949 is for daily management of arterial ECMO/ECLS. Select 33948 when the support configuration is venovenous.

Does 33948 include cannula placement?

No. The daily management service concerns ongoing physician oversight; cannula insertion is described by separate cannulation codes when that procedure is performed.

How often is 33948 reported?

It represents daily management, so documentation should support the physician’s work for the date reported rather than counting individual circuit adjustments as separate services.

What documentation supports 33948?

Document the venovenous configuration, date of management, patient and circuit assessment, and the physician’s decisions or direction regarding ongoing ECMO support.

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 33948PPRRVU2026_Oct_nonQPP.csv, line 4,134 (RVU26D)

Open CMS sourceHow we calculate rates

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