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Billing code 33953: ECMO cannulationMedicare rate & RVUs

Reports open placement of peripheral cannulae for ECMO or ECLS in patients age six and older, rather than percutaneous or central cannulation.

CMS RVU26DEffective Oct 1, 2026109 payment localities

Medicare pays $433.21 for 33953 nationally in a facility.

Medicare rate · 33953

ECMO cannulation

Swap in your local Medicare rate.

Work RVUs
8.88
Total RVUs
12.97
Global days
000

National rate · 2026

$433.21

Facility setting, before claim adjustments.

See every locality for 33953 → · 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 33953 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 33953 covers

This service covers open surgical insertion of peripheral cannulae to establish extracorporeal membrane oxygenation or extracorporeal life support. It is used when a patient age six or older needs extracorporeal cardiopulmonary support and the cannulae are placed through an open approach, such as surgical exposure of peripheral vessels. Cardiothoracic or vascular surgeons typically perform the procedure in a hospital setting during urgent support for severe cardiac or respiratory failure.

Select this code based on the patient’s age, peripheral cannula location, and open technique; percutaneous insertion and central cannulation are coded separately. The operative report should document the open approach, cannula placement, and the patient’s age. The service 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 multiple procedure reduction. Modifier 50 is inappropriate for this descriptor and anatomy. 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 33953 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

33953 office and facility rates by payment locality
Payment localityOfficeFacility
AlabamaUnavailable$394.25
Alaska*Unavailable$553.99
ArizonaUnavailable$420.97
ArkansasUnavailable$389.59
AtlantaUnavailable$449.39
AustinUnavailable$429.55
BakersfieldUnavailable$417.48
Baltimore/Surr. CntysUnavailable$459.54
BeaumontUnavailable$422.26
BrazoriaUnavailable$419.41

33953 rates by state

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

MEWIVTNHMTNDMNMINYMARIWAIDWYSDIAILINOHPANJCTORNVUTCONEMOKYWVVAMDDECAAZNMKSOKARTNNCSCDCTXLAMSALGAFLAKHI

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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.

View every state and territory as a table
33953 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 33953 rate is calculated

Each of 33953’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 · 33953

RVUs × geographic indexes × conversion factor

Swap in your local Medicare rate.

Work 8.88Practice expense 1.97Malpractice 2.12

12.9700 adjusted RVUs×$33.4009 conversion factor=$433.21

All indexes start at 1.000 (the national rate). Enter a ZIP or drag a slider.

Payment rules and modifiers for 33953

The CMS indicators that decide how 33953 is paid alongside other services.

CMS payment indicators · 33953

ECMO cannulation

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

33953 without 51 · national facility

$433.21

ECMO cannulation

33953-51 · Second procedure: 50%

$216.61

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

33953 compared with similar codes

Compare codes

33953 vs 33951 vs 33954 vs 33955 vs 33946: national Medicare rates

Swap in your local Medicare rate.

  • 33953
    ECMO cannulation · 8.88 wRVU
    —
  • 33951
    ECMO cannulation · 7.95 wRVU
    —
  • 33954
    ECMO cannulation · 8.88 wRVU
    —
  • 33955
    Central cannulation · 15.6 wRVU
    —
  • 33946
    ECMO initiation · 5.85 wRVU
    —

How to choose

33951ECMO cannulation
Both cover peripheral cannula insertion for patients age six and older. Choose 33953 for an open approach and 33951 for a percutaneous approach.
33954ECMO cannulation
This is the open peripheral insertion code for patients age five and younger; 33953 is for patients age six and older.
33955Central cannulation
33955 describes open central cannula insertion in patients age six and older. Use 33953 when the cannulae are placed peripherally.
33946ECMO initiation
33946 reports venovenous ECMO/ECLS initiation, not open peripheral cannula insertion. The services may be reported separately when both are performed.

Codes related to 33953

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

Codes related to 33953
CodeHow it relatesNational office range
Same family
33951ECMO cannulationOpen versus percutaneous approach distinguishes these peripheral cannula insertion codes for patients age six and older.No office rate
33954ECMO cannulationOpen peripheral cannula insertion for patients age five and younger.No office rate
33955Central cannulationOpen central cannula insertion for patients age six and older.No office rate
Often billed with
33946ECMO initiationVenovenous ECMO/ECLS initiation may be reported when that separate service is performed.No office rate
33947ECMO initiationVenoarterial ECMO/ECLS initiation may be reported when that separate service is performed.No office rate

33953 billing questions

When should 33953 be selected instead of 33951?

Use 33953 for open peripheral cannula insertion in a patient age six or older. Code 33951 describes percutaneous insertion for that age group.

How does 33953 differ from 33954?

Both describe open peripheral cannula insertion, but 33954 is for patients age five and younger; 33953 is for patients age six and older.

Is central cannula placement reported with 33953?

No. This code is for peripheral cannulae; open central cannula insertion is represented by 33955 for patients age six and older.

Can cannula insertion and ECMO initiation be reported together?

Cannula insertion and ECMO/ECLS initiation describe distinct services and may be reported together when both are performed and documented. The initiation code depends on the support configuration.

What documentation supports reporting 33953?

The operative report should establish the patient’s age, the peripheral location, and that cannulae were inserted using an open surgical approach.

Can an assistant surgeon be paid for 33953?

Assistant-at-surgery payment is available only when the record documents medical necessity. Co-surgeons and team surgery are not permitted for this code.

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 33953PPRRVU2026_Oct_nonQPP.csv, line 4,139 (RVU26D)

Open CMS sourceHow we calculate rates

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