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Billing code 33954: ECMO cannulationMedicare rate & RVUs

Reports percutaneous placement of peripheral cannulae for ECMO or ECLS in a patient age six or older as part of extracorporeal support.

CMS RVU26DEffective Oct 1, 2026109 payment localities281 Medicare services in 2024

Medicare pays $431.87 for 33954 nationally in a facility.

Medicare rate · 33954

ECMO cannulation

Swap in your local Medicare rate.

Work RVUs
8.88
Total RVUs
12.93
Global days
000

National rate · 2026

$431.87

Facility setting, before claim adjustments.

See every locality for 33954 → · 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 33954 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 33954 covers

This service covers percutaneous placement of peripheral cannulae to establish extracorporeal membrane oxygenation or extracorporeal life support in patients age six and older. A cardiothoracic or vascular surgeon, or another physician qualified to perform the access, places cannulae through peripheral vessels; femoral vessels are common access sites. The service is performed in settings such as an operating room or intensive care unit when urgent circulatory or respiratory support is needed.

Select this code for percutaneous peripheral cannulation in the specified age group; use the applicable sibling code when the age group or insertion approach differs. Document the patient’s age, peripheral access site, percutaneous technique, and cannula placement. The 0-day global period includes same-day preoperative and postoperative care. 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% 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 33954 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

33954 office and facility rates by payment locality
Payment localityOfficeFacility
AlabamaUnavailable$393.29
Alaska*Unavailable$552.91
ArizonaUnavailable$419.75
ArkansasUnavailable$388.67
AtlantaUnavailable$447.90
AustinUnavailable$428.25
BakersfieldUnavailable$416.34
Baltimore/Surr. CntysUnavailable$458.00
BeaumontUnavailable$421.03
BrazoriaUnavailable$418.23

33954 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
33954 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 33954 rate is calculated

Each of 33954’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 · 33954

RVUs × geographic indexes × conversion factor

Swap in your local Medicare rate.

Work 8.88Practice expense 1.95Malpractice 2.10

12.9300 adjusted RVUs×$33.4009 conversion factor=$431.87

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

Payment rules and modifiers for 33954

The CMS indicators that decide how 33954 is paid alongside other services.

CMS payment indicators · 33954

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

33954 without 51 · national facility

$431.87

ECMO cannulation

33954-51 · Second procedure: 50%

$215.94

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

33954 compared with similar codes

Compare codes

33954 vs 33951 vs 33955 vs 33946: national Medicare rates

Swap in your local Medicare rate.

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

How to choose

33951ECMO cannulation
Both codes concern peripheral cannula insertion, but 33954 identifies the percutaneous approach for patients age six and older. Apply the sibling code criteria when the approach or age group differs.
33955Central cannulation
33954 covers percutaneous peripheral cannula placement; 33955 is in the central cannula insertion family.
33946ECMO initiation
33954 reports the percutaneous peripheral cannula placement. Code 33946 reports veno-venous ECMO/ECLS initiation, a distinct service when performed.

Codes related to 33954

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

Codes related to 33954
CodeHow it relatesNational office range
Same family
33951ECMO cannulationRelated peripheral cannula insertion code; distinguish by age group and insertion approach.No office rate
33952ECMO cannulationPeripheral cannula insertion sibling for a different patient age group.No office rate
33953ECMO cannulationPeripheral cannula insertion sibling for neonates.No office rate
Used instead
33955Central cannulationUse for central rather than peripheral cannula insertion.No office rate
Often billed with
33946ECMO initiationVeno-venous ECMO/ECLS initiation may accompany cannula placement when performed.No office rate
33947ECMO initiationVeno-arterial ECMO/ECLS initiation may accompany cannula placement when performed.No office rate

33954 billing questions

How does 33954 differ from 33951?

33954 is for percutaneous peripheral cannula insertion in a patient age six or older. Choose 33951 when the insertion approach and the patient’s age match that code’s criteria instead.

When should a central cannula insertion code be used instead?

Use the central cannula insertion family when cannulae are placed centrally rather than through peripheral vessels. Code 33954 describes percutaneous peripheral access.

Can this be reported with an ECMO/ECLS initiation code?

Peripheral cannula placement may be reported with the applicable initiation service when both services are performed and documented. Select the initiation code for the veno-venous or veno-arterial circuit.

Can modifier 50 be appended for cannulation on both sides?

No. The CMS bilateral adjustment does not apply, and modifier 50 is inappropriate for this code.

What documentation supports 33954?

Record the patient’s age, the peripheral vessel access site, the percutaneous approach, and the cannula placement performed for ECMO/ECLS.

May an assistant surgeon or co-surgeon be reported?

Assistant-at-surgery payment requires documentation of medical necessity. Co-surgeons and team surgery are not permitted.

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 33954PPRRVU2026_Oct_nonQPP.csv, line 4,140 (RVU26D)

Open CMS sourceHow we calculate rates

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