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Billing code 33958: Cannula repositioningMedicare rate & RVUs

Reports open repositioning of an existing peripheral ECMO/ECLS cannula in a patient younger than six years when its position requires surgical correction.

CMS RVU26DEffective Oct 1, 2026109 payment localities80 Medicare services in 2024

Medicare pays $170.01 for 33958 nationally in a facility.

Medicare rate · 33958

Cannula repositioning

Swap in your local Medicare rate.

Work RVUs
3.42
Total RVUs
5.09
Global days
000

National rate · 2026

$170.01

Facility setting, before claim adjustments.

See every locality for 33958 → · 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 33958 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 33958 covers

This service covers surgically repositioning an existing peripheral cannula used for extracorporeal membrane oxygenation or extracorporeal life support in a patient younger than six years. A surgeon may adjust a cannula in a peripheral vessel, such as a cervical or femoral vessel, when its position needs correction during ECMO/ECLS support. The procedure is typically performed in a hospital operating room or intensive care setting by a cardiac or vascular surgeon.

Select this code for open repositioning in the specified age group, not for initial cannula placement, percutaneous repositioning, central cannula repositioning, or cannula removal. The operative report should identify the patient’s age, the peripheral cannula, the open approach, and the repositioning performed. 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 multiple procedure reduction. Modifier 50 is not appropriate. Assistant-at-surgery payment requires medical-necessity documentation; 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 33958 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

33958 office and facility rates by payment locality
Payment localityOfficeFacility
AlabamaUnavailable$154.58
Alaska*Unavailable$216.67
ArizonaUnavailable$165.19
ArkansasUnavailable$152.72
AtlantaUnavailable$176.31
AustinUnavailable$168.76
BakersfieldUnavailable$164.20
Baltimore/Surr. CntysUnavailable$180.40
BeaumontUnavailable$165.51
BrazoriaUnavailable$164.64

33958 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.

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33958 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 33958 rate is calculated

Each of 33958’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 · 33958

RVUs × geographic indexes × conversion factor

Swap in your local Medicare rate.

Work 3.42Practice expense 0.85Malpractice 0.82

5.0900 adjusted RVUs×$33.4009 conversion factor=$170.01

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

Payment rules and modifiers for 33958

The CMS indicators that decide how 33958 is paid alongside other services.

CMS payment indicators · 33958

Cannula repositioning

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

33958 without 51 · national facility

$170.01

Cannula repositioning

33958-51 · Second procedure: 50%

$85.01

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

33958 compared with similar codes

Compare codes

33958 vs 33957 vs 33962 vs 33951 vs 33965: national Medicare rates

Swap in your local Medicare rate.

  • 33958
    Cannula repositioning · 3.42 wRVU
    —
  • 33957
    ECMO cannula repositioning · 3.42 wRVU
    —
  • 33962
    ECMO cannula · 4.36 wRVU
    —
  • 33951
    ECMO cannulation · 7.95 wRVU
    —
  • 33965
    ECMO cannula removal · 3.42 wRVU
    —

How to choose

33957ECMO cannula repositioning
Both describe open repositioning of a peripheral ECMO/ECLS cannula; 33958 is for patients younger than six years, while 33957 is for patients six years and older.
33962ECMO cannula
This is the percutaneous counterpart for patients younger than six years. Choose 33958 when the repositioning is performed through an open approach.
33951ECMO cannulation
33951 describes insertion of a peripheral ECMO/ECLS cannula, not adjustment of an existing cannula’s position.
33965ECMO cannula removal
33965 describes removal of a peripheral cannula. Use 33958 when the existing cannula is repositioned rather than removed.

Codes related to 33958

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

Codes related to 33958
CodeHow it relatesNational office range
Same family
33957ECMO cannula repositioningOpen peripheral cannula repositioning for patients six years and older.No office rate
33964Cannula repositioningOpen central cannula repositioning for patients younger than six years.No office rate
Used instead
33959Cannula repositioningPercutaneous peripheral cannula repositioning for patients six years and older.No office rate
33962ECMO cannulaPercutaneous peripheral cannula repositioning for patients younger than six years.No office rate

33958 billing questions

When should this code be selected instead of 33957?

Use 33958 for open repositioning of a peripheral cannula in a patient younger than six years. Code 33957 describes the corresponding open service for patients six years and older.

How does this differ from 33962?

Both codes describe peripheral cannula repositioning for patients younger than six years, but 33958 is the open approach and 33962 is the percutaneous approach.

Is this code for placing or removing a cannula?

No. It describes repositioning an existing peripheral cannula. Initial placement and cannula removal are separate services with their own codes.

What should the operative report document?

Document the patient’s age, that the cannula is peripheral, the open approach, and the repositioning performed. The record should distinguish repositioning from insertion or removal.

Can an assistant-at-surgery be reported?

CMS pays an assistant at surgery only when medical necessity is documented. Co-surgeons and team surgery are not permitted for this code.

How does the 0-day global period affect same-day care?

Same-day preoperative and postoperative care is included in the procedure. CMS applies the standard multiple procedure reduction when other procedures are performed in the same session.

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 33958PPRRVU2026_Oct_nonQPP.csv, line 4,144 (RVU26D)

Open CMS sourceHow we calculate rates

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