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CPT 33964: Cannula repositioningMedicare rate & RVUs

Reports open surgical repositioning of a peripheral ECMO or ECLS cannula in a patient aged 5 through 17 years.

CMS RVU26DEffective Oct 1, 2026109 payment localities

Medicare pays $451.58 for 33964 nationally in a facility.

Medicare rate · 33964

Cannula repositioning

Swap in your local Medicare rate.

Work RVUs
9.26
Total RVUs
13.52
Global days
000

National rate · 2026

$451.58

Facility setting, before claim adjustments.

See every locality for 33964 →

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 33964 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 33964 covers

This service covers surgically exposing and moving a peripheral cannula to a better position while extracorporeal membrane oxygenation or extracorporeal life support is in use. It is selected for patients ages 5 through 17 when the repositioning is performed through an open approach, rather than percutaneously. Cardiothoracic or other appropriately qualified surgeons typically perform it in an operating room or intensive care setting when cannula position needs correction to support the circuit or address a positioning problem.

Report the code for the open repositioning service, not for initial cannula placement or cannula removal alone. The record should identify the patient’s age, the peripheral cannula, the reason for repositioning, the open approach, and the repositioning performed. The code 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. Assistant-at-surgery, co-surgeon, and team-surgery payment require supporting documentation.

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 33964 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

33964 office and facility rates by payment locality
Payment localityOfficeFacility
AlabamaUnavailable$410.99
Alaska*Unavailable$577.53
ArizonaUnavailable$438.83
ArkansasUnavailable$406.12
AtlantaUnavailable$468.44
AustinUnavailable$447.76
BakersfieldUnavailable$435.17
Baltimore/Surr. CntysUnavailable$479.02
BeaumontUnavailable$440.18
BrazoriaUnavailable$437.20

33964 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
33964 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 33964 rate is calculated

Each of 33964’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 · 33964

RVUs × geographic indexes × conversion factor

Swap in your local Medicare rate.

Work 9.26Practice expense 2.05Malpractice 2.21

13.5200 adjusted RVUs×$33.4009 conversion factor=$451.58

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

Payment rules and modifiers for 33964

The CMS indicators that decide how 33964 is paid alongside other services.

CMS payment indicators · 33964

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)1Permitted with supporting documentation.
Team surgery (66)1Permitted with supporting documentation.
Professional/technical0Physician service: no professional/technical split.

What modifiers do to the payment

Modifier 51 · payment effect

With and without the modifier

33964 without 51 · national facility

$451.58

Cannula repositioning

33964-51 · Second procedure: 50%

$225.79

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

33964 compared with similar codes

Compare codes

33964 vs 33959 vs 33963 vs 33965: national Medicare rates

Swap in your local Medicare rate.

  • 33964
    Cannula repositioning · 9.26 wRVU
    —
  • 33959
    Cannula repositioning · 4.36 wRVU
    —
  • 33963
    ECMO cannula repositioning · 8.78 wRVU
    —
  • 33965
    ECMO cannula removal · 3.42 wRVU
    —

How to choose

33959Cannula repositioning
Both codes cover peripheral cannula repositioning in patients ages 5 through 17. Choose 33964 for an open approach and 33959 for a percutaneous approach.
33963ECMO cannula repositioning
This is the open repositioning sibling for patients younger than 5 years; 33964 is for patients ages 5 through 17.
33965ECMO cannula removal
33965 reports peripheral cannula removal. Use 33964 when the service is repositioning the cannula rather than removing it.

Codes related to 33964

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

Codes related to 33964
CodeHow it relatesNational office range
Same family
33962ECMO cannulaOpen peripheral cannula repositioning for patients 18 years and older.No office rate
33963ECMO cannula repositioningOpen peripheral cannula repositioning for patients younger than 5 years.No office rate
Used instead
33959Cannula repositioningPercutaneous repositioning option for patients ages 5 through 17.No office rate

33964 billing questions

How do I distinguish this code from 33959?

Both describe peripheral cannula repositioning for patients ages 5 through 17. Use this code for an open approach and 33959 for a percutaneous approach.

Is this code for initial cannula placement?

No. It describes repositioning a cannula already in place. Initial peripheral cannula insertion is reported with an insertion code, such as 33951–33954, based on the applicable approach and patient age.

Does the 0-day global include same-day care?

Yes. Same-day preoperative and postoperative care is included in this minor procedure’s 0-day global period.

Can modifier 50 be used when more than one cannula is repositioned?

No. Bilateral adjustment does not apply to this code, and modifier 50 is inappropriate. Document the cannula or cannulae repositioned and the work performed.

When is an assistant or co-surgeon payable?

Assistant-at-surgery payment requires documentation of medical necessity. Co-surgeon and team-surgery payment also require supporting documentation.

How are other procedures in the same session paid?

The highest-valued procedure is paid in full; other procedures in the same session are subject to the standard multiple-procedure reduction.

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 33964PPRRVU2026_Oct_nonQPP.csv, line 4,149 (RVU26D)

Open CMS sourceHow we calculate rates

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