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Billing code 33966: ECMO cannula removalMedicare rate & RVUs

Reports open surgical removal of peripheral ECMO or ECLS cannulae when extracorporeal support ends and the cannula is removed through an operative approach.

CMS RVU26DEffective Oct 1, 2026109 payment localities637 Medicare services in 2024

Medicare pays $215.77 for 33966 nationally in a facility.

Medicare rate · 33966

ECMO cannula removal

Swap in your local Medicare rate.

Work RVUs
4.39
Total RVUs
6.46
Global days
000

National rate · 2026

$215.77

Facility setting, before claim adjustments.

See every locality for 33966 → · 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 33966 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 33966 covers

This service covers surgical removal of peripheral cannulae used for extracorporeal membrane oxygenation or extracorporeal life support. A surgeon, commonly a cardiothoracic or vascular surgeon, removes the cannula through an open approach, typically in a hospital operating room or intensive care setting when a patient is ready to come off extracorporeal support. The service concerns removal of the cannula, not its initial placement or repositioning.

Select this code when the documented removal uses an open approach and matches the code’s cannula and patient criteria; distinguish it from the percutaneous removal variant. The operative note should identify the peripheral cannula removed and describe the open removal. 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 50% multiple-procedure 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 33966 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

33966 office and facility rates by payment locality
Payment localityOfficeFacility
AlabamaUnavailable$196.50
Alaska*Unavailable$275.90
ArizonaUnavailable$209.74
ArkansasUnavailable$194.19
AtlantaUnavailable$223.68
AustinUnavailable$214.16
BakersfieldUnavailable$208.44
Baltimore/Surr. CntysUnavailable$228.81
BeaumontUnavailable$210.20
BrazoriaUnavailable$209.06

33966 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
33966 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 33966 rate is calculated

Each of 33966’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 · 33966

RVUs × geographic indexes × conversion factor

Swap in your local Medicare rate.

Work 4.39Practice expense 1.04Malpractice 1.03

6.4600 adjusted RVUs×$33.4009 conversion factor=$215.77

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

Payment rules and modifiers for 33966

The CMS indicators that decide how 33966 is paid alongside other services.

CMS payment indicators · 33966

ECMO cannula removal

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

33966 without 51 · national facility

$215.77

ECMO cannula removal

33966-51 · Second procedure: 50%

$107.89

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

33966 compared with similar codes

Compare codes

33966 vs 33965 vs 33969 vs 33957 vs 33952: national Medicare rates

Swap in your local Medicare rate.

  • 33966
    ECMO cannula removal · 4.39 wRVU
    —
  • 33965
    ECMO cannula removal · 3.42 wRVU
    —
  • 33969
    ECMO cannula removal · 5.09 wRVU
    —
  • 33957
    ECMO cannula repositioning · 3.42 wRVU
    —
  • 33952
    ECMO cannulation · 7.95 wRVU
    —

How to choose

33965ECMO cannula removal
Use 33965 for percutaneous peripheral cannula removal. This code describes removal through an open approach.
33969ECMO cannula removal
Both are peripheral cannula-removal codes. Apply the specific cannula and patient criteria in the applicable descriptor to select between them.
33957ECMO cannula repositioning
33957 represents repositioning a peripheral ECMO/ECLS cannula, not removing it from the patient.
33952ECMO cannulation
33952 is a peripheral cannula insertion code. Choose it for placement, not decannulation.

Codes related to 33966

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

Codes related to 33966
CodeHow it relatesNational office range
Same family
33965ECMO cannula removalPeripheral ECMO/ECLS cannula removal by percutaneous rather than open approach.No office rate
33969ECMO cannula removalAnother peripheral ECMO/ECLS cannula-removal code in the same code family.No office rate
Often billed with
33948ECMO managementDaily ECMO/ECLS management may be reported for a qualifying management service on the removal date.No office rate

33966 billing questions

How is this code distinguished from 33965?

This code is for open removal of peripheral ECMO/ECLS cannulae; 33965 is the percutaneous removal counterpart. Use the approach documented in the operative report.

Does this code include initial cannula placement or repositioning?

No. It represents cannula removal. Placement and repositioning are separate services with their own codes and documentation requirements.

What does the 0-day global period include?

Same-day preoperative and postoperative care is included. The global period does not extend beyond the day of the procedure.

Can an assistant surgeon be reported?

Assistant-at-surgery payment is allowed only when medical necessity is documented. Co-surgeons and team surgery are not permitted under the CMS rules for this code.

Can modifier 50 be used for bilateral removal?

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

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 33966PPRRVU2026_Oct_nonQPP.csv, line 4,151 (RVU26D)

Open CMS sourceHow we calculate rates

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