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Billing code 33984: ECMO cannula removalMedicare rate & RVUs

Report open surgical removal of peripheral cannulae used for ECMO or ECLS when extracorporeal support is discontinued.

CMS RVU26DEffective Oct 1, 2026109 payment localities533 Medicare services in 2024

Medicare pays $258.52 for 33984 nationally in a facility.

Medicare rate · 33984

ECMO cannula removal

Work RVUs
5.32
Total RVUs
7.74
Global days
000

National rate · 2026

$258.52

Facility setting, before claim adjustments.

See every locality for 33984 →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 33984 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 33984 covers

This service is the open surgical decannulation of peripheral extracorporeal membrane oxygenation or extracorporeal life support access. After support has ended, a surgeon exposes the access site, removes the cannula or cannulae, and manages the vessel and surrounding tissues. Common peripheral access sites include the femoral vessels; peripheral venous access may also be through the neck. The work is typically performed in a hospital operating room or intensive care setting by a surgeon familiar with vascular or cardiothoracic procedures.

Select this code when the removed ECMO/ECLS cannulae are peripheral and the removal is performed open. The operative report should identify the support system, access site, peripheral location, and removal approach. The code has a 0-day global period, so same-day preoperative and postoperative care is included. When other procedures occur in the same session, CMS pays the highest-valued procedure in full and reduces the others. Assistant-at-surgery payment requires documented medical necessity; co-surgeon and team-surgery reporting are not permitted. Modifier 50 is inappropriate for this descriptor.

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 33984 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

33984 office and facility rates by payment locality
Payment localityOfficeFacility
AlabamaUnavailable$234.90
Alaska*Unavailable$330.13
ArizonaUnavailable$251.07
ArkansasUnavailable$232.07
AtlantaUnavailable$268.44
AustinUnavailable$256.04
BakersfieldUnavailable$248.35
Baltimore/Surr. CntysUnavailable$274.44
BeaumontUnavailable$252.08
BrazoriaUnavailable$249.98

33984 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
33984 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 33984 rate is calculated

Each of 33984’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 · 33984

RVUs × geographic indexes × conversion factor

Work5.32

5.32 RVUs× 1.000 GPCI

Practice expense1.11

1.11 RVUs× 1.000 GPCI

Malpractice1.31

1.31 RVUs× 1.000 GPCI

Adjusted RVUs

7.7400

Conversion factor

$33.4009

Medicare rate

$258.52

Every GPCI starts at 1.000, the national rate. Enter a ZIP or drag a slider.

Payment rules and modifiers for 33984

The CMS indicators that decide how 33984 is paid alongside other services.

CMS payment indicators · 33984

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

33984 without 51 · national facility

$258.52

ECMO cannula removal

33984-51 · Second procedure: 50%

$129.26

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

33984 compared with similar codes

Compare codes · National

4 codes, side by side

  • 33984

    ECMO cannula removal5.32 wRVU

    Not priced

  • 33985

    ECMO cannula removal9.64 wRVU

    Not priced

  • 33986

    ECMO cannula removal9.75 wRVU

    Not priced

  • 33992

    VAD removal3.46 wRVU

    Not priced

How to choose

33985ECMO cannula removal
Use 33985 for open removal of central ECMO/ECLS cannulae; 33984 describes peripheral cannula removal.
33986ECMO cannula removal
33986 is for central cannula removal with vessel repair, with or without patch graft; 33984 is for peripheral cannula removal.
33992VAD removal
33992 describes removal of a percutaneous left-heart VAD, not open removal of peripheral ECMO/ECLS cannulae.

Codes related to 33984

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

Codes related to 33984
CodeHow it relatesNational office range
Same family
33985ECMO cannula removalOpen removal in the same ECMO/ECLS series for central cannulae.No office rate
33986ECMO cannula removalCentral-cannula removal in the same ECMO/ECLS series, with a vessel-repair distinction.No office rate
Used instead
33992VAD removalRemoval of a percutaneous left-heart VAD rather than ECMO/ECLS cannulae.No office rate

33984 billing questions

How does 33984 differ from 33985?

33984 is for open removal of peripheral ECMO/ECLS cannulae. Use the central-cannula removal code when the cannulae are positioned centrally.

When is 33984 reported?

Report it for open surgical removal of peripheral cannulae after ECMO/ECLS support is discontinued. Document the support system, access site, and removal approach.

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

Yes. Same-day preoperative and postoperative care is included in the procedure's 0-day global period.

How are other procedures in the same session paid?

CMS pays the highest-valued procedure in full and reduces the other procedures to 50% when multiple procedures are performed in the same session.

Can an assistant or co-surgeon be reported?

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

Can modifier 50 be used for bilateral cannula removal?

No. Modifier 50 is inappropriate for this descriptor; report the applicable peripheral cannula removal service.

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 33984PPRRVU2026_Oct_nonQPP.csv, line 4,168 (RVU26D)

Open CMS sourceHow we calculate rates

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