No office rate
Both codes cover percutaneous repositioning of peripheral ECMO/ECLS cannulae; 33957 is selected for venovenous support, while 33958 represents a different circuit configuration.
On this page
CMS RVU26D · Effective 2026-10-01
33957 in Wyoming**
Office / nonfacility
Not available in this setting
Base rate per service
Facility setting
$162.89
Base rate per service
Amounts below use the non-QP conversion factor for participating physicians. These are base physician payments before claim-level adjustments, not patient costs or total hospital charges.
ECMO/ECLS
About 33957: Percutaneous peripheral ECMO cannula repositioning
Reports percutaneous repositioning of peripheral cannulae in a venovenous ECMO or ECLS circuit when the cannula position needs adjustment.
This service covers percutaneous adjustment of peripheral cannula position in a venovenous extracorporeal membrane oxygenation or extracorporeal life support circuit. It may be needed when a cannula is malpositioned or its position interferes with effective circuit flow. Cardiothoracic or vascular surgeons and other clinicians experienced in ECMO cannulation may perform the procedure in an operating room, catheterization laboratory, or intensive care setting. The service concerns repositioning an existing peripheral cannula, not placing or removing one.
Select the code when the documented procedure is percutaneous repositioning for venovenous support; the record should identify the cannula site, the reason for adjustment, and the technique performed. CMS assigns a 0-day global period, so same-day preoperative and postoperative care is included. When multiple procedures are performed in the same session, the highest-valued procedure is paid in full and other procedures are subject to the standard multiple procedure reduction. Assistant-at-surgery payment requires documentation of medical necessity. Co-surgeons and team surgery are not permitted.
CMS billing rules for 33957
- Global period
- Minor procedure with a 0-day global period: same-day preoperative and postoperative care is included.
- Multiple procedures
- Standard multiple procedure reduction: the highest-valued procedure is paid in full and others at 50% when performed in the same session.
- Bilateral procedures
- Bilateral adjustment does not apply; the descriptor or anatomy makes modifier 50 inappropriate.
- Assistant at surgery
- Assistant at surgery is paid only with documentation of medical necessity.
- Co-surgeons
- Co-surgeons not permitted.
- Team surgery
- Team surgery not permitted.
Where the value comes from
- Work RVU3.42 · 67%
- Practice expense (office) RVU0.85 · 17%
- Malpractice RVU0.82 · 16%
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.
33957 compared with similar codes
Office rates for Wyoming**, from the same CMS release.
No office rate
33951 is for peripheral cannula insertion. Use 33957 when the service adjusts the position of an existing cannula percutaneously.
No office rate
33965 describes removal of a peripheral ECMO/ECLS cannula, not adjustment of its position.
No office rate
33948 is for daily management of venovenous ECMO/ECLS; 33957 is for a percutaneous cannula repositioning procedure.
The same code, a different location
How does Wyoming** compare?
33957 across payment areas
Same release and payment basis · bars start at $0
Wyoming** · This locality
Unavailable
No comparable rate is available in this setting.
Unavailable
No comparable rate is available in this setting.
Unavailable
No comparable rate is available in this setting.
Unavailable
No comparable rate is available in this setting.
Unavailable
No comparable rate is available in this setting.
Unavailable
No comparable rate is available in this setting.
Other payment areas listed in Wyoming appear first, followed by selected cross-country examples. The chart compares amounts, not distance.
The code’s RVUs stay the same in these comparisons. Geographic adjustments to work, practice expense and malpractice change the dollar amount. A city name alone may not identify the payment area for a service address.
Compare all 108 other payment areas
Alabama
Alabama · 33957
Office
Unavailable
Facility
$154.58
No comparable office rate is available.
Arkansas
Arkansas · 33957
Office
Unavailable
Facility
$152.72
No comparable office rate is available.
Arizona
Arizona · 33957
Office
Unavailable
Facility
$165.19
No comparable office rate is available.
Bakersfield
California · 33957
Office
Unavailable
Facility
$164.20
No comparable office rate is available.
Chico
California · 33957
Office
Unavailable
Facility
$161.97
No comparable office rate is available.
El Centro
California · 33957
Office
Unavailable
Facility
$162.11
No comparable office rate is available.
Fresno
California · 33957
Office
Unavailable
Facility
$161.97
No comparable office rate is available.
Hanford-Corcoran
California · 33957
Office
Unavailable
Facility
$161.97
No comparable office rate is available.
Madera
California · 33957
Office
Unavailable
Facility
$161.97
No comparable office rate is available.
Merced
California · 33957
Office
Unavailable
Facility
$161.97
No comparable office rate is available.
Modesto
California · 33957
Office
Unavailable
Facility
$161.97
No comparable office rate is available.
Napa
California · 33957
Office
Unavailable
Facility
$172.76
No comparable office rate is available.
Oxnard-Thousand Oaks-Ventura
California · 33957
Office
Unavailable
Facility
$168.05
No comparable office rate is available.
Redding
California · 33957
Office
Unavailable
Facility
$161.97
No comparable office rate is available.
Rest Of California
California · 33957
Office
Unavailable
Facility
$161.97
No comparable office rate is available.
Riverside-San Bernardino-Ontario
California · 33957
Office
Unavailable
Facility
$170.77
No comparable office rate is available.
Sacramento-Roseville-Folsom
California · 33957
Office
Unavailable
Facility
$166.04
No comparable office rate is available.
Salinas
California · 33957
Office
Unavailable
Facility
$165.36
No comparable office rate is available.
San Diego-Chula Vista-Carlsbad
California · 33957
Office
Unavailable
Facility
$166.46
No comparable office rate is available.
San Francisco-Oakland-Berkeley (Marin Cnty)
California · 33957
Office
Unavailable
Facility
$177.69
No comparable office rate is available.
San Francisco-Oakland-Berkeley (San Francisco/San Mateo/Alameda/Contra Costa Cnty)
California · 33957
Office
Unavailable
Facility
$176.75
No comparable office rate is available.
San Jose-Sunnyvale-Santa Clara (San Benito Cnty)
California · 33957
Office
Unavailable
Facility
$182.42
No comparable office rate is available.
San Jose-Sunnyvale-Santa Clara (Santa Clara Cnty)
California · 33957
Office
Unavailable
Facility
$178.61
No comparable office rate is available.
San Luis Obispo-Paso Robles
California · 33957
Office
Unavailable
Facility
$163.19
No comparable office rate is available.
Santa Cruz-Watsonville
California · 33957
Office
Unavailable
Facility
$165.81
No comparable office rate is available.
Santa Maria-Santa Barbara
California · 33957
Office
Unavailable
Facility
$165.21
No comparable office rate is available.
Santa Rosa-Petaluma
California · 33957
Office
Unavailable
Facility
$167.20
No comparable office rate is available.
Stockton
California · 33957
Office
Unavailable
Facility
$161.97
No comparable office rate is available.
Vallejo
California · 33957
Office
Unavailable
Facility
$171.42
No comparable office rate is available.
Visalia
California · 33957
Office
Unavailable
Facility
$161.97
No comparable office rate is available.
Yuba City
California · 33957
Office
Unavailable
Facility
$161.97
No comparable office rate is available.
Colorado
Colorado · 33957
Office
Unavailable
Facility
$167.20
No comparable office rate is available.
Connecticut
Connecticut · 33957
Office
Unavailable
Facility
$180.23
No comparable office rate is available.
Delaware
Delaware · 33957
Office
Unavailable
Facility
$167.47
No comparable office rate is available.
Fort Lauderdale
Florida · 33957
Office
Unavailable
Facility
$192.51
No comparable office rate is available.
Rest Of Florida
Florida · 33957
Office
Unavailable
Facility
$182.54
No comparable office rate is available.
Atlanta
Georgia · 33957
Office
Unavailable
Facility
$176.31
No comparable office rate is available.
Rest Of Georgia
Georgia · 33957
Office
Unavailable
Facility
$172.20
No comparable office rate is available.
Hawaii, Guam
Hawaii · 33957
Office
Unavailable
Facility
$162.37
No comparable office rate is available.
Iowa
Iowa · 33957
Office
Unavailable
Facility
$151.08
No comparable office rate is available.
Idaho
Idaho · 33957
Office
Unavailable
Facility
$153.31
No comparable office rate is available.
East St. Louis
Illinois · 33957
Office
Unavailable
Facility
$195.51
No comparable office rate is available.
Rest Of Illinois
Illinois · 33957
Office
Unavailable
Facility
$182.96
No comparable office rate is available.
Suburban Chicago
Illinois · 33957
Office
Unavailable
Facility
$192.72
No comparable office rate is available.
Indiana
Indiana · 33957
Office
Unavailable
Facility
$153.86
No comparable office rate is available.
Kansas
Kansas · 33957
Office
Unavailable
Facility
$153.70
No comparable office rate is available.
Kentucky
Kentucky · 33957
Office
Unavailable
Facility
$164.53
No comparable office rate is available.
New Orleans
Louisiana · 33957
Office
Unavailable
Facility
$172.06
No comparable office rate is available.
Rest Of Louisiana
Louisiana · 33957
Office
Unavailable
Facility
$165.60
No comparable office rate is available.
Metropolitan Boston
Massachusetts · 33957
Office
Unavailable
Facility
$177.19
No comparable office rate is available.
Rest Of Massachusetts
Massachusetts · 33957
Office
Unavailable
Facility
$167.78
No comparable office rate is available.
Baltimore/Surr. Cntys
Maryland · 33957
Office
Unavailable
Facility
$180.40
No comparable office rate is available.
Rest Of Maryland
Maryland · 33957
Office
Unavailable
Facility
$169.25
No comparable office rate is available.
Rest Of Maine
Maine · 33957
Office
Unavailable
Facility
$157.39
No comparable office rate is available.
Southern Maine
Maine · 33957
Office
Unavailable
Facility
$159.65
No comparable office rate is available.
Detroit
Michigan · 33957
Office
Unavailable
Facility
$187.81
No comparable office rate is available.
Rest Of Michigan
Michigan · 33957
Office
Unavailable
Facility
$171.07
No comparable office rate is available.
Minnesota
Minnesota · 33957
Office
Unavailable
Facility
$151.55
No comparable office rate is available.
Metropolitan Kansas City
Missouri · 33957
Office
Unavailable
Facility
$167.65
No comparable office rate is available.
Metropolitan St. Louis
Missouri · 33957
Office
Unavailable
Facility
$168.70
No comparable office rate is available.
Rest Of Missouri
Missouri · 33957
Office
Unavailable
Facility
$165.38
No comparable office rate is available.
Mississippi
Mississippi · 33957
Office
Unavailable
Facility
$158.92
No comparable office rate is available.
Montana**
Montana · 33957
Office
Unavailable
Facility
$169.96
No comparable office rate is available.
North Carolina
North Carolina · 33957
Office
Unavailable
Facility
$158.22
No comparable office rate is available.
North Dakota**
North Dakota · 33957
Office
Unavailable
Facility
$153.74
No comparable office rate is available.
Nebraska
Nebraska · 33957
Office
Unavailable
Facility
$150.79
No comparable office rate is available.
New Hampshire
New Hampshire · 33957
Office
Unavailable
Facility
$167.75
No comparable office rate is available.
Northern Nj
New Jersey · 33957
Office
Unavailable
Facility
$183.61
No comparable office rate is available.
Rest Of New Jersey
New Jersey · 33957
Office
Unavailable
Facility
$179.85
No comparable office rate is available.
New Mexico
New Mexico · 33957
Office
Unavailable
Facility
$173.16
No comparable office rate is available.
Nevada**
Nevada · 33957
Office
Unavailable
Facility
$165.47
No comparable office rate is available.
Nyc Suburbs/Long Island
New York · 33957
Office
Unavailable
Facility
$206.16
No comparable office rate is available.
Poughkpsie/N Nyc Suburbs
New York · 33957
Office
Unavailable
Facility
$183.60
No comparable office rate is available.
Queens
New York · 33957
Office
Unavailable
Facility
$194.59
No comparable office rate is available.
Rest Of New York
New York · 33957
Office
Unavailable
Facility
$160.46
No comparable office rate is available.
Ohio
Ohio · 33957
Office
Unavailable
Facility
$167.76
No comparable office rate is available.
Oklahoma
Oklahoma · 33957
Office
Unavailable
Facility
$160.87
No comparable office rate is available.
Portland
Oregon · 33957
Office
Unavailable
Facility
$167.98
No comparable office rate is available.
Rest Of Oregon
Oregon · 33957
Office
Unavailable
Facility
$161.76
No comparable office rate is available.
Metropolitan Philadelphia
Pennsylvania · 33957
Office
Unavailable
Facility
$178.52
No comparable office rate is available.
Rest Of Pennsylvania
Pennsylvania · 33957
Office
Unavailable
Facility
$166.18
No comparable office rate is available.
Puerto Rico
Puerto Rico · 33957
Office
Unavailable
Facility
$169.91
No comparable office rate is available.
Rhode Island
Rhode Island · 33957
Office
Unavailable
Facility
$170.16
No comparable office rate is available.
South Carolina
South Carolina · 33957
Office
Unavailable
Facility
$163.74
No comparable office rate is available.
South Dakota**
South Dakota · 33957
Office
Unavailable
Facility
$151.82
No comparable office rate is available.
Tennessee
Tennessee · 33957
Office
Unavailable
Facility
$154.75
No comparable office rate is available.
Austin
Texas · 33957
Office
Unavailable
Facility
$168.76
No comparable office rate is available.
Beaumont
Texas · 33957
Office
Unavailable
Facility
$165.51
No comparable office rate is available.
Brazoria
Texas · 33957
Office
Unavailable
Facility
$164.64
No comparable office rate is available.
Dallas
Texas · 33957
Office
Unavailable
Facility
$167.04
No comparable office rate is available.
Fort Worth
Texas · 33957
Office
Unavailable
Facility
$167.11
No comparable office rate is available.
Galveston
Texas · 33957
Office
Unavailable
Facility
$166.01
No comparable office rate is available.
Houston
Texas · 33957
Office
Unavailable
Facility
$181.02
No comparable office rate is available.
Rest Of Texas
Texas · 33957
Office
Unavailable
Facility
$165.91
No comparable office rate is available.
Utah
Utah · 33957
Office
Unavailable
Facility
$165.51
No comparable office rate is available.
Virginia
Virginia · 33957
Office
Unavailable
Facility
$161.48
No comparable office rate is available.
Virgin Islands
United States Virgin Islands · 33957
Office
Unavailable
Facility
$169.91
No comparable office rate is available.
Vermont
Vermont · 33957
Office
Unavailable
Facility
$156.20
No comparable office rate is available.
Rest Of Washington
Washington · 33957
Office
Unavailable
Facility
$166.45
No comparable office rate is available.
Seattle (King Cnty)
Washington · 33957
Office
Unavailable
Facility
$177.15
No comparable office rate is available.
Wisconsin
Wisconsin · 33957
Office
Unavailable
Facility
$149.87
No comparable office rate is available.
West Virginia
West Virginia · 33957
Office
Unavailable
Facility
$178.10
No comparable office rate is available.
See how rates vary across the country
33957 · Office / nonfacility · Non-QP. Choose a state to explore its payment localities. A range means the amount varies within that state.
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 all state and territory rates as a table
| State / territory | Rate range | Localities |
|---|---|---|
| AK | No published base rate | 1 |
| AL | No published base rate | 1 |
| AR | No published base rate | 1 |
| AZ | No published base rate | 1 |
| CA | No published base rate | 29 |
| CO | No published base rate | 1 |
| CT | No published base rate | 1 |
| DC | No published base rate | 1 |
| DE | No published base rate | 1 |
| FL | No published base rate | 3 |
| GA | No published base rate | 2 |
| GU | No published base rate | 1 |
| HI | No published base rate | 1 |
| IA | No published base rate | 1 |
| ID | No published base rate | 1 |
| IL | No published base rate | 4 |
| IN | No published base rate | 1 |
| KS | No published base rate | 1 |
| KY | No published base rate | 1 |
| LA | No published base rate | 2 |
| MA | No published base rate | 2 |
| MD | No published base rate | 3 |
| ME | No published base rate | 2 |
| MI | No published base rate | 2 |
| MN | No published base rate | 1 |
| MO | No published base rate | 3 |
| MS | No published base rate | 1 |
| MT | No published base rate | 1 |
| NC | No published base rate | 1 |
| ND | No published base rate | 1 |
| NE | No published base rate | 1 |
| NH | No published base rate | 1 |
| NJ | No published base rate | 2 |
| NM | No published base rate | 1 |
| NV | No published base rate | 1 |
| NY | No published base rate | 5 |
| OH | No published base rate | 1 |
| OK | No published base rate | 1 |
| OR | No published base rate | 2 |
| PA | No published base rate | 2 |
| PR | No published base rate | 1 |
| RI | No published base rate | 1 |
| SC | No published base rate | 1 |
| SD | No published base rate | 1 |
| TN | No published base rate | 1 |
| TX | No published base rate | 8 |
| UT | No published base rate | 1 |
| VA | No published base rate | 2 |
| VI | No published base rate | 1 |
| VT | No published base rate | 1 |
| WA | No published base rate | 2 |
| WI | No published base rate | 1 |
| WV | No published base rate | 1 |
| WY | No published base rate | 1 |
Where does this rate apply?
Wyoming** is a Medicare payment area. Our Census mapping connects it to 205 cities and communities in Wyoming, including the examples shown here.
Some communities span more than one payment area. Follow a city link to compare all of its mapped areas, or check the service-location ZIP above for an address-level starting point.
Use this rate
What is a percentage of Medicare worth?
Turn a percentage into dollars for 33957 in Wyoming**. This uses the base rate on this page, so the locality and release stay consistent.
Reference amount per service
$179.18
$162.89 × 110% = $179.18
A contract may specify another Medicare year or additional adjustments. This is percentage arithmetic on the displayed base rate, not a claim adjudication.
Working with a whole code list?
Compare an offer across your annual code mix, including an older Medicare schedule or flat per-code rates.
How this local rate is calculated
Each RVU component is multiplied by its own geographic practice cost index (GPCI). The three adjusted components are added, then multiplied by the conversion factor. These are the inputs used for 33957 in Wyoming**.
PPRRVU2026_Oct_nonQPP.csv
4,143
- Code
- 33957
- Physician work
- 3.42
- Practice expense
- 0.85
- Malpractice
- 0.82
GPCI2026.csv
112
- Locality
- Wyoming**
- Physician work
- 1.000
- Practice expense
- 1.000
- Malpractice
- 0.740
| Component | RVU | Locality factor | Adjusted |
|---|---|---|---|
| Physician work | 3.42 | × 1.000 | 3.4200 |
| Practice expense | 0.85 | × 1.000 | 0.8500 |
| Malpractice | 0.82 | × 0.740 | 0.6068 |
| Total RVUs | 4.8768 | ||
| Conversion factor | × 33.4009 | ||
Facility rate, Wyoming**$162.89
Open 33957 in the RVU calculator →
Explore RVUs, geographic factors and the full formula
Facility
| Component | RVU | Local GPCI |
|---|---|---|
| Work | 3.42 | 1 |
| Practice expense | 0.85 | 1 |
| Malpractice | 0.82 | 0.74 |
(3.42 × 1 + 0.85 × 1 + 0.82 × 0.74) × $33.4009 = $162.89
The office and facility calculations use their respective practice-expense RVUs. The facility amount here is the physician fee, not a separate hospital or facility bill.
How this rate has changed
33957 · Office / nonfacility
Rate unavailable
Effective 2026-10-01
A rate is unavailable in one of these releases, so a change cannot be calculated.
One bar per available release, ordered by effective date. Missing rates remain gaps. These comparisons hold the code, setting and locality identifiers constant; they do not isolate which policy or input caused a change.
What changed, release by release
Explore release dates and calculate this code in an earlier period →
Each row uses the accepted CMS release effective on that date and the same contractor and locality identifiers. Missing rates stay visible. Historical boundaries may differ; verify the service address for an older claim.
Inspect every release and its CMS source
| Effective from | Office / nonfacility | Facility | CMS release |
|---|---|---|---|
| 2026-10-01 | Not available in this setting | $162.89 | RVU26D |
| 2026-07-01 | Not available in this setting | $162.89 | RVU26C |
| 2026-04-01 | Not available in this setting | $162.89 | RVU26B |
| 2026-01-01 | Not available in this setting | $162.89 | RVU26A |
| 2025-10-01 | Not available in this setting | $167.83 | RVU25D |
| 2025-07-01 | Not available in this setting | $167.83 | RVU25C |
| 2025-04-01 | Not available in this setting | $167.83 | RVU25B |
| 2025-01-01 | Not available in this setting | $167.83 | RVU25A |
33957 billing questions
How is this code distinguished from 33958?
Both codes describe percutaneous repositioning of peripheral ECMO/ECLS cannulae. Choose based on the circuit configuration documented; 33957 is for venovenous support.
Can this be reported for initial cannula placement?
No. This code describes repositioning an existing peripheral cannula. Use the applicable insertion code when the service places a cannula.
Is same-day postoperative care separately reported?
Same-day preoperative and postoperative care is included in this procedure's 0-day global period.
Can modifier 50 be used?
No. CMS identifies bilateral adjustment as inappropriate for this code.
When is assistant-at-surgery payment allowed?
Only when the record documents medical necessity for the assistant. Co-surgeons and team surgery are not permitted.
How are other procedures in the same session paid?
The highest-valued procedure is paid in full; other procedures 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 indices and the applicable conversion factor. Unavailable or separately priced services are labeled rather than assigned a made-up amount.
Source: RVU26D. Effective 2026-10-01 through the day before 2027-01-01.
4,14033954,,Ecmo/ecls insj prph cannula,A,,8.88,1.95,NA,1.95,,2.10,12.93,12.93,0,000,0.00,0.00,0.00,2,0,0,0,0,9,,33.4009,09,0,99,0.00,0.00,0.00
4,14133955,,Ecmo/ecls insj ctr cannula,A,,15.60,3.35,NA,3.35,,3.74,22.69,22.69,0,000,0.00,0.00,0.00,2,0,0,1,1,9,,33.4009,09,0,99,0.00,0.00,0.00
4,14233956,,Ecmo/ecls insj ctr cannula,A,,15.60,3.28,NA,3.28,,3.76,22.64,22.64,0,000,0.00,0.00,0.00,2,0,0,1,1,9,,33.4009,09,0,99,0.00,0.00,0.00
4,14333957,,Ecmo/ecls repos perph cnula,A,,3.42,0.85,NA,0.85,,0.82,5.09,5.09,0,000,0.00,0.00,0.00,2,0,0,0,0,9,,33.4009,09,0,99,0.00,0.00,0.00
4,14433958,,Ecmo/ecls repos perph cnula,A,,3.42,0.85,NA,0.85,,0.82,5.09,5.09,0,000,0.00,0.00,0.00,2,0,0,0,0,9,,33.4009,09,0,99,0.00,0.00,0.00
4,14533959,,Ecmo/ecls repos perph cnula,A,,4.36,1.05,NA,1.05,,1.06,6.47,6.47,0,000,0.00,0.00,0.00,2,0,0,0,0,9,,33.4009,09,0,99,0.00,0.00,0.00
4,1463395F,,Quant nonher2 ihc brst cx,M,,0.00,0.00,,0.00,,0.00,0.00,0.00,9,XXX,0.00,0.00,0.00,9,9,9,9,9,9,,33.4009,09,0,99,0.00,0.00,0.00
10902402,WA,99,REST OF WASHINGTON,1.013,1.053,0.761
11011402,WV,16,WEST VIRGINIA,1.000,0.869,1.431
11106302,WI,00,WISCONSIN,1.000,0.958,0.308
11203602,WY,21,WYOMING**,1.000,1.000,0.740
113"MAC Assignments as of November 22, 2023",,,,,,
114,,,,,,
115*Work GPCI reflects a 1.5 floor in Alaska established by the MIPPA.,,,,,,