Billing code 33953: ECMO cannulationMedicare rate & RVUs in Alaska
Reports open placement of peripheral cannulae for ECMO or ECLS in patients age six and older, rather than percutaneous or central cannulation.
CMS doesn’t publish an office rate for 33953 in Alaska.
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 9 sections
What 33953 covers
This service covers open surgical insertion of peripheral cannulae to establish extracorporeal membrane oxygenation or extracorporeal life support. It is used when a patient age six or older needs extracorporeal cardiopulmonary support and the cannulae are placed through an open approach, such as surgical exposure of peripheral vessels. Cardiothoracic or vascular surgeons typically perform the procedure in a hospital setting during urgent support for severe cardiac or respiratory failure.
Select this code based on the patient’s age, peripheral cannula location, and open technique; percutaneous insertion and central cannulation are coded separately. The operative report should document the open approach, cannula placement, and the patient’s age. The service 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 for this descriptor and anatomy. 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.
33953 in Alaska*
| Payment locality | Office | Facility |
|---|---|---|
| Alaska* | Unavailable | $553.99 |
How the 33953 rate is calculated
Each of 33953’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 · 33953
RVUs × geographic indexes × conversion factor
Swap in your local Medicare rate.
Work 8.88Practice expense 1.97Malpractice 2.12
All indexes start at 1.000 (the national rate). Enter a ZIP or drag a slider.
Payment rules and modifiers for 33953
The CMS indicators that decide how 33953 is paid alongside other services.
CMS payment indicators · 33953
ECMO cannulation
| Rule | CMS value | What it means |
|---|---|---|
| Global period | 000 | Same-day global: pre- and post-op care on the day of the procedure is included. |
| Multiple procedures | 2 | Standard reduction: highest-valued procedure at 100%, others at 50%. |
| Bilateral (modifier 50) | 0 | The 150% bilateral adjustment doesn’t apply. |
| Assistant at surgery (80/81/82/AS) | 0 | Not paid without supporting documentation. |
| Co-surgeons (62) | 0 | Not permitted. |
| Team surgery (66) | 0 | Not permitted. |
| Professional/technical | 0 | Physician service: no professional/technical split. |
What modifiers do to the payment
Modifier 51 · payment effect
With and without the modifier
33953 without 51 · national facility
$433.21
ECMO cannulation
33953-51 · Second procedure: 50%
$216.61
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%).
33953 compared with similar codes
Compare codes
33953 vs 33951 vs 33954 vs 33955 vs 33946: national Medicare rates
Swap in your local Medicare rate.
How to choose
- 33951ECMO cannulation
- Both cover peripheral cannula insertion for patients age six and older. Choose 33953 for an open approach and 33951 for a percutaneous approach.
- 33954ECMO cannulation
- This is the open peripheral insertion code for patients age five and younger; 33953 is for patients age six and older.
- 33955Central cannulation
- 33955 describes open central cannula insertion in patients age six and older. Use 33953 when the cannulae are placed peripherally.
- 33946ECMO initiation
- 33946 reports venovenous ECMO/ECLS initiation, not open peripheral cannula insertion. The services may be reported separately when both are performed.
33953 billing questions
When should 33953 be selected instead of 33951?
Use 33953 for open peripheral cannula insertion in a patient age six or older. Code 33951 describes percutaneous insertion for that age group.
How does 33953 differ from 33954?
Both describe open peripheral cannula insertion, but 33954 is for patients age five and younger; 33953 is for patients age six and older.
Is central cannula placement reported with 33953?
No. This code is for peripheral cannulae; open central cannula insertion is represented by 33955 for patients age six and older.
Can cannula insertion and ECMO initiation be reported together?
Cannula insertion and ECMO/ECLS initiation describe distinct services and may be reported together when both are performed and documented. The initiation code depends on the support configuration.
What documentation supports reporting 33953?
The operative report should establish the patient’s age, the peripheral location, and that cannulae were inserted using an open surgical approach.
Can an assistant surgeon be paid for 33953?
Assistant-at-surgery payment is available only when the record documents medical necessity. Co-surgeons and team surgery are not permitted for this code.
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
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