No office rate
Use 33969 for percutaneous peripheral cannula removal; 33965 describes removal by an open approach.
On this page
CMS RVU26D · Effective 2026-10-01
33969 ECMO cannula removal Medicare reimbursement rates in Alaska
Reports percutaneous removal of a peripheral ECMO/ECLS cannula when extracorporeal support is discontinued and the cannula is removed. Compare 33969 office and facility rates across CMS payment localities in Alaska.
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.
What does Medicare pay for 33969 in Alaska?
Alaska has 1 payment locality in this comparison. Use the service location to choose the applicable amount. These are the supported base rates for the payment area shown below, using the same CMS release.
Office / nonfacility
No supported rate
Facility setting
$319.80
1 of 1 localities have a supported rate.
Payment area: Alaska*
One mapped payment locality.
These are locality ranges, not averages or address-specific quotes. A facility-setting amount covers the physician service; it does not include a hospital’s separate bill. Choose a locality below to inspect its calculation, compare other payment areas, or price a percentage of Medicare.
Cardiovascular surgery
About 33969: Percutaneous peripheral ECMO cannula removal
Reports percutaneous removal of a peripheral ECMO/ECLS cannula when extracorporeal support is discontinued and the cannula is removed.
This service covers percutaneous removal of a peripheral cannula used for extracorporeal membrane oxygenation or extracorporeal life support. It is performed during decannulation when the patient no longer needs extracorporeal support; the cannula may have been placed through a peripheral vessel such as the femoral artery or vein. A cardiovascular surgeon or another physician managing the patient’s ECMO care may perform the removal in a hospital setting.
Choose this code for the percutaneous removal procedure, not for cannula repositioning or daily ECMO management. Documentation should identify the peripheral cannula removed, its site, the percutaneous approach, and the decannulation work 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. Do not append modifier 50. Assistant-at-surgery payment requires documented medical necessity; co-surgeons and team surgery are not permitted.
CMS billing rules for 33969
- 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 RVU5.09 · 68%
- Practice expense (office) RVU1.19 · 16%
- Malpractice RVU1.22 · 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.
33969 compared with similar codes
Office rates for Alaska, from the same CMS release.
No office rate
This is a related open-removal code. Select between it and 33969 based on the removal approach documented.
No office rate
Use a repositioning code when the peripheral cannula is moved but remains in place; 33969 represents removal.
Compare 33969 by payment locality
Find the payment area for your service address, then open its rate page for calculation inputs, release history and the percentage-of-Medicare tool. A city may cross payment-area boundaries; the ZIP lookup above helps resolve the location.
1 of 1 payment localities
Alaska* →
Office / nonfacility
Unavailable
Facility
$319.80
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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 33969 in Alaska*.
PPRRVU2026_Oct_nonQPP.csv
4,154
- Code
- 33969
- Physician work
- 5.09
- Practice expense
- 1.19
- Malpractice
- 1.22
GPCI2026.csv
5
- Locality
- Alaska*
- Physician work
- 1.500
- Practice expense
- 1.065
- Malpractice
- 0.551
| Component | RVU | Locality factor | Adjusted |
|---|---|---|---|
| Physician work | 5.09 | × 1.500 | 7.6350 |
| Practice expense | 1.19 | × 1.065 | 1.2673 |
| Malpractice | 1.22 | × 0.551 | 0.6722 |
| Total RVUs | 9.5746 | ||
| Conversion factor | × 33.4009 | ||
Facility rate, Alaska*$319.80
Explore RVUs, geographic factors and the full formula
Facility
| Component | RVU | Local GPCI |
|---|---|---|
| Work | 5.09 | 1.5 |
| Practice expense | 1.19 | 1.065 |
| Malpractice | 1.22 | 0.551 |
(5.09 × 1.5 + 1.19 × 1.065 + 1.22 × 0.551) × $33.4009 = $319.80
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.
33969 billing questions
How does this differ from 33965 or 33966?
This code is for percutaneous removal of a peripheral ECMO/ECLS cannula. Codes 33965 and 33966 describe removal by an open approach.
Can this code be used for cannula repositioning?
No. Repositioning a peripheral ECMO/ECLS cannula is a different service; use the applicable repositioning code when the cannula is moved rather than removed.
Is daily ECMO management included in this removal service?
The code represents the percutaneous cannula removal procedure, not daily ECMO management. Document the decannulation work separately from routine management activities.
Can modifier 50 be reported?
No. Modifier 50 is inappropriate for this service.
When is an assistant-at-surgery payment supported?
CMS allows assistant-at-surgery payment only when the record documents medical necessity for the assistant.
How does CMS handle other procedures performed in the same session?
The highest-valued procedure is paid in full, and 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 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.
4,15133966,,Ecmo/ecls rmvl prph cannula,A,,4.39,1.04,NA,1.04,,1.03,6.46,6.46,0,000,0.00,0.00,0.00,2,0,0,0,0,9,,33.4009,09,0,99,0.00,0.00,0.00
4,15233967,,Insert i-aort percut device,A,,4.72,0.92,NA,0.92,,1.09,6.73,6.73,0,000,0.00,0.00,0.00,2,0,0,0,0,9,,33.4009,09,0,99,0.00,0.00,0.00
4,15333968,,Remove aortic assist device,A,,0.62,0.13,NA,0.13,,0.14,0.89,0.89,0,000,0.00,0.00,0.00,0,0,1,0,0,9,,33.4009,09,0,99,0.00,0.00,0.00
4,15433969,,Ecmo/ecls rmvl perph cannula,A,,5.09,1.19,NA,1.19,,1.22,7.50,7.50,0,000,0.00,0.00,0.00,2,0,0,0,0,9,,33.4009,09,0,99,0.00,0.00,0.00
4,15533970,,Aortic circulation assist,A,,6.57,1.27,NA,1.27,,1.57,9.41,9.41,0,000,0.00,0.00,0.00,2,0,2,1,0,9,,33.4009,09,0,99,0.00,0.00,0.00
4,15633971,,Aortic circulation assist,A,,11.69,5.64,NA,5.64,,2.77,20.10,20.10,0,090,0.09,0.84,0.07,2,0,1,0,0,9,,33.4009,09,0,99,0.00,0.00,0.00
4,15733973,,Insert balloon device,A,,9.51,1.95,NA,1.95,,2.27,13.73,13.73,0,000,0.00,0.00,0.00,2,0,2,1,0,9,,33.4009,09,0,99,0.00,0.00,0.00
2,,,,,,
3Medicare Administrative Contractor (MAC),State,Locality Number,Locality Name,2026 PW GPCI (with 1.0 Floor)***,2026 PE GPCI,2026 MP GPCI
410112,AL,00,ALABAMA,1.000,0.875,0.566
502102,AK,01,ALASKA*,1.500,1.065,0.551
603102,AZ,00,ARIZONA,1.000,0.969,0.856
707102,AR,13,ARKANSAS,1.000,0.859,0.515
801112,CA,54,BAKERSFIELD,1.019,1.096,0.609