No office rate
Choose 33948 for daily management of venovenous ECMO/ECLS; choose 33949 when support is venoarterial.
On this page
CMS RVU26D · Effective 2026-10-01
33949 ECMO management Medicare reimbursement rates in California
Reports a physician’s daily management of venoarterial ECMO or ECLS, including clinical oversight of the patient and extracorporeal support circuit. Compare 33949 office and facility rates across CMS payment localities in California.
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 33949 in California?
California has 29 payment localities in this comparison. Use the service location to choose the applicable amount. These are the supported base rates for the 29 payment areas shown below, using the same CMS release.
Office / nonfacility
No supported rate
Facility setting
$203.29–$229.02
29 of 29 localities have a supported rate.
Lowest: Chico
Highest: San Jose-Sunnyvale-Santa Clara (San Benito Cnty)
A spread of $25.73 per service.
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.
Where 33949 pays more and less in California
Cardiovascular services
About 33949: Venoarterial ECMO daily management
Reports a physician’s daily management of venoarterial ECMO or ECLS, including clinical oversight of the patient and extracorporeal support circuit.
Code 33949 represents a physician’s daily management of venoarterial extracorporeal membrane oxygenation or extracorporeal life support. This support configuration returns oxygenated blood to the arterial circulation and may be used for severe cardiac or combined cardiopulmonary failure. Management typically occurs in an intensive care setting while the patient remains on support, with physician involvement from specialties such as critical care or cardiothoracic surgery.
Report the service for each date on which the physician provides the daily management, rather than for ECMO initiation or a cannula procedure. The record should support the physician’s assessment of the patient and circuit, management decisions, and any adjustments made to the support plan. Select this code for venoarterial support; the parallel daily-management code 33948 is for venovenous support. The CMS facts supplied for this code list no additional payment rules.
Where the value comes from
- Work RVU4.49 · 72%
- Practice expense (office) RVU1.02 · 16%
- Malpractice RVU0.75 · 12%
7.2K
Medicare services in 2024 · #1647 by national volume
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.
33949 compared with similar codes
Office rates for California, from the same CMS release.
No office rate
Code 33947 represents initiation of venoarterial ECMO/ECLS. Code 33949 represents its daily management.
No office rate
Code 33946 is for venovenous ECMO/ECLS initiation. Code 33949 is for daily management of venoarterial support.
Compare 33949 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.
29 of 29 payment localities
| Payment locality | Office | Facility |
|---|---|---|
| Bakersfield | Office Unavailable | Facility $205.41 |
| Chico | Office Unavailable | Facility $203.29 |
| El Centro | Office Unavailable | Facility $203.41 |
| Fresno | Office Unavailable | Facility $203.29 |
| Hanford-Corcoran | Office Unavailable | Facility $203.29 |
| Los Angeles-Long Beach-Anaheim (Los Angeles/Orange Cnty) | Office Unavailable | Facility $213.06 |
| Madera | Office Unavailable | Facility $203.29 |
| Merced | Office Unavailable | Facility $203.29 |
| Modesto | Office Unavailable | Facility $203.29 |
| Napa | Office Unavailable | Facility $217.05 |
| Oxnard-Thousand Oaks-Ventura | Office Unavailable | Facility $210.05 |
| Redding | Office Unavailable | Facility $203.29 |
| Rest Of California | Office Unavailable | Facility $203.29 |
| Riverside-San Bernardino-Ontario | Office Unavailable | Facility $211.38 |
| Sacramento-Roseville-Folsom | Office Unavailable | Facility $208.42 |
| Salinas | Office Unavailable | Facility $207.53 |
| San Diego-Chula Vista-Carlsbad | Office Unavailable | Facility $208.79 |
| San Francisco-Oakland-Berkeley (Marin Cnty) | Office Unavailable | Facility $223.75 |
| San Francisco-Oakland-Berkeley (San Francisco/San Mateo/Alameda/Contra Costa Cnty) | Office Unavailable | Facility $222.90 |
| San Jose-Sunnyvale-Santa Clara (San Benito Cnty) | Office Unavailable | Facility $229.02 |
| San Jose-Sunnyvale-Santa Clara (Santa Clara Cnty) | Office Unavailable | Facility $225.54 |
| San Luis Obispo-Paso Robles | Office Unavailable | Facility $204.75 |
| Santa Cruz-Watsonville | Office Unavailable | Facility $207.94 |
| Santa Maria-Santa Barbara | Office Unavailable | Facility $207.32 |
| Santa Rosa-Petaluma | Office Unavailable | Facility $209.73 |
| Stockton | Office Unavailable | Facility $203.29 |
| Vallejo | Office Unavailable | Facility $215.82 |
| Visalia | Office Unavailable | Facility $203.29 |
| Yuba City | Office Unavailable | Facility $203.29 |
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33949 billing questions
How does 33949 differ from 33948?
Use 33949 for venoarterial ECMO/ECLS daily management. Code 33948 is the corresponding daily-management service for venovenous support.
Is 33949 the code for starting ECMO?
No. It describes daily management after support is in use; 33947 describes initiation of venoarterial ECMO/ECLS.
Can 33949 be reported for cannula insertion or repositioning?
No. It represents daily management, not a cannula procedure. Use the applicable procedure code when insertion or repositioning is performed and documented.
How often is 33949 reported?
It represents daily management, so report it for each date the physician provides that service. Documentation should establish the physician’s work on that date.
What documentation supports 33949?
Document that the patient is receiving venoarterial ECMO/ECLS and the physician’s daily assessment and management of the patient and support circuit.
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.
4,13233946,,Ecmo/ecls initiation venous,A,,5.85,1.26,NA,1.26,,1.26,8.37,8.37,0,XXX,0.00,0.00,0.00,0,0,1,0,0,9,,33.4009,09,0,99,0.00,0.00,0.00
4,13333947,,Ecmo/ecls initiation artery,A,,6.46,1.36,NA,1.36,,1.41,9.23,9.23,0,XXX,0.00,0.00,0.00,0,0,1,0,0,9,,33.4009,09,0,99,0.00,0.00,0.00
4,13433948,,Ecmo/ecls daily mgmt-venous,A,,4.61,1.08,NA,1.08,,0.81,6.50,6.50,0,XXX,0.00,0.00,0.00,0,0,1,0,0,9,,33.4009,09,0,99,0.00,0.00,0.00
4,13533949,,Ecmo/ecls daily mgmt artery,A,,4.49,1.02,NA,1.02,,0.75,6.26,6.26,0,XXX,0.00,0.00,0.00,0,0,1,0,0,9,,33.4009,09,0,99,0.00,0.00,0.00
4,1363394F,,Quant her2 ihc eval 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
4,13733951,,Ecmo/ecls insj prph cannula,A,,7.95,1.79,NA,1.79,,1.91,11.65,11.65,0,000,0.00,0.00,0.00,2,0,0,0,0,9,,33.4009,09,0,99,0.00,0.00,0.00
4,13833952,,Ecmo/ecls insj prph cannula,A,,7.95,1.75,NA,1.75,,1.82,11.52,11.52,0,000,0.00,0.00,0.00,2,0,0,0,0,9,,33.4009,09,0,99,0.00,0.00,0.00