No office rate
33951 concerns insertion of a peripheral ECMO or ECLS cannula. Report 33963 when the documented work repositions an existing peripheral cannula rather than places one.
On this page
CMS RVU26D · Effective 2026-10-01
33963 ECMO cannula repositioning Medicare reimbursement rates in California
Report this procedure when a physician repositions an existing peripheral ECMO or ECLS cannula to address a documented positioning problem. Compare 33963 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 33963 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
$407.23–$457.03
29 of 29 localities have a supported rate.
Lowest: Chico
Highest: San Jose-Sunnyvale-Santa Clara (San Benito Cnty)
A spread of $49.80 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 33963 pays more and less in California
ECMO procedures
About 33963: Peripheral ECMO cannula repositioning
Report this procedure when a physician repositions an existing peripheral ECMO or ECLS cannula to address a documented positioning problem.
This procedure addresses the position of a peripheral cannula already in use for extracorporeal membrane oxygenation (ECMO) or extracorporeal life support (ECLS). A physician adjusts an arterial or venous cannula, such as one placed through femoral or jugular vessels, when its position interferes with support or creates another documented concern. The work may occur in an intensive care unit or operating room and is distinct from placing a new cannula or removing one at the end of support.
Report 33963 for the documented peripheral cannula repositioning procedure, not for routine monitoring or circuit management alone. The procedure note should identify the cannula and access site, the reason for adjustment, and the repositioning performed. CMS assigns a 0-day global period, so routine preoperative and postoperative care on the procedure date is included. When multiple procedures occur in one session, CMS pays the highest-valued procedure in full and other procedures at 50%. Modifier 50 is inappropriate. Payment for an assistant at surgery, co-surgeons, or a surgical team requires supporting documentation.
CMS billing rules for 33963
- 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 paid only with supporting documentation.
- Team surgery
- Team surgery paid only with supporting documentation.
Where the value comes from
- Work RVU8.78 · 68%
- Practice expense (office) RVU1.95 · 15%
- Malpractice RVU2.10 · 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.
33963 compared with similar codes
Office rates for California, from the same CMS release.
No office rate
33965 concerns removal of a peripheral ECMO or ECLS cannula. Report 33963 when the cannula is adjusted for continued use.
No office rate
33949 describes daily management of arterial ECMO or ECLS support. It does not describe the hands-on peripheral cannula repositioning reported with 33963.
Compare 33963 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 $412.93 |
| Chico | Office Unavailable | Facility $407.23 |
| El Centro | Office Unavailable | Facility $407.58 |
| Fresno | Office Unavailable | Facility $407.23 |
| Hanford-Corcoran | Office Unavailable | Facility $407.23 |
| Los Angeles-Long Beach-Anaheim (Los Angeles/Orange Cnty) | Office Unavailable | Facility $428.91 |
| Madera | Office Unavailable | Facility $407.23 |
| Merced | Office Unavailable | Facility $407.23 |
| Modesto | Office Unavailable | Facility $407.23 |
| Napa | Office Unavailable | Facility $433.21 |
| Oxnard-Thousand Oaks-Ventura | Office Unavailable | Facility $422.16 |
| Redding | Office Unavailable | Facility $407.23 |
| Rest Of California | Office Unavailable | Facility $407.23 |
| Riverside-San Bernardino-Ontario | Office Unavailable | Facility $429.75 |
| Sacramento-Roseville-Folsom | Office Unavailable | Facility $417.16 |
| Salinas | Office Unavailable | Facility $415.43 |
| San Diego-Chula Vista-Carlsbad | Office Unavailable | Facility $417.97 |
| San Francisco-Oakland-Berkeley (Marin Cnty) | Office Unavailable | Facility $445.15 |
| San Francisco-Oakland-Berkeley (San Francisco/San Mateo/Alameda/Contra Costa Cnty) | Office Unavailable | Facility $442.77 |
| San Jose-Sunnyvale-Santa Clara (San Benito Cnty) | Office Unavailable | Facility $457.03 |
| San Jose-Sunnyvale-Santa Clara (Santa Clara Cnty) | Office Unavailable | Facility $447.28 |
| San Luis Obispo-Paso Robles | Office Unavailable | Facility $410.03 |
| Santa Cruz-Watsonville | Office Unavailable | Facility $416.15 |
| Santa Maria-Santa Barbara | Office Unavailable | Facility $415.01 |
| Santa Rosa-Petaluma | Office Unavailable | Facility $419.64 |
| Stockton | Office Unavailable | Facility $407.23 |
| Vallejo | Office Unavailable | Facility $429.77 |
| Visalia | Office Unavailable | Facility $407.23 |
| Yuba City | Office Unavailable | Facility $407.23 |
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33963 billing questions
When is 33963 reported instead of a peripheral cannula insertion code?
Use 33963 for repositioning an existing peripheral ECMO or ECLS cannula. Codes such as 33951 describe insertion rather than adjustment of a cannula already in place.
Does routine ECMO management support reporting 33963?
No. The record must describe a procedure that repositions the peripheral cannula; monitoring circuit performance alone does not establish that work.
Is same-day care separately included with 33963?
CMS assigns a 0-day global period, which includes routine preoperative and postoperative care on the procedure date.
Should modifier 50 be used if more than one peripheral cannula is adjusted?
No. CMS does not apply a bilateral adjustment to 33963, and modifier 50 is inappropriate.
What supports payment for additional surgeons on 33963?
An assistant at surgery requires documentation of medical necessity. Co-surgeons and team surgery also require supporting documentation.
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.
4,14533959,,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
4,14733962,,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
4,14833963,,Ecmo/ecls repos perph cnula,A,,8.78,1.95,NA,1.95,,2.10,12.83,12.83,0,000,0.00,0.00,0.00,2,0,0,1,1,9,,33.4009,09,0,99,0.00,0.00,0.00
4,14933964,,Ecmo/ecls repos perph cnula,A,,9.26,2.05,NA,2.05,,2.21,13.52,13.52,0,000,0.00,0.00,0.00,2,0,0,1,1,9,,33.4009,09,0,99,0.00,0.00,0.00
4,15033965,,Ecmo/ecls rmvl perph cannula,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
4,15133966,,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