Billing code 33958: Cannula repositioningMedicare rate & RVUs in Georgia
Reports open repositioning of an existing peripheral ECMO/ECLS cannula in a patient younger than six years when its position requires surgical correction.
CMS doesn’t publish an office rate for 33958 in Georgia.
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 33958 covers
This service covers surgically repositioning an existing peripheral cannula used for extracorporeal membrane oxygenation or extracorporeal life support in a patient younger than six years. A surgeon may adjust a cannula in a peripheral vessel, such as a cervical or femoral vessel, when its position needs correction during ECMO/ECLS support. The procedure is typically performed in a hospital operating room or intensive care setting by a cardiac or vascular surgeon.
Select this code for open repositioning in the specified age group, not for initial cannula placement, percutaneous repositioning, central cannula repositioning, or cannula removal. The operative report should identify the patient’s age, the peripheral cannula, the open approach, and the repositioning performed. CMS assigns 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 not appropriate. Assistant-at-surgery payment requires medical-necessity documentation; 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.
Where 33958 pays more and less in Georgia
| Payment locality | Office | Facility |
|---|---|---|
| Atlanta | Unavailable | $176.31 |
| Rest Of Georgia | Unavailable | $172.20 |
How the 33958 rate is calculated
Each of 33958’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 · 33958
RVUs × geographic indexes × conversion factor
Work3.42
3.42 RVUs× 1.000 GPCI
Practice expense0.85
0.85 RVUs× 1.000 GPCI
Malpractice0.82
0.82 RVUs× 1.000 GPCI
Adjusted RVUs
5.0900
Conversion factor
$33.4009
Medicare rate
$170.01
Every GPCI starts at 1.000, the national rate. Enter a ZIP or drag a slider.
Payment rules and modifiers for 33958
The CMS indicators that decide how 33958 is paid alongside other services.
CMS payment indicators · 33958
Cannula repositioning
| 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
33958 without 51 · national facility
$170.01
Cannula repositioning
33958-51 · Second procedure: 50%
$85.01
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%).
33958 compared with similar codes
Compare codes · National
5 codes, side by side
How to choose
- 33957ECMO cannula repositioning
- Both describe open repositioning of a peripheral ECMO/ECLS cannula; 33958 is for patients younger than six years, while 33957 is for patients six years and older.
- 33962ECMO cannula
- This is the percutaneous counterpart for patients younger than six years. Choose 33958 when the repositioning is performed through an open approach.
- 33951ECMO cannulation
- 33951 describes insertion of a peripheral ECMO/ECLS cannula, not adjustment of an existing cannula’s position.
- 33965ECMO cannula removal
- 33965 describes removal of a peripheral cannula. Use 33958 when the existing cannula is repositioned rather than removed.
33958 billing questions
When should this code be selected instead of 33957?
Use 33958 for open repositioning of a peripheral cannula in a patient younger than six years. Code 33957 describes the corresponding open service for patients six years and older.
How does this differ from 33962?
Both codes describe peripheral cannula repositioning for patients younger than six years, but 33958 is the open approach and 33962 is the percutaneous approach.
Is this code for placing or removing a cannula?
No. It describes repositioning an existing peripheral cannula. Initial placement and cannula removal are separate services with their own codes.
What should the operative report document?
Document the patient’s age, that the cannula is peripheral, the open approach, and the repositioning performed. The record should distinguish repositioning from insertion or removal.
Can an assistant-at-surgery be reported?
CMS pays an assistant at surgery only when medical necessity is documented. Co-surgeons and team surgery are not permitted for this code.
How does the 0-day global period affect same-day care?
Same-day preoperative and postoperative care is included in the procedure. CMS applies the standard multiple procedure reduction when other procedures are performed in the same session.
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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