No office rate
Both codes report ECMO/ECLS initiation; 33947 is for venoarterial support, while 33946 is for venovenous support.
On this page
CMS RVU26D · Effective 2026-10-01
33947 ECMO initiation Medicare reimbursement rates in Indiana
Reports physician initiation of venoarterial ECMO/ECLS to provide circulatory and respiratory support in severe cardiac or cardiopulmonary failure. Compare 33947 office and facility rates across CMS payment localities in Indiana.
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 33947 in Indiana?
Indiana 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
$280.77
1 of 1 localities have a supported rate.
Payment area: Indiana
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 services
About 33947: Venoarterial ECMO initiation
Reports physician initiation of venoarterial ECMO/ECLS to provide circulatory and respiratory support in severe cardiac or cardiopulmonary failure.
This service covers starting venoarterial extracorporeal membrane oxygenation or extracorporeal life support, which returns oxygenated blood to the arterial circulation while supporting cardiac and respiratory function. Cardiothoracic or vascular surgeons and other physicians involved in ECMO care may perform the initiation in an intensive care unit, operating room, or emergency setting. Typical circumstances include cardiogenic shock, cardiac arrest, or inability to separate from cardiopulmonary bypass when temporary extracorporeal support is needed.
Report 33947 for the initiation phase, not for ongoing daily management. The record should establish the clinical need for support, the venoarterial configuration, and the physician’s role in starting the circuit. Cannula insertion has its own codes when that work is performed and separately reportable; identify the cannula site and procedure in the documentation. CMS rules supplied for this code list no specific add-on, global-period, component, or reduction rule, so the code-specific facts here do not establish a separate payment adjustment or bundling instruction.
Where the value comes from
- Work RVU6.46 · 70%
- Practice expense (office) RVU1.36 · 15%
- Malpractice RVU1.41 · 15%
1.6K
Medicare services in 2024 · #2613 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.
33947 compared with similar codes
Office rates for Indiana, from the same CMS release.
No office rate
33949 is for daily management of venoarterial ECMO/ECLS, not starting the circuit.
No office rate
33951 represents peripheral cannula insertion. It describes cannulation work rather than the initiation service reported by 33947.
No office rate
33955 represents central cannula insertion, whereas 33947 reports initiation of venoarterial ECMO/ECLS.
Compare 33947 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
Indiana →
Office / nonfacility
Unavailable
Facility
$280.77
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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 33947 in Indiana.
PPRRVU2026_Oct_nonQPP.csv
4,133
- Code
- 33947
- Physician work
- 6.46
- Practice expense
- 1.36
- Malpractice
- 1.41
GPCI2026.csv
52
- Locality
- Indiana
- Physician work
- 1.000
- Practice expense
- 0.927
- Malpractice
- 0.486
| Component | RVU | Locality factor | Adjusted |
|---|---|---|---|
| Physician work | 6.46 | × 1.000 | 6.4600 |
| Practice expense | 1.36 | × 0.927 | 1.2607 |
| Malpractice | 1.41 | × 0.486 | 0.6853 |
| Total RVUs | 8.4060 | ||
| Conversion factor | × 33.4009 | ||
Facility rate, Indiana$280.77
Explore RVUs, geographic factors and the full formula
Facility
| Component | RVU | Local GPCI |
|---|---|---|
| Work | 6.46 | 1 |
| Practice expense | 1.36 | 0.927 |
| Malpractice | 1.41 | 0.486 |
(6.46 × 1 + 1.36 × 0.927 + 1.41 × 0.486) × $33.4009 = $280.77
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.
33947 billing questions
When should 33947 be chosen instead of 33946?
Use 33947 for venoarterial ECMO/ECLS initiation, with blood returned to the arterial circulation. Code 33946 describes venovenous initiation.
Is 33947 for daily ECMO management?
No. It represents initiation. Daily management of venoarterial ECMO is represented by 33949.
Can cannula insertion be reported separately?
ECMO cannula insertion has separate codes, including codes for peripheral and central cannula placement. Document the cannulation work and site to support the applicable insertion code.
What documentation supports 33947?
Document the indication for extracorporeal support, the venoarterial configuration, and the physician’s work initiating the circuit. Distinguish initiation from subsequent daily management.
Does 33947 describe venovenous support?
No. It describes venoarterial initiation. Venovenous initiation is reported with 33946.
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.
4,13033944,,Prepare donor heart,C,,0.00,0.00,,0.00,,0.00,0.00,0.00,0,XXX,0.00,0.00,0.00,2,0,2,1,0,9,,33.4009,09,0,99,0.00,0.00,0.00
4,13133945,,Transplantation of heart,R,,87.26,26.39,NA,26.39,,21.58,135.23,135.23,0,090,0.09,0.84,0.07,2,0,2,1,2,9,,33.4009,09,0,99,0.00,0.00,0.00
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
4906102,IL,12,EAST ST. LOUIS,1.000,0.920,2.014
5006102,IL,15,SUBURBAN CHICAGO,1.007,1.027,1.772
5106102,IL,99,REST OF ILLINOIS,1.000,0.913,1.563
5208102,IN,00,INDIANA,1.000,0.927,0.486
5305102,IA,00,IOWA,1.000,0.915,0.397
5405202,KS,00,KANSAS,1.000,0.904,0.504
5515102,KY,00,KENTUCKY,1.000,0.889,0.915