No office rate
Use 33956 for central cannula insertion in a patient younger than five; use 33955 for a patient age five or older.
On this page
CMS RVU26D · Effective 2026-10-01
33956 ECMO cannula insertion Medicare reimbursement rates in Iowa
Reports placement of central cannulae for extracorporeal support in a patient younger than five, rather than peripheral access or ECMO initiation. Compare 33956 office and facility rates across CMS payment localities in Iowa.
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 33956 in Iowa?
Iowa 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
$671.16
1 of 1 localities have a supported rate.
Payment area: Iowa
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.
ECMO/ECLS
About 33956: Central ECMO cannula insertion, under age five
Reports placement of central cannulae for extracorporeal support in a patient younger than five, rather than peripheral access or ECMO initiation.
This service covers placing cannulae in central vessels or the heart to establish access for extracorporeal membrane oxygenation or extracorporeal life support in a patient younger than five. It is typically performed by a cardiac surgeon or another surgeon experienced in ECMO cannulation, often in an operating room or intensive care setting when severe cardiac or respiratory failure requires extracorporeal support. The code represents cannula insertion, not the separate work of initiating or managing ECMO/ECLS.
Select the code based on the patient’s age and central rather than peripheral cannula placement. The operative or procedure note should identify the central access site, cannulae placed, and the patient’s age. CMS assigns a 0-day global period, so same-day preoperative and postoperative care is included. When multiple procedures are performed in one session, the highest-valued procedure is paid in full and other procedures are subject to the standard 50% reduction. Modifier 50 is inappropriate. Assistant-at-surgery payment requires medical-necessity documentation; co-surgeon and team-surgery payment require supporting documentation.
CMS billing rules for 33956
- 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 RVU15.60 · 69%
- Practice expense (office) RVU3.28 · 14%
- Malpractice RVU3.76 · 17%
441
Medicare services in 2024 · #3658 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.
33956 compared with similar codes
Office rates for Iowa, from the same CMS release.
No office rate
33952 describes peripheral percutaneous cannula insertion in a younger patient. This code is for central cannula insertion.
No office rate
33954 describes peripheral open cannula insertion in a younger patient. Choose this code when the cannulae are placed centrally.
No office rate
33946 reports initiation of venovenous ECMO/ECLS; this code reports placement of central cannulae in a younger patient.
Compare 33956 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
Iowa →
Office / nonfacility
Unavailable
Facility
$671.16
Need rates for a whole code list?
Fee-sheet and API access are in early access. Tell us which codes and locations your team needs.
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 33956 in Iowa.
PPRRVU2026_Oct_nonQPP.csv
4,142
- Code
- 33956
- Physician work
- 15.60
- Practice expense
- 3.28
- Malpractice
- 3.76
GPCI2026.csv
53
- Locality
- Iowa
- Physician work
- 1.000
- Practice expense
- 0.915
- Malpractice
- 0.397
| Component | RVU | Locality factor | Adjusted |
|---|---|---|---|
| Physician work | 15.60 | × 1.000 | 15.6000 |
| Practice expense | 3.28 | × 0.915 | 3.0012 |
| Malpractice | 3.76 | × 0.397 | 1.4927 |
| Total RVUs | 20.0939 | ||
| Conversion factor | × 33.4009 | ||
Facility rate, Iowa$671.16
Explore RVUs, geographic factors and the full formula
Facility
| Component | RVU | Local GPCI |
|---|---|---|
| Work | 15.6 | 1 |
| Practice expense | 3.28 | 0.915 |
| Malpractice | 3.76 | 0.397 |
(15.6 × 1 + 3.28 × 0.915 + 3.76 × 0.397) × $33.4009 = $671.16
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.
33956 billing questions
How is this code distinguished from 33955?
Both describe central cannula insertion for ECMO/ECLS. This code is for patients younger than five; 33955 is for patients age five and older.
When should a peripheral cannula insertion code be used instead?
Use the applicable peripheral insertion code when the cannulae are placed through peripheral rather than central access. The peripheral code also depends on the patient’s age and insertion approach.
Does this code report ECMO initiation?
No. It reports central cannula insertion. ECMO/ECLS initiation is a separate service when performed and documented.
What documentation supports reporting this code?
Document the patient’s age, central access site, cannulae placed, and the procedure performed. The record should distinguish central cannulation from peripheral access.
How does the 0-day global period affect same-day care?
Same-day preoperative and postoperative care is included in the procedure’s global period.
Can an assistant or additional surgeon be reported?
Assistant-at-surgery payment requires documentation of medical necessity. Co-surgeon and team-surgery payment 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.
4,13933953,,Ecmo/ecls insj prph cannula,A,,8.88,1.97,NA,1.97,,2.12,12.97,12.97,0,000,0.00,0.00,0.00,2,0,0,0,0,9,,33.4009,09,0,99,0.00,0.00,0.00
4,14033954,,Ecmo/ecls insj prph cannula,A,,8.88,1.95,NA,1.95,,2.10,12.93,12.93,0,000,0.00,0.00,0.00,2,0,0,0,0,9,,33.4009,09,0,99,0.00,0.00,0.00
4,14133955,,Ecmo/ecls insj ctr cannula,A,,15.60,3.35,NA,3.35,,3.74,22.69,22.69,0,000,0.00,0.00,0.00,2,0,0,1,1,9,,33.4009,09,0,99,0.00,0.00,0.00
4,14233956,,Ecmo/ecls insj ctr cannula,A,,15.60,3.28,NA,3.28,,3.76,22.64,22.64,0,000,0.00,0.00,0.00,2,0,0,1,1,9,,33.4009,09,0,99,0.00,0.00,0.00
4,14333957,,Ecmo/ecls repos perph cnula,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
4,14433958,,Ecmo/ecls repos perph cnula,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
4,14533959,,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
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
5607202,LA,01,NEW ORLEANS,1.000,0.941,1.136