Billing code 33986: ECMO cannula removalMedicare rate & RVUs in Nebraska
Reports removal of central ECMO or ECLS cannulae through an approach other than sternotomy or thoracotomy, including repair of the vessel.
CMS doesn’t publish an office rate for 33986 in Nebraska.
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 33986 covers
This code is for removing central cannulae used for extracorporeal membrane oxygenation or extracorporeal life support when the removal approach is not a sternotomy or thoracotomy. The work includes repair of the involved vessel, with or without a patch graft. A cardiothoracic or cardiovascular surgeon typically performs the procedure when a patient is being decannulated after central ECMO/ECLS support, commonly in an operating room or another setting equipped for surgical vascular management.
Select this code based on the cannula location and removal approach: central cannulae removed without sternotomy or thoracotomy belong here, while the sternotomy/thoracotomy approach is represented by 33985. The operative report should identify the central cannulae, approach, removal, and any vessel repair. The 0-day global period includes same-day preoperative and postoperative care. When multiple procedures occur 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.
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.
33986 in Nebraska
| Payment locality | Office | Facility |
|---|---|---|
| Nebraska | Unavailable | $421.75 |
How the 33986 rate is calculated
Each of 33986’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 · 33986
RVUs × geographic indexes × conversion factor
Work9.75
9.75 RVUs× 1.000 GPCI
Practice expense2.13
2.13 RVUs× 1.000 GPCI
Malpractice2.41
2.41 RVUs× 1.000 GPCI
Adjusted RVUs
14.2900
Conversion factor
$33.4009
Medicare rate
$477.30
Every GPCI starts at 1.000, the national rate. Enter a ZIP or drag a slider.
Payment rules and modifiers for 33986
The CMS indicators that decide how 33986 is paid alongside other services.
CMS payment indicators · 33986
ECMO cannula removal
| 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) | 1 | Permitted with supporting documentation. |
| Team surgery (66) | 1 | Permitted with supporting documentation. |
| Professional/technical | 0 | Physician service: no professional/technical split. |
What modifiers do to the payment
Modifier 51 · payment effect
With and without the modifier
33986 without 51 · national facility
$477.30
ECMO cannula removal
33986-51 · Second procedure: 50%
$238.65
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%).
33986 compared with similar codes
Compare codes · National
33986 vs 33984 vs 33985: Medicare rates
How to choose
- 33984ECMO cannula removal
- 33984 applies to peripheral cannula removal. This code is for central cannulae removed without sternotomy or thoracotomy.
- 33985ECMO cannula removal
- 33985 applies when central cannulae are removed through sternotomy or thoracotomy. This code describes central cannula removal through another approach.
33986 billing questions
How does 33986 differ from 33985?
Both report removal of central ECMO/ECLS cannulae. Use 33986 for an approach other than sternotomy or thoracotomy; use 33985 when removal is through a sternotomy or thoracotomy.
When should 33984 be used instead?
33984 is for removal of peripheral ECMO/ECLS cannulae. Choose based on whether the cannulae are peripheral or central, not simply on the fact that the patient is being decannulated.
Is vessel repair included in 33986?
Yes. The service includes repair of the involved vessel, with or without a patch graft.
Can modifier 50 be reported for removal of cannulae on both sides?
No. Modifier 50 is inappropriate for this code. Report the service according to the applicable code and documentation rather than treating it as a bilateral procedure.
What documentation supports 33986?
The operative report should establish that the cannulae were central, describe the removal approach as other than sternotomy or thoracotomy, and document any vessel repair.
How are other procedures in the same session paid?
The highest-valued procedure is paid in full, with other procedures subject to the standard multiple-procedure reduction. Assistant-at-surgery payment requires medical-necessity documentation; 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 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
Fee sheets
Put 33986 and the rest of your codes on one sheet
Build a fee sheet from your own code list at your locality, put your payer contracts beside Medicare, and see what changed each quarter.
Build my fee sheetOr price your code list free →