No office rate
Both codes cover percutaneous repositioning of peripheral ECMO/ECLS cannulae; 33957 is selected for venovenous support, while 33958 represents a different circuit configuration.
On this page
CMS RVU26D · Effective 2026-10-01
33957 ECMO cannula repositioning Medicare reimbursement rates in Oklahoma
Reports percutaneous repositioning of peripheral cannulae in a venovenous ECMO or ECLS circuit when the cannula position needs adjustment. Compare 33957 office and facility rates across CMS payment localities in Oklahoma.
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 33957 in Oklahoma?
Oklahoma 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
$160.87
1 of 1 localities have a supported rate.
Payment area: Oklahoma
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 33957: Percutaneous peripheral ECMO cannula repositioning
Reports percutaneous repositioning of peripheral cannulae in a venovenous ECMO or ECLS circuit when the cannula position needs adjustment.
This service covers percutaneous adjustment of peripheral cannula position in a venovenous extracorporeal membrane oxygenation or extracorporeal life support circuit. It may be needed when a cannula is malpositioned or its position interferes with effective circuit flow. Cardiothoracic or vascular surgeons and other clinicians experienced in ECMO cannulation may perform the procedure in an operating room, catheterization laboratory, or intensive care setting. The service concerns repositioning an existing peripheral cannula, not placing or removing one.
Select the code when the documented procedure is percutaneous repositioning for venovenous support; the record should identify the cannula site, the reason for adjustment, and the technique performed. CMS assigns a 0-day global period, so same-day preoperative and postoperative care is included. When multiple procedures are performed in the same session, the highest-valued procedure is paid in full and other procedures are subject to the standard multiple procedure reduction. Assistant-at-surgery payment requires documentation of medical necessity. Co-surgeons and team surgery are not permitted.
CMS billing rules for 33957
- 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 not permitted.
- Team surgery
- Team surgery not permitted.
Where the value comes from
- Work RVU3.42 · 67%
- Practice expense (office) RVU0.85 · 17%
- Malpractice RVU0.82 · 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.
33957 compared with similar codes
Office rates for Oklahoma, from the same CMS release.
No office rate
33951 is for peripheral cannula insertion. Use 33957 when the service adjusts the position of an existing cannula percutaneously.
No office rate
33965 describes removal of a peripheral ECMO/ECLS cannula, not adjustment of its position.
No office rate
33948 is for daily management of venovenous ECMO/ECLS; 33957 is for a percutaneous cannula repositioning procedure.
Compare 33957 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
Oklahoma →
Office / nonfacility
Unavailable
Facility
$160.87
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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 33957 in Oklahoma.
PPRRVU2026_Oct_nonQPP.csv
4,143
- Code
- 33957
- Physician work
- 3.42
- Practice expense
- 0.85
- Malpractice
- 0.82
GPCI2026.csv
86
- Locality
- Oklahoma
- Physician work
- 1.000
- Practice expense
- 0.893
- Malpractice
- 0.777
| Component | RVU | Locality factor | Adjusted |
|---|---|---|---|
| Physician work | 3.42 | × 1.000 | 3.4200 |
| Practice expense | 0.85 | × 0.893 | 0.7591 |
| Malpractice | 0.82 | × 0.777 | 0.6371 |
| Total RVUs | 4.8162 | ||
| Conversion factor | × 33.4009 | ||
Facility rate, Oklahoma$160.87
Explore RVUs, geographic factors and the full formula
Facility
| Component | RVU | Local GPCI |
|---|---|---|
| Work | 3.42 | 1 |
| Practice expense | 0.85 | 0.893 |
| Malpractice | 0.82 | 0.777 |
(3.42 × 1 + 0.85 × 0.893 + 0.82 × 0.777) × $33.4009 = $160.87
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.
33957 billing questions
How is this code distinguished from 33958?
Both codes describe percutaneous repositioning of peripheral ECMO/ECLS cannulae. Choose based on the circuit configuration documented; 33957 is for venovenous support.
Can this be reported for initial cannula placement?
No. This code describes repositioning an existing peripheral cannula. Use the applicable insertion code when the service places a cannula.
Is same-day postoperative care separately reported?
Same-day preoperative and postoperative care is included in this procedure's 0-day global period.
Can modifier 50 be used?
No. CMS identifies bilateral adjustment as inappropriate for this code.
When is assistant-at-surgery payment allowed?
Only when the record documents medical necessity for the assistant. Co-surgeons and team surgery are not permitted.
How are other procedures in the same session paid?
The highest-valued procedure is paid in full; other procedures are subject to the standard multiple procedure reduction.
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.
4,14033954,,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
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
8311502,NC,00,NORTH CAROLINA,1.000,0.933,0.639
8403302,ND,01,NORTH DAKOTA**,1.000,1.000,0.406
8515202,OH,00,OHIO,1.000,0.913,1.008
8604312,OK,00,OKLAHOMA,1.000,0.893,0.777
8702302,OR,01,PORTLAND,1.016,1.111,0.744
8802302,OR,99,REST OF OREGON,1.000,0.996,0.703
8912502,PA,01,METROPOLITAN PHILADELPHIA,1.018,1.041,1.193