Billing code 33969: ECMO cannula removalMedicare rate & RVUs in Oregon
Reports percutaneous removal of a peripheral ECMO/ECLS cannula when extracorporeal support is discontinued and the cannula is removed.
CMS doesn’t publish an office rate for 33969 in Oregon.
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 33969 covers
This service covers percutaneous removal of a peripheral cannula used for extracorporeal membrane oxygenation or extracorporeal life support. It is performed during decannulation when the patient no longer needs extracorporeal support; the cannula may have been placed through a peripheral vessel such as the femoral artery or vein. A cardiovascular surgeon or another physician managing the patient’s ECMO care may perform the removal in a hospital setting.
Choose this code for the percutaneous removal procedure, not for cannula repositioning or daily ECMO management. Documentation should identify the peripheral cannula removed, its site, the percutaneous approach, and the decannulation work 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. Do not append modifier 50. Assistant-at-surgery payment requires documented medical necessity; 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 33969 pays more and less in Oregon
| Payment locality | Office | Facility |
|---|---|---|
| Portland | Unavailable | $247.21 |
| Rest Of Oregon | Unavailable | $238.25 |
How the 33969 rate is calculated
Each of 33969’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 · 33969
RVUs × geographic indexes × conversion factor
Swap in your local Medicare rate.
Work 5.09Practice expense 1.19Malpractice 1.22
All indexes start at 1.000 (the national rate). Enter a ZIP or drag a slider.
Payment rules and modifiers for 33969
The CMS indicators that decide how 33969 is paid alongside other services.
CMS payment indicators · 33969
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) | 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
33969 without 51 · national facility
$250.51
ECMO cannula removal
33969-51 · Second procedure: 50%
$125.26
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%).
33969 compared with similar codes
Compare codes
33969 vs 33965 vs 33966 vs 33957: national Medicare rates
Swap in your local Medicare rate.
How to choose
- 33965ECMO cannula removal
- Use 33969 for percutaneous peripheral cannula removal; 33965 describes removal by an open approach.
- 33966ECMO cannula removal
- This is a related open-removal code. Select between it and 33969 based on the removal approach documented.
- 33957ECMO cannula repositioning
- Use a repositioning code when the peripheral cannula is moved but remains in place; 33969 represents removal.
33969 billing questions
How does this differ from 33965 or 33966?
This code is for percutaneous removal of a peripheral ECMO/ECLS cannula. Codes 33965 and 33966 describe removal by an open approach.
Can this code be used for cannula repositioning?
No. Repositioning a peripheral ECMO/ECLS cannula is a different service; use the applicable repositioning code when the cannula is moved rather than removed.
Is daily ECMO management included in this removal service?
The code represents the percutaneous cannula removal procedure, not daily ECMO management. Document the decannulation work separately from routine management activities.
Can modifier 50 be reported?
No. Modifier 50 is inappropriate for this service.
When is an assistant-at-surgery payment supported?
CMS allows assistant-at-surgery payment only when the record documents medical necessity for the assistant.
How does CMS handle other procedures performed in the same session?
The highest-valued procedure is paid in full, and other procedures in the same session 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 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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