Billing code 33946: ECMO initiationMedicare rate & RVUs in Rhode Island
Reports physician work to initiate venovenous ECMO/ECLS in patients age six and older when respiratory support is needed through extracorporeal gas exchange.
CMS doesn’t publish an office rate for 33946 in Rhode Island.
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 33946 covers
This service covers starting venovenous extracorporeal membrane oxygenation or extracorporeal life support in a patient age six or older. Venous blood is routed through an extracorporeal circuit for gas exchange and returned to the venous circulation, supporting patients with severe respiratory failure when conventional respiratory support is inadequate. The physician directing initiation may be a critical care specialist, cardiothoracic surgeon, or another clinician experienced in ECMO, typically in an intensive care setting.
Report 33946 for the initiation phase, not for ongoing daily ECMO management or an arterial-return configuration. The record should establish the patient’s age, the venovenous support configuration, the clinical need for ECMO, and the physician’s work initiating the service. Cannula insertion has separate codes in the ECMO/ECLS code family when that work is performed. CMS lists no special payment rules for this code in the supplied facts.
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.
33946 in Rhode Island
| Payment locality | Office | Facility |
|---|---|---|
| Rhode Island | Unavailable | $280.12 |
How the 33946 rate is calculated
Each of 33946’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 · 33946
RVUs × geographic indexes × conversion factor
Work5.85
5.85 RVUs× 1.000 GPCI
Practice expense1.26
1.26 RVUs× 1.000 GPCI
Malpractice1.26
1.26 RVUs× 1.000 GPCI
Adjusted RVUs
8.3700
Conversion factor
$33.4009
Medicare rate
$279.57
Every GPCI starts at 1.000, the national rate. Enter a ZIP or drag a slider.
Payment rules and modifiers for 33946
33946 has no global surgery period, no multiple-procedure, bilateral or assistant-at-surgery adjustment, and no professional/technical split. What changes the payment is where the service happens: the place of service on the claim decides whether Medicare pays the office or the facility rate.
Place of service · 33946
Which rate does Medicare pay?
The POS code on the claim line (CMS-1500 box 24B).
POS 11 · non-facility rate · national
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33946 isn’t priced in this setting.
33946 compared with similar codes
Compare codes · National
5 codes, side by side
How to choose
- 33947ECMO initiation
- Both codes report ECMO/ECLS initiation in patients age six and older. Choose 33946 for venovenous support and 33947 for venoarterial support.
- 33948ECMO management
- This code reports daily management of venovenous ECMO/ECLS after initiation; 33946 reports starting the support.
- 33949ECMO management
- This code reports daily management of venoarterial ECMO/ECLS, rather than venovenous initiation.
- 33951ECMO cannulation
- This code represents peripheral cannula insertion, not initiation of the venovenous ECMO/ECLS service.
33946 billing questions
When is 33946 chosen instead of 33947?
Use 33946 for venovenous support, with blood returned to the venous circulation. Code 33947 describes initiation of a venoarterial configuration.
Can 33946 be used for daily ECMO management?
No. It represents initiation; 33948 describes daily management of venovenous ECMO/ECLS.
Does 33946 include cannula insertion?
Cannula insertion is represented by separate codes in the ECMO/ECLS family when that work is performed. Document the insertion separately from the physician’s initiation work.
What age range does 33946 cover?
This initiation code applies to patients age six and older. Check the applicable age-specific code when the patient is younger.
What documentation supports reporting 33946?
Document the respiratory indication, venovenous circuit configuration, initiation work, and patient age. The record should distinguish initiation from subsequent daily management.
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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