Billing code 33965: ECMO cannula removalMedicare rate & RVUs in Rhode Island
Reports percutaneous removal of peripheral ECMO or ECLS cannulae in patients age five and older when extracorporeal support is discontinued.
CMS doesn’t publish an office rate for 33965 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 33965 covers
This service covers percutaneous removal of peripheral cannulae used for extracorporeal membrane oxygenation or extracorporeal life support in a patient age five or older. It is performed when the patient no longer needs extracorporeal support, often in an intensive care unit or procedure setting. The physician removes the cannulae through the percutaneous access sites and manages hemostasis. Cardiovascular and vascular surgeons, along with other physicians involved in ECMO care, may perform the procedure.
Select this code for percutaneous removal in the specified age group; document the patient’s age, the ECMO/ECLS indication, the peripheral cannulae removed, and the percutaneous approach. The code has a 0-day global period, so same-day preoperative and postoperative care is included. When multiple procedures occur in the same session, the highest-valued procedure is paid in full and other procedures are subject to the standard 50% multiple-procedure reduction. Modifier 50 is inappropriate for this service. An assistant at surgery is payable only when medical necessity is documented; 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.
33965 in Rhode Island
| Payment locality | Office | Facility |
|---|---|---|
| Rhode Island | Unavailable | $170.16 |
How the 33965 rate is calculated
Each of 33965’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 · 33965
RVUs × geographic indexes × conversion factor
Work3.42
3.42 RVUs× 1.000 GPCI
Practice expense0.85
0.85 RVUs× 1.000 GPCI
Malpractice0.82
0.82 RVUs× 1.000 GPCI
Adjusted RVUs
5.0900
Conversion factor
$33.4009
Medicare rate
$170.01
Every GPCI starts at 1.000, the national rate. Enter a ZIP or drag a slider.
Payment rules and modifiers for 33965
The CMS indicators that decide how 33965 is paid alongside other services.
CMS payment indicators · 33965
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
33965 without 51 · national facility
$170.01
ECMO cannula removal
33965-51 · Second procedure: 50%
$85.01
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%).
33965 compared with similar codes
Compare codes · National
5 codes, side by side
How to choose
- 33966ECMO cannula removal
- Both describe percutaneous peripheral ECMO/ECLS cannula removal; choose 33965 for patients age five and older and 33966 for younger patients.
- 33969ECMO cannula removal
- This code represents percutaneous removal. Code 33969 is the open approach to peripheral ECMO/ECLS cannula removal.
- 33951ECMO cannulation
- Code 33951 covers percutaneous insertion of peripheral ECMO/ECLS cannulae, not their removal after support ends.
- 33957ECMO cannula repositioning
- Code 33957 describes percutaneous repositioning of peripheral cannulae that remain in use; 33965 describes their removal.
33965 billing questions
How does this code differ from 33966?
This code is for percutaneous removal in patients age five and older. Code 33966 is the corresponding percutaneous removal code for patients younger than five.
When is removal reported instead of repositioning?
Report removal when the peripheral ECMO/ECLS cannulae are taken out after support ends. Repositioning codes describe changing cannula position while the cannulae remain in use.
What documentation supports the percutaneous approach?
Record the ECMO/ECLS indication, the peripheral cannulae removed, the patient's age, and that removal was performed percutaneously.
Can an assistant surgeon be reported?
An assistant at surgery is payable only when the record supports medical necessity. Co-surgeons and team surgery are not permitted for this code.
How does the 0-day global period affect same-day care?
Same-day preoperative and postoperative care is included in the procedure. The 0-day global period does not include care on later dates.
How are other procedures in the same session paid?
The highest-valued procedure is paid in full, and other procedures in the session are subject to the standard 50% 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
Fee sheets
Put 33965 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 →