No office rate
Both codes concern peripheral cannula insertion, but 33954 identifies the percutaneous approach for patients age six and older. Apply the sibling code criteria when the approach or age group differs.
On this page
CMS RVU26D · Effective 2026-10-01
33954 ECMO cannulation Medicare reimbursement rates in Texas
Reports percutaneous placement of peripheral cannulae for ECMO or ECLS in a patient age six or older as part of extracorporeal support. Compare 33954 office and facility rates across CMS payment localities in Texas.
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 33954 in Texas?
Texas has 8 payment localities in this comparison. Use the service location to choose the applicable amount. These are the supported base rates for the 8 payment areas shown below, using the same CMS release.
Office / nonfacility
No supported rate
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.
Where 33954 pays more and less in Texas
Cardiothoracic surgery
About 33954: Percutaneous peripheral ECMO cannula insertion
Reports percutaneous placement of peripheral cannulae for ECMO or ECLS in a patient age six or older as part of extracorporeal support.
This service covers percutaneous placement of peripheral cannulae to establish extracorporeal membrane oxygenation or extracorporeal life support in patients age six and older. A cardiothoracic or vascular surgeon, or another physician qualified to perform the access, places cannulae through peripheral vessels; femoral vessels are common access sites. The service is performed in settings such as an operating room or intensive care unit when urgent circulatory or respiratory support is needed.
Select this code for percutaneous peripheral cannulation in the specified age group; use the applicable sibling code when the age group or insertion approach differs. Document the patient’s age, peripheral access site, percutaneous technique, and cannula placement. The 0-day global period includes same-day preoperative and postoperative care. 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% reduction. Modifier 50 is inappropriate. Assistant-at-surgery payment requires documented medical necessity; co-surgeons and team surgery are not permitted.
CMS billing rules for 33954
- 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 RVU8.88 · 69%
- Practice expense (office) RVU1.95 · 15%
- Malpractice RVU2.10 · 16%
281
Medicare services in 2024 · #4045 by national volume
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.
33954 compared with similar codes
Office rates for Texas, from the same CMS release.
No office rate
33954 covers percutaneous peripheral cannula placement; 33955 is in the central cannula insertion family.
No office rate
33954 reports the percutaneous peripheral cannula placement. Code 33946 reports veno-venous ECMO/ECLS initiation, a distinct service when performed.
Compare 33954 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.
8 of 8 payment localities
| Payment locality | Office | Facility |
|---|---|---|
| Austin | Office Unavailable | Facility $428.25 |
| Beaumont | Office Unavailable | Facility $421.03 |
| Brazoria | Office Unavailable | Facility $418.23 |
| Dallas | Office Unavailable | Facility $424.32 |
| Fort Worth | Office Unavailable | Facility $424.58 |
| Galveston | Office Unavailable | Facility $421.73 |
| Houston | Office Unavailable | Facility $460.16 |
| Rest Of Texas | Office Unavailable | Facility $421.75 |
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33954 billing questions
How does 33954 differ from 33951?
33954 is for percutaneous peripheral cannula insertion in a patient age six or older. Choose 33951 when the insertion approach and the patient’s age match that code’s criteria instead.
When should a central cannula insertion code be used instead?
Use the central cannula insertion family when cannulae are placed centrally rather than through peripheral vessels. Code 33954 describes percutaneous peripheral access.
Can this be reported with an ECMO/ECLS initiation code?
Peripheral cannula placement may be reported with the applicable initiation service when both services are performed and documented. Select the initiation code for the veno-venous or veno-arterial circuit.
Can modifier 50 be appended for cannulation on both sides?
No. The CMS bilateral adjustment does not apply, and modifier 50 is inappropriate for this code.
What documentation supports 33954?
Record the patient’s age, the peripheral vessel access site, the percutaneous approach, and the cannula placement performed for ECMO/ECLS.
May an assistant surgeon or co-surgeon be reported?
Assistant-at-surgery payment requires documentation of medical necessity. Co-surgeons and team surgery are not permitted.
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.
4,13733951,,Ecmo/ecls insj prph cannula,A,,7.95,1.79,NA,1.79,,1.91,11.65,11.65,0,000,0.00,0.00,0.00,2,0,0,0,0,9,,33.4009,09,0,99,0.00,0.00,0.00
4,13833952,,Ecmo/ecls insj prph cannula,A,,7.95,1.75,NA,1.75,,1.82,11.52,11.52,0,000,0.00,0.00,0.00,2,0,0,0,0,9,,33.4009,09,0,99,0.00,0.00,0.00
4,13933953,,Ecmo/ecls insj prph cannula,A,,8.88,1.97,NA,1.97,,2.12,12.97,12.97,0,000,0.00,0.00,0.00,2,0,0,0,0,9,,33.4009,09,0,99,0.00,0.00,0.00
4,14033954,,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