Billing code 33984: ECMO cannula removalMedicare rate & RVUs in Texas
Report open surgical removal of peripheral cannulae used for ECMO or ECLS when extracorporeal support is discontinued.
CMS doesn’t publish an office rate for 33984 in Texas.
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 33984 covers
This service is the open surgical decannulation of peripheral extracorporeal membrane oxygenation or extracorporeal life support access. After support has ended, a surgeon exposes the access site, removes the cannula or cannulae, and manages the vessel and surrounding tissues. Common peripheral access sites include the femoral vessels; peripheral venous access may also be through the neck. The work is typically performed in a hospital operating room or intensive care setting by a surgeon familiar with vascular or cardiothoracic procedures.
Select this code when the removed ECMO/ECLS cannulae are peripheral and the removal is performed open. The operative report should identify the support system, access site, peripheral location, and removal approach. The code has a 0-day global period, so same-day preoperative and postoperative care is included. When other procedures occur in the same session, CMS pays the highest-valued procedure in full and reduces the others. Assistant-at-surgery payment requires documented medical necessity; co-surgeon and team-surgery reporting are not permitted. Modifier 50 is inappropriate for this descriptor.
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 33984 pays more and less in Texas
The same RVUs, adjusted for each area’s costs. Open a locality for its calculation, history and nearby areas.
8 of 8 payment localities
| Payment locality | Office | Facility |
|---|---|---|
| Austin | Unavailable | $256.04 |
| Beaumont | Unavailable | $252.08 |
| Brazoria | Unavailable | $249.98 |
| Dallas | Unavailable | $253.76 |
| Fort Worth | Unavailable | $253.96 |
| Galveston | Unavailable | $252.16 |
| Houston | Unavailable | $276.14 |
| Rest Of Texas | Unavailable | $252.39 |
How the 33984 rate is calculated
Each of 33984’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 · 33984
RVUs × geographic indexes × conversion factor
Swap in your local Medicare rate.
Work 5.32Practice expense 1.11Malpractice 1.31
All indexes start at 1.000 (the national rate). Enter a ZIP or drag a slider.
Payment rules and modifiers for 33984
The CMS indicators that decide how 33984 is paid alongside other services.
CMS payment indicators · 33984
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
33984 without 51 · national facility
$258.52
ECMO cannula removal
33984-51 · Second procedure: 50%
$129.26
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%).
33984 compared with similar codes
Compare codes
33984 vs 33985 vs 33986 vs 33992: national Medicare rates
Swap in your local Medicare rate.
How to choose
- 33985ECMO cannula removal
- Use 33985 for open removal of central ECMO/ECLS cannulae; 33984 describes peripheral cannula removal.
- 33986ECMO cannula removal
- 33986 is for central cannula removal with vessel repair, with or without patch graft; 33984 is for peripheral cannula removal.
- 33992VAD removal
- 33992 describes removal of a percutaneous left-heart VAD, not open removal of peripheral ECMO/ECLS cannulae.
33984 billing questions
How does 33984 differ from 33985?
33984 is for open removal of peripheral ECMO/ECLS cannulae. Use the central-cannula removal code when the cannulae are positioned centrally.
When is 33984 reported?
Report it for open surgical removal of peripheral cannulae after ECMO/ECLS support is discontinued. Document the support system, access site, and removal approach.
Does the 0-day global period include same-day care?
Yes. Same-day preoperative and postoperative care is included in the procedure's 0-day global period.
How are other procedures in the same session paid?
CMS pays the highest-valued procedure in full and reduces the other procedures to 50% when multiple procedures are performed in the same session.
Can an assistant or co-surgeon be reported?
Assistant-at-surgery payment requires documentation of medical necessity. Co-surgeons and team surgery are not permitted for this code.
Can modifier 50 be used for bilateral cannula removal?
No. Modifier 50 is inappropriate for this descriptor; report the applicable peripheral cannula removal service.
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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