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CMS RVU26D · Effective 2026-10-01

33955 Central cannulation Medicare reimbursement rates in Vermont

Reports central ECMO/ECLS cannula placement through a chest incision in a patient from birth through age five when central access is selected. Compare 33955 office and facility rates across CMS payment localities in Vermont.

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 33955 in Vermont?

Vermont has 1 payment locality in this comparison. Use the service location to choose the applicable amount. These are the supported base rates for the payment area shown below, using the same CMS release.

Office / nonfacility

No supported rate

Facility setting

$695.04

1 of 1 localities have a supported rate.

Payment area: Vermont

One mapped payment locality.

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.

Find 33955 in your payment locality →

ECMO/ECLS

About 33955: Central ECMO cannula insertion, birth through age five

Reports central ECMO/ECLS cannula placement through a chest incision in a patient from birth through age five when central access is selected.

This service covers placement of central cannulae for extracorporeal membrane oxygenation or extracorporeal life support through a sternotomy or thoracotomy in a patient from birth through age five. A cardiothoracic or cardiac surgeon typically performs it in an operating room, including when central access is established during or after cardiac surgery. Central cannulation places access directly in the chest rather than through peripheral vessels.

Select this code based on the patient’s age and the central surgical access documented in the operative report; peripheral cannulation is coded separately. The record should support the need for ECMO/ECLS, the chest approach, and cannula placement. Same-day preoperative and postoperative care is included in the 0-day global period. When multiple procedures occur in the same session, the highest-valued procedure is paid in full and the others at 50%. Assistant-at-surgery payment requires medical-necessity documentation; co-surgeon and team-surgery claims require supporting documentation.

CMS billing rules for 33955

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 paid only with supporting documentation.
Team surgery
Team surgery paid only with supporting documentation.

Where the value comes from

  • Work RVU15.60 · 69%
  • Practice expense (office) RVU3.35 · 15%
  • Malpractice RVU3.74 · 16%

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.

33955 compared with similar codes

Office rates for Vermont, from the same CMS release.

33956

ECMO cannula insertion

Central, younger than five

No office rate

Both report central cannula insertion through a chest incision; choose 33955 for patients from birth through age five and 33956 for patients age six and older.

33951

ECMO cannulation

Percutaneous, age 5 or older

No office rate

Code 33951 is for peripheral open cannula insertion in patients from birth through age five. This code describes central placement through a sternotomy or thoracotomy.

33947

ECMO initiation

Venoarterial configuration

No office rate

Code 33947 reports venoarterial ECMO/ECLS initiation, not the central cannula placement itself. Report the services according to what was performed and documented.

Compare 33955 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.

1 of 1 payment localities

Office and facility base rates · shared scale starting at $0

  • Vermont →

    Office / nonfacility

    Unavailable

    Facility

    $695.04

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How this local rate is calculated

Each RVU component is multiplied by its own geographic practice cost index (GPCI). The three adjusted components are added, then multiplied by the conversion factor. These are the inputs used for 33955 in Vermont.

PPRRVU2026_Oct_nonQPP.csv

4,141

Code
33955
Physician work
15.60
Practice expense
3.35
Malpractice
3.74

GPCI2026.csv

105

Locality
Vermont
Physician work
1.000
Practice expense
0.990
Malpractice
0.506
Facility calculation for 33955 in Vermont
ComponentRVULocality factorAdjusted
Physician work15.60× 1.00015.6000
Practice expense3.35× 0.9903.3165
Malpractice3.74× 0.5061.8924
Total RVUs20.8089
Conversion factor× 33.4009

Facility rate, Vermont$695.04

Explore RVUs, geographic factors and the full formula

Facility

Facility calculation inputs
ComponentRVULocal GPCI
Work15.61
Practice expense3.350.99
Malpractice3.740.506

(15.6 × 1 + 3.35 × 0.99 + 3.74 × 0.506) × $33.4009 = $695.04

The office and facility calculations use their respective practice-expense RVUs. The facility amount here is the physician fee, not a separate hospital or facility bill.

33955 billing questions

How does this differ from peripheral cannula insertion?

Use this code for central cannula placement through a sternotomy or thoracotomy. Peripheral access uses the applicable peripheral insertion code.

How does this differ from code 33956?

Code 33956 is the central cannula insertion counterpart for patients age six and older. This code is for patients from birth through age five.

Is ECMO initiation part of this service?

This code reports cannula placement. ECMO/ECLS initiation is a separate service; code 33947 describes venoarterial initiation when that service is performed and documented.

Should modifier 50 be used?

No. Modifier 50 is inappropriate for this central-cannula service; document the central approach and cannula placement.

What documentation supports the age-specific code?

The operative report should identify the patient’s age, the sternotomy or thoracotomy approach, and the central cannula placement for ECMO/ECLS.

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.

RVUs for 33955PPRRVU2026_Oct_nonQPP.csv, line 4,141 (RVU26D)
Geographic factors for VermontGPCI2026.csv, line 105 (RVU26D)
Open CMS sourceHow this rate is calculatedBuild a fee sheet