No office rate
Both describe percutaneous peripheral ECMO/ECLS cannula removal; choose 33965 for patients age five and older and 33966 for younger patients.
On this page
CMS RVU26D · Effective 2026-10-01
33965 ECMO cannula removal Medicare reimbursement rates in Vermont
Reports percutaneous removal of peripheral ECMO or ECLS cannulae in patients age five and older when extracorporeal support is discontinued. Compare 33965 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 33965 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
$156.20
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.
Cardiovascular surgery
About 33965: Percutaneous ECMO cannula removal, age five and older
Reports percutaneous removal of peripheral ECMO or ECLS cannulae in patients age five and older when extracorporeal support is discontinued.
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.
CMS billing rules for 33965
- 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 RVU3.42 · 67%
- Practice expense (office) RVU0.85 · 17%
- Malpractice RVU0.82 · 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.
33965 compared with similar codes
Office rates for Vermont, from the same CMS release.
No office rate
This code represents percutaneous removal. Code 33969 is the open approach to peripheral ECMO/ECLS cannula removal.
No office rate
Code 33951 covers percutaneous insertion of peripheral ECMO/ECLS cannulae, not their removal after support ends.
No office rate
Code 33957 describes percutaneous repositioning of peripheral cannulae that remain in use; 33965 describes their removal.
Compare 33965 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
Vermont →
Office / nonfacility
Unavailable
Facility
$156.20
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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 33965 in Vermont.
PPRRVU2026_Oct_nonQPP.csv
4,150
- Code
- 33965
- Physician work
- 3.42
- Practice expense
- 0.85
- Malpractice
- 0.82
GPCI2026.csv
105
- Locality
- Vermont
- Physician work
- 1.000
- Practice expense
- 0.990
- Malpractice
- 0.506
| Component | RVU | Locality factor | Adjusted |
|---|---|---|---|
| Physician work | 3.42 | × 1.000 | 3.4200 |
| Practice expense | 0.85 | × 0.990 | 0.8415 |
| Malpractice | 0.82 | × 0.506 | 0.4149 |
| Total RVUs | 4.6764 | ||
| Conversion factor | × 33.4009 | ||
Facility rate, Vermont$156.20
Explore RVUs, geographic factors and the full formula
Facility
| Component | RVU | Local GPCI |
|---|---|---|
| Work | 3.42 | 1 |
| Practice expense | 0.85 | 0.99 |
| Malpractice | 0.82 | 0.506 |
(3.42 × 1 + 0.85 × 0.99 + 0.82 × 0.506) × $33.4009 = $156.20
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.
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 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.
4,14733962,,Ecmo/ecls repos perph cnula,A,,4.36,1.05,NA,1.05,,1.06,6.47,6.47,0,000,0.00,0.00,0.00,2,0,0,0,0,9,,33.4009,09,0,99,0.00,0.00,0.00
4,14833963,,Ecmo/ecls repos perph cnula,A,,8.78,1.95,NA,1.95,,2.10,12.83,12.83,0,000,0.00,0.00,0.00,2,0,0,1,1,9,,33.4009,09,0,99,0.00,0.00,0.00
4,14933964,,Ecmo/ecls repos perph cnula,A,,9.26,2.05,NA,2.05,,2.21,13.52,13.52,0,000,0.00,0.00,0.00,2,0,0,1,1,9,,33.4009,09,0,99,0.00,0.00,0.00
4,15033965,,Ecmo/ecls rmvl perph cannula,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
4,15133966,,Ecmo/ecls rmvl prph cannula,A,,4.39,1.04,NA,1.04,,1.03,6.46,6.46,0,000,0.00,0.00,0.00,2,0,0,0,0,9,,33.4009,09,0,99,0.00,0.00,0.00
4,15233967,,Insert i-aort percut device,A,,4.72,0.92,NA,0.92,,1.09,6.73,6.73,0,000,0.00,0.00,0.00,2,0,0,0,0,9,,33.4009,09,0,99,0.00,0.00,0.00
4,15333968,,Remove aortic assist device,A,,0.62,0.13,NA,0.13,,0.14,0.89,0.89,0,000,0.00,0.00,0.00,0,0,1,0,0,9,,33.4009,09,0,99,0.00,0.00,0.00
10204412,TX,18,HOUSTON,1.008,0.993,1.376
10304412,TX,99,REST OF TEXAS,1.000,0.949,0.903
10403502,UT,09,UTAH,1.000,0.940,0.898
10514512,VT,50,VERMONT,1.000,0.990,0.506
10611302,VA,00,VIRGINIA,1.000,0.983,0.706
10709202,VI,50,VIRGIN ISLANDS,1.000,1.011,0.985
10802402,WA,02,SEATTLE (KING CNTY),1.050,1.227,0.817