No office rate
Both describe open repositioning of a peripheral ECMO/ECLS cannula; 33958 is for patients younger than six years, while 33957 is for patients six years and older.
On this page
CMS RVU26D · Effective 2026-10-01
33958 Cannula repositioning Medicare reimbursement rates in Virginia
Reports open repositioning of an existing peripheral ECMO/ECLS cannula in a patient younger than six years when its position requires surgical correction. Compare 33958 office and facility rates across CMS payment localities in Virginia.
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 33958 in Virginia?
Virginia has 2 payment localities in this comparison. Use the service location to choose the applicable amount. These are the supported base rates for the 2 payment areas shown below, using the same CMS release.
Office / nonfacility
No supported rate
Facility setting
$161.48–$184.33
2 of 2 localities have a 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.
Cardiothoracic surgery
About 33958: Open peripheral ECMO cannula repositioning
Reports open repositioning of an existing peripheral ECMO/ECLS cannula in a patient younger than six years when its position requires surgical correction.
This service covers surgically repositioning an existing peripheral cannula used for extracorporeal membrane oxygenation or extracorporeal life support in a patient younger than six years. A surgeon may adjust a cannula in a peripheral vessel, such as a cervical or femoral vessel, when its position needs correction during ECMO/ECLS support. The procedure is typically performed in a hospital operating room or intensive care setting by a cardiac or vascular surgeon.
Select this code for open repositioning in the specified age group, not for initial cannula placement, percutaneous repositioning, central cannula repositioning, or cannula removal. The operative report should identify the patient’s age, the peripheral cannula, the open approach, and the repositioning performed. CMS assigns 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 multiple procedure reduction. Modifier 50 is not appropriate. Assistant-at-surgery payment requires medical-necessity documentation; co-surgeons and team surgery are not permitted.
CMS billing rules for 33958
- 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%
80
Medicare services in 2024 · #5051 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.
33958 compared with similar codes
Office rates for Virginia, from the same CMS release.
No office rate
This is the percutaneous counterpart for patients younger than six years. Choose 33958 when the repositioning is performed through an open approach.
No office rate
33951 describes insertion of a peripheral ECMO/ECLS cannula, not adjustment of an existing cannula’s position.
No office rate
33965 describes removal of a peripheral cannula. Use 33958 when the existing cannula is repositioned rather than removed.
Compare 33958 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.
2 of 2 payment localities
Dc + Md/Va Suburbs →
Office / nonfacility
Unavailable
Facility
$184.33
Virginia →
Office / nonfacility
Unavailable
Facility
$161.48
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33958 billing questions
When should this code be selected instead of 33957?
Use 33958 for open repositioning of a peripheral cannula in a patient younger than six years. Code 33957 describes the corresponding open service for patients six years and older.
How does this differ from 33962?
Both codes describe peripheral cannula repositioning for patients younger than six years, but 33958 is the open approach and 33962 is the percutaneous approach.
Is this code for placing or removing a cannula?
No. It describes repositioning an existing peripheral cannula. Initial placement and cannula removal are separate services with their own codes.
What should the operative report document?
Document the patient’s age, that the cannula is peripheral, the open approach, and the repositioning performed. The record should distinguish repositioning from insertion or removal.
Can an assistant-at-surgery be reported?
CMS pays an assistant at surgery only when medical necessity is documented. 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. CMS applies the standard multiple procedure reduction when other procedures are performed in the same session.
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.
4,14133955,,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
4,14433958,,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
4,14533959,,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
4,1463395F,,Quant nonher2 ihc brst cx,M,,0.00,0.00,,0.00,,0.00,0.00,0.00,9,XXX,0.00,0.00,0.00,9,9,9,9,9,9,,33.4009,09,0,99,0.00,0.00,0.00
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