Billing code 33951: ECMO cannulationMedicare rate & RVUs in Washington
Reports percutaneous placement of peripheral ECMO/ECLS cannulae for patients age five or older, such as femoral vascular access for extracorporeal support.
CMS doesn’t publish an office rate for 33951 in Washington.
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 33951 covers
This service covers percutaneous placement of cannulae in peripheral vessels to establish extracorporeal membrane oxygenation or extracorporeal life support. It is used when a patient needs temporary circulatory or respiratory support, including situations requiring peripheral access such as femoral cannulation. Cardiothoracic and other surgeons who perform ECMO access procedures commonly provide the service in a hospital setting. The age threshold for this code is five years or older.
Select this code when the cannulae are placed percutaneously in peripheral vessels; use a different code when the patient is younger or the access is open or central. The operative record should identify the access approach, peripheral site, cannula placement, and patient age. The service has a 0-day global period, so same-day preoperative and postoperative care is included. When other procedures occur in the same session, the highest-valued procedure is paid in full and the others are subject to the standard multiple procedure reduction. Modifier 50 is inappropriate. Assistant-at-surgery payment requires documented medical necessity; co-surgeons and team surgery are not permitted.
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 33951 pays more and less in Washington
| Payment locality | Office | Facility |
|---|---|---|
| Rest Of Washington | Unavailable | $380.49 |
| Seattle (King Cnty) | Unavailable | $404.29 |
How the 33951 rate is calculated
Each of 33951’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 · 33951
RVUs × geographic indexes × conversion factor
Swap in your local Medicare rate.
Work 7.95Practice expense 1.79Malpractice 1.91
All indexes start at 1.000 (the national rate). Enter a ZIP or drag a slider.
Payment rules and modifiers for 33951
The CMS indicators that decide how 33951 is paid alongside other services.
CMS payment indicators · 33951
ECMO cannulation
| 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
33951 without 51 · national facility
$389.12
ECMO cannulation
33951-51 · Second procedure: 50%
$194.56
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%).
33951 compared with similar codes
Compare codes
33951 vs 33952 vs 33953 vs 33955 vs 33946: national Medicare rates
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How to choose
- 33952ECMO cannulation
- Both codes cover percutaneous peripheral ECMO/ECLS cannula insertion; 33952 is for patients younger than five, while 33951 is for patients age five or older.
- 33953ECMO cannulation
- 33953 is for open peripheral cannula insertion in patients age five or older. Report 33951 when the peripheral cannulae are placed percutaneously.
- 33955Central cannulation
- 33955 describes open central cannula insertion. 33951 is for percutaneous placement in peripheral vessels.
- 33946ECMO initiation
- 33946 reports venous ECMO/ECLS initiation, not peripheral cannula placement. Cannulation and initiation are distinct services when both are performed and documented.
33951 billing questions
How does 33951 differ from 33952?
Both describe percutaneous peripheral ECMO/ECLS cannula insertion. Use 33951 for patients age five or older and 33952 for patients younger than five.
When should 33953 be considered instead?
33953 describes open peripheral cannula insertion for patients age five or older. The access technique, rather than the peripheral site alone, distinguishes it from 33951.
Is modifier 50 appropriate for cannulation on both sides?
No. The CMS bilateral adjustment does not apply to 33951, and modifier 50 is inappropriate.
What documentation supports reporting 33951?
Document the patient's age, the peripheral access site, the percutaneous approach, and placement of the cannulae for ECMO/ECLS.
Can an assistant-at-surgery be reported?
Assistant-at-surgery payment is limited to cases with documented medical necessity. Co-surgeons and team surgery are not permitted.
How does the 0-day global period affect same-day care?
Same-day preoperative and postoperative care is included in the procedure's 0-day global period.
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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