2025 CPT code 33954
(Active) Effective Date: N/A Revision Date: N/A Surgery - Surgical Procedures on the Cardiovascular System Surgery Feed
Insertion of peripheral (arterial and/or venous) cannula(e) for extracorporeal membrane oxygenation (ECMO)/extracorporeal life support (ECLS), open approach, in patients 6 years and older.
Modifiers may be applicable depending on the circumstances of the procedure (e.g., modifier 59 for distinct procedural service, modifier 76 for repeat procedure).Appropriate modifier use should align with the specific circumstances of each case.
ECMO/ECLS is medically necessary when a patient has severe respiratory or cardio-respiratory failure that is unresponsive to conventional medical treatments and poses an immediate life threat.Documentation must support the severity of the condition and the failure of other interventions.
The physician is responsible for the surgical insertion of the peripheral cannula(e) for ECMO/ECLS. This includes prepping the patient, making the incision, inserting the cannula(e), and closing the incision.The physician may also utilize fluoroscopic guidance during the procedure.
In simple words: The doctor inserts tubes (cannulas) into a vein and/or artery to connect the patient to a machine that acts as an artificial heart and/or lung. This helps the patient's heart and lungs rest and recover. The procedure is done through a small cut in the leg or other area and is for children six years and older.
This CPT code (33954) represents the physician's services for inserting peripheral arterial and/or venous cannula(e) during an open surgical approach to initiate extracorporeal membrane oxygenation (ECMO) or extracorporeal life support (ECLS) in patients aged six years and older.The procedure involves incising the skin over the chosen vessel (femoral or other artery/vein), preparing the site, and carefully inserting the cannula(e) to establish extracorporeal circulation. Fluoroscopic guidance may be used.The cannula(e) serve as the exit point for deoxygenated blood, which is then processed by an external oxygenator before being returned to the patient's circulation.This code does not encompass the ongoing daily management of the ECMO/ECLS circuit or the overall patient care.
Example 1: A six-year-old child is admitted to the hospital with severe respiratory failure due to pneumonia.The physician determines that ECMO support is necessary.Code 33954 is used to bill for the insertion of the peripheral cannula(e) for initiation of ECMO., An 18-year-old patient experiences cardiac arrest following a motor vehicle accident.The patient is placed on veno-arterial ECMO support, requiring the insertion of both arterial and venous cannula(e). Code 33954 is used to bill for the insertion of both cannula(e)., A 70-year-old patient presents with severe acute respiratory distress syndrome (ARDS) following a major surgery. The physician chooses ECMO as a life support measure and utilizes code 33954 to bill the insertion of the cannula(e).
Detailed operative report including the type and location of cannula(e) insertion, use of fluoroscopy, type of ECMO/ECLS circuit used (veno-venous or veno-arterial), and any complications encountered during the procedure.Patient’s medical history and the reason for requiring ECMO/ECLS should be documented.
** This code is specific to the insertion of cannula(e) and does not include other services related to ECMO/ECLS management or overall patient care.Those services are reported using separate codes.
- Payment Status: Active
- Modifier TC rule: Not applicable.
- Specialties:Cardiothoracic Surgery, Cardiovascular Surgery, Critical Care Medicine, Anesthesiology
- Place of Service:Inpatient Hospital, Ambulatory Surgical Center