2025 CPT code 33953

Insertion of peripheral (arterial and/or venous) cannula(e) for ECMO/ECLS, open approach, in children birth through 5 years old.

Follow CPT guidelines for ECMO/ECLS procedures.Appropriate documentation is crucial for accurate coding.Consult the latest CPT manual for any updates or changes.

Modifiers may be applicable depending on the circumstances of the procedure (e.g., 59 for distinct procedural service, 78 or 79 for unplanned return to the OR). Consult the CPT manual for modifier usage guidelines.

ECMO/ECLS is medically necessary when the patient's heart and/or lungs are unable to provide adequate oxygenation and/or circulation. This is often seen in conditions such as severe respiratory distress syndrome, cardiac arrest, or other critical illnesses.

The surgeon's responsibilities include prepping the patient, making the incision, inserting the cannula(e) into the chosen vessel(s), and closing the incision.They may use fluoroscopy for guidance.Post-operative care is not included in this code.

IMPORTANT 33954 (same procedure for patients 6 years and older), 33946, 33947 (ECMO/ECLS initiation), 33948, 33949 (daily ECMO/ECLS management), 33957-33964 (cannula repositioning), 33965-33966, 33969, 33984-33986 (cannula removal).Additional codes may be necessary for extensive vessel repair (e.g., 35266, 35286, 35371, 35665).

In simple words: The doctor makes a small cut to put in a tube (cannula) into a blood vessel (usually in the leg) to connect the child to a machine that does the work of the heart and lungs while they heal. This is for children from birth to age 5.

This CPT code 33953 represents the physician's service of inserting peripheral arterial and/or venous cannula(e) via an open surgical approach for extracorporeal membrane oxygenation (ECMO) or extracorporeal life support (ECLS) in children aged birth through 5 years.The procedure involves surgical incision, cannula insertion into a vessel (femoral vein or artery commonly used), and closure of the incision. Fluoroscopic guidance may be utilized.This code excludes the initiation, daily management, and discontinuation of the ECMO/ECLS circuit, which are billed separately using codes 33946, 33947, 33948, and 33949, and patient management which is billed using other relevant evaluation and management codes.

Example 1: A newborn infant with severe respiratory distress syndrome requires ECMO support. The surgeon inserts peripheral cannula(e) for initiation of veno-venous ECMO., A 3-year-old child experiencing cardiac arrest after a motor vehicle accident needs veno-arterial ECMO. The surgeon performs an open cannulation of the femoral artery and vein., A 5-year-old child with severe pneumonia requiring ECMO support undergoes cannulation of the internal jugular vein for veno-venous ECMO. The surgeon uses fluoroscopic guidance during the procedure.

* Operative report detailing the surgical technique, location of cannula placement, and any complications.* Preoperative and postoperative assessments of the patient's condition.* Anesthesia records.* Imaging studies (if fluoroscopy was used).* Documentation of the need for ECMO/ECLS.

** This code is specifically for children under 6 years old.For older children and adults, code 33954 should be used.The use of fluoroscopy should be documented if performed.

  • Payment Status: Active
  • Modifier TC rule: Not applicable
  • Specialties:Cardiothoracic Surgery, Pediatric Surgery
  • Place of Service:Inpatient Hospital, Ambulatory Surgical Center
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