Summary & Overview
CPT 33954: Open Peripheral Cannula Insertion for Extracorporeal Circulation, Child ≥6
CPT code 33954 denotes the open surgical insertion of a peripheral cannula for extracorporeal circulation in children aged six years and older. This pediatric cardiothoracic procedure establishes vascular access for cardiopulmonary bypass or other extracorporeal support and is performed in surgical settings such as operating rooms. Nationally, accurate coding for 33954 matters for proper procedure classification, facility billing, and pediatric surgical care reporting.
Key payers addressed in the analysis include Aetna, Blue Cross Blue Shield, Cigna Health, UnitedHealthcare, and Medicare. The publication provides an overview of clinical context for the procedure, common payer considerations, and coding benchmarks where available. Readers will find concise guidance on the clinical scope of the code, typical site-of-service implications, and the payer landscape relevant to 33954.
The report summarizes benchmarks and payer coverage patterns when available, notes common modifiers associated with billing workflows, and situates 33954 within pediatric cardiothoracic surgical coding practices. Data not available in the input is identified as such, and the focus remains on national-level policy and billing context rather than state-specific rules.
Billing Code Overview
CPT code 33954 describes the insertion of a peripheral cannula for extracorporeal circulation through an open surgical approach in a child six years and older. This procedure involves surgically creating access to peripheral vessels to establish extracorporeal circulation for cardiopulmonary support in pediatric patients aged six years and above.
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Service type: Open surgical insertion of peripheral cannula for extracorporeal circulation in pediatric patients
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Typical site of service: Operating room or other surgical suite where open pediatric cardiothoracic procedures are performed
Data not available in the input.
Clinical & Coding Specifications
Clinical Context
A typical scenario involves a 7-year-old child with congenital cardiac disease or traumatic injury requiring cardiopulmonary bypass support for a corrective or emergent cardiac procedure. The child is brought to the operating room, undergoes general anesthesia, and the cardiac surgical team exposes peripheral vessels (commonly the femoral artery and vein or carotid/jugular vessels depending on anatomy and prior surgeries). Using an open surgical approach, the surgeon places a peripheral cannula to establish extracorporeal circulation for initiation of cardiopulmonary bypass. Intraoperative perfusionists manage the bypass circuit while the surgical team completes the primary repair. Post-placement, the cannula is secured, heparinization is managed per protocol, and the patient is transferred to pediatric cardiac intensive care for monitoring, ventilatory support, anticoagulation management, and planned decannulation when clinically appropriate.
Coding Specifications
| Modifier | Description | When to Use |
|---|---|---|
00 | No modifier | Standard reporting when no additional modifier applies |
11 | Decision for surgical procedure | Use when service represents the primary procedure performed by the reporting practitioner |
22 | Increased procedural services | Use when work required is substantially greater than typically required |
23 | Unusual anesthesia | Use when general anesthesia is inappropriate and local/ regional sedation is used for an unusual circumstance |
50 | Bilateral procedure | Use when peripheral cannulation is performed bilaterally during same operative session |
52 | Reduced services | Use when the procedure is partially reduced or not completed as described in full code |
53 | Discontinued procedure | Use when the procedure is started but discontinued due to extenuating circumstances |
62 | Two surgeons | Use when two surgeons work together as primary surgeons performing distinct parts of the procedure |
76 | Repeat procedure by same physician (NOT in provided list) | Data not available in the input. |
78 | Unplanned return to the operating/procedure room | Use when patient returns to OR for related procedure during global period |
80 | Assistant surgeon | Use when an assistant surgeon provided substantial assistance |
81 | Minimum assistant surgeon | Use when assistant role is minimal |
82 | Assistant surgeon (when qualified resident not available) | Use when a qualified resident is not available and assistant is needed |
AS | Physician assistant, nurse practitioner, or clinical nurse specialist | Use when an advanced practice clinician performs the service under applicable rules |
| Taxonomy Code | Specialty | Notes |
|---|---|---|
| 207RC0000X | Cardiothoracic Surgery | Primary specialty performing pediatric open cannulation for cardiopulmonary bypass |
| 2080P0207X | Pediatric Cardiac Surgery | Subspecialty focus on congenital heart surgery in children |
| 207L00000X | Vascular Surgery | May perform peripheral vessel exposure and cannulation in select cases |
| 367A00000X | Perfusionist | Provides extracorporeal circulation management (non-physician clinical role) |
| 208000000X | Pediatric Surgery | In centers where pediatric surgeons assist with access and complex anatomy |
Related Diagnoses
| ICD-10 Code | Description | Clinical Relevance |
|---|---|---|
| Data not available in the input. |
Related CPT Codes
| CPT Code | Description | Relationship to This Procedure |
|---|---|---|
33950 | Cannulation of central vessels for cardiopulmonary bypass | Often used for central (aortic/atrial) cannulation during the same operative episode when peripheral access is not used |
33956 | The provider inserts a peripheral cannula for extracorporeal circulation through an open surgical approach in a child younger than six years | Used for younger pediatric patients; contrasts with 33954 age criterion |
33990 | Removal of cannulae from heart or great vessels; not otherwise specified | Performed at decannulation after extracorporeal circulation support is discontinued |
36556 | Insertion of non-tunneled centrally inserted central venous catheter; age 5 years or older | May be performed preoperatively or postoperatively for central venous access, medication, or monitoring |
00561 | Anesthesia for procedures on the heart, major vessels, and pericardium | Anesthesia support code commonly billed for pediatric cardiac procedures requiring cardiopulmonary bypass |