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    v1.0.30
    OpenPayerBilling CodesExtracorporeal Membrane Oxygenation or Extracorporeal Life Support Services and ProceduresCPT cpt-33958-percutaneous-cannula-repositioning-extracorporeal-circulation-child
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    CPT 33958: Percutaneous Repositioning of Peripheral Cannula for Extracorporeal Circulation

    Medicare pays $171 on average nationally for this procedure.

    CPT code 33958 describes percutaneous repositioning of a peripheral cannula through an incision to enable extracorporeal circulation in a child aged six years or older, performed with fluoroscopic guidance; this is a percutaneous extracorporeal circulation cannula repositioning procedure typically provided in an operating room or interventional radiology suite as a surgical/percutaneous vascular access service.

    For related coverage guidance, see recent payer policy updates: Dental Anesthesia Services, Anesthesia Services for Interventional Pain Management Procedures in an Adult, General Anesthesia and Conscious Sedation Services.

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    Clinical & Coding Specifications

    Clinical Context

    A typical scenario is a pediatric patient aged six years or older who requires extracorporeal circulation support during a cardiac surgical or interventional procedure. Example: a 7-year-old with complex congenital heart disease who arrives to the operating room for corrective surgery and requires repositioning of a peripheral cannula to optimize cardiopulmonary bypass access. The clinical workflow includes preoperative assessment by pediatric cardiac surgery and anesthesia teams, placement of a peripheral cannula through a percutaneous incision, intraoperative fluoroscopic guidance to confirm and reposition the cannula tip, hemodynamic monitoring while connecting to the extracorporeal circuit, and post-procedure imaging and ICU transfer for continued cardiopulmonary support and monitoring. Documentation should note age (≥6 years), percutaneous approach, fluoroscopic guidance, cannula repositioning maneuvers, and whether the procedure occurred as part of an operative session or standalone vascular access adjustment.

    Related CPT Codes

    CPT CodeDescriptionRelationship to This Procedure
    33956Cannulation for extracorporeal circulation; initial peripheral cannula placement in a child less than 6 years of ageDescribes initial peripheral cannulation for younger children; contrasts by age criteria with 33958.
    33957Cannulation for extracorporeal circulation; initial central cannula placement in a child 6 years or olderRelated central cannulation technique often performed in the same operative session when peripheral access is inadequate.
    33959Repositioning of central cannula through percutaneous incision to perform extracorporeal circulation in a child less than 6 years of agePediatric equivalent for younger patients; 33958 is the ≥6 years peripheral counterpart.
    76937Ultrasound guidance for vascular access and/or peripheral insertion of catheterOften used adjunctively for vascular access localization or confirmation prior to fluoroscopic repositioning.
    77002Fluoroscopic guidance for needle placement (when separately reportable)Reflects the imaging guidance component; 33958 includes fluoroscopic guidance in its description, but additional imaging codes may apply if separate services are documented.

    Related Modifiers

    10 rows

    ModifierDescriptionWhen to Use
    22Modifier –22 (Increased Procedural Services) is used when a reported procedure is substantially more extensive than normally required. The CPT Manual and CMS state it may be appended only when the…- When to use: Append modifier -22 to a procedural CPT code when the service performed is substantially more extensive than the usual service described by that code — i.e., the procedure required…
    23Modifier -23 (Unusual Anesthesia) is used on anesthesia service CPT codes when a procedure that normally requires no anesthesia or only local anesthesia must be performed under general anesthesia…- Use modifier -23 only on anesthesia CPT codes (00100–01999) when a procedure that normally requires no anesthesia or only local anesthesia must be performed under general anesthesia because of…
    52Modifier ‑52 (Reduced Services) indicates that a service or procedure was partially reduced or omitted at the provider’s discretion, allowing reporting of the basic procedure number with a qualifier…- Use modifier -52 when a physician or qualified health professional electively reduces or omits part of a procedure or service (for example, performing fewer required views or omitting a portion of…
    53Modifier 53 (Discontinued Procedure) signals that a surgical or diagnostic service was begun by the physician but terminated because of extenuating circumstances that threatened the patient’s…- Use modifier -53 when a physician/qualified healthcare professional has started a surgical or diagnostic procedure (e.g., anesthesia administered, incision or scope insertion) and then discontinues…
    62Modifier 62 indicates that two surgeons function as co‑surgeons, each performing distinct parts of the same primary surgical procedure. It is appended to the primary procedure code (and any…- Use modifier -62 when two surgeons act as co‑surgeons (both primary surgeons) on a single definitive primary procedure, each performing distinct parts of the same surgical procedure (append -62 to…
    66Modifier 66 (Surgical Team) is used when three or more surgeons act as primary surgeons on a single, highly complex procedure. The AMA defines it for use when a surgical team — often composed of…- Use modifier 66 when three or more surgeons act as primary surgeons working collaboratively as a surgical team on a single, highly complex or difficult procedure (for example organ…
    78CPT modifier -78 indicates an unplanned, related return to the operating or procedure room by the same provider during the global postoperative period. It is appended when treatment for a…- Use modifier -78 when an unplanned, related complication during the original procedure’s global postoperative period requires the patient to return to a formal operating or procedure room and the…
    80CPT® Modifier 80 (Assistant Surgeon) is appended to a surgical CPT code when a physician (MD or DO) provides full, continuous assistance throughout the operative procedure. It is intended only for…- Use CPT Modifier -80 when a physician (MD or DO) serves as an assistant surgeon and provides full, continuous assistance throughout the entire operative procedure; append -80 to the surgical CPT…
    81Modifier -81 indicates a physician served as a minimal assistant surgeon for part—not all—of an operative procedure. Use when a physician’s assisting role is limited and does not represent full…- Use CPT modifier -81 when a physician acts as a minimum assistant surgeon who assists during only part (a limited portion) of an operative procedure; append -81 to the primary surgical CPT code to…
    82Modifier 82 is appended to a surgical CPT code to indicate that an attending physician acted as an assistant because a qualified resident surgeon was unavailable. In teaching hospitals it documents…- When to use: Append modifier 82 in teaching-hospital settings to indicate a physician served as an assistant surgeon because a qualified resident surgeon was unavailable (includes situations where…

    Related Provider Taxonomies

    8 rows

    Taxonomy Code
    208100000X
    207P00000X
    207K00000X
    207L00000X
    2084S0012X
    2255R0406X
    305R00000X
    3336S0011X

    Related Payer Policy Updates

    Specialty: Anesthesiology1 / 4

    10 rows

    PolicyPayerEffective Date
    Dental Anesthesia ServicesProvidence Health Plan2026-10-01
    Anesthesia Services for Interventional Pain Management Procedures in an AdultCigna2026-09-15
    General Anesthesia and Conscious Sedation ServicesUnitedHealthcare2026-09-01
    Intravenous Anesthetics for the Treatment of Chronic Pain and Psychiatric or Substance Use DisordersPremera Bluecross2026-07-01
    Intravenous Anesthetics for the Treatment of Chronic Pain and Psychiatric or Substance Use DisordersPremera Bluecross2026-07-01
    Intravenous Anesthetics for the Treatment of Chronic Pain and Psychiatric or Substance Use DisordersPremera Bluecross2026-07-01
    Intravenous Anesthetics for the Treatment of Chronic Pain and Psychiatric or Substance Use DisordersPremera Bluecross2026-07-01
    Elective Inpatient Services (for Idaho Only)UnitedHealthcare2026-06-01
    Sites of Servicepriority health2026-06-01
    Coverage for Ambulatory Surgery Unit (ASU)/Outpatient Facility and Anesthesia for Dental Servicesuniverahealthcare2026-05-21

    Related Codes

    CPT-33946-VENOVENOUS-EXTRACORPOREAL-CIRCULATION-INITIATION

    CPT 33946: Venovenous Extracorporeal Circulation (VV ECMO) Cannulation

    CPT-33947-VENO-ARTERIAL-EXTRACORPOREAL-CIRCULATION-INITIATION

    CPT 33947: Veno-Arterial Extracorporeal Circulation Initiation

    CPT-33948-VENOVENOUS-ECMO-ECLS-DAILY-MANAGEMENT

    CPT 33948: Venovenous ECMO (VV ECLS) Daily Management

    CPT-33949-VA-ECMO-ECLS-MANAGEMENT

    CPT 33949: Veno‑arterial ECMO/ECLS Daily Management

    CPT-33951-PEDIATRIC-PERCUTANEOUS-EXTRACORPOREAL-CANNULATION

    CPT 33951: Percutaneous Pediatric Extracorporeal Circulation

    CPT-33952-PERCUTANEOUS-CANNULATION-EXTRACORPOREAL-CIRCULATION-PEDIATRIC

    CPT 33952: Percutaneous Peripheral Cannula for Extracorporeal Circulation (Child 6+)

    CPT-33953-PEDIATRIC-PERIPHERAL-CANNULA-EXTRACORPOREAL-CIRCULATION-OPEN

    CPT 33953: Peripheral Cannula Insertion for Extracorporeal Circulation, Age 0–5

    CPT-33954-PERIPHERAL-CANNULA-EXTRACORPOREAL-CIRCULATION-PEDIATRIC-OPEN-APPROACH

    CPT 33954: Peripheral Cannula Insertion for Extracorporeal Circulation, Child 6+

    CPT-33955-PEDIATRIC-CENTRAL-CANNULA-EXTRACORPOREAL-CIRCULATION

    CPT 33955: Pediatric Central Cannula Insertion for Extracorporeal Circulation

    CPT-33956-CENTRAL-CANNULA-INSERTION-OPEN-APPROACH-PEDIATRIC

    CPT 33956: Central Cannula Insertion for Extracorporeal Circulation (Age ≥6)

    Showing 1–10 of 16

    Frequently Asked Questions

    References

    1. 1.CPT® Codes and Descriptions. AAPC. Retrieved Aug 11, 2026.Maintains the CPT code set's official descriptions and guidelines, licensed from the American Medical Association, used as the definitional source for CPT codes on this page.
    2. 2.HCPCS Quarterly Update. Centers for Medicare & Medicaid Services (CMS). Retrieved Aug 11, 2026.CMS's quarterly release of HCPCS Level II codes and short/long descriptors, the source for HCPCS code definitions and update history.
    3. 3.ICD-10-CM Full Code List. Centers for Medicare & Medicaid Services (CMS). Retrieved Aug 11, 2026.CMS's complete ICD-10-CM diagnosis code list, used to cross-reference diagnosis codes associated with this procedure or service.
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