Summary & Overview
CPT 33962: Reposition Peripheral Cannula for Extracorporeal Circulation, Child
CPT code 33962 represents an open surgical procedure to reposition a peripheral cannula used for extracorporeal circulation in pediatric patients aged six years and older, performed with fluoroscopic guidance. This code is relevant to hospitals and surgical centers that manage pediatric cardiothoracic support and extracorporeal membrane oxygenation (ECMO) access, and it captures a specialized operative service with imaging assistance.
Key payers addressed in national coverage discussions include Aetna, Blue Cross Blue Shield, Cigna Health, UnitedHealthcare, and Medicare. Readers will find an overview of the clinical context for cannula repositioning, the typical sites where the service is provided, and the procedural elements that distinguish this code (open surgical approach plus fluoroscopic guidance).
The publication outlines expectations for coding and billing encounters involving pediatric extracorporeal cannulation management, summarizes common modifiers associated with complex operative services, and highlights areas where policy language and payer coverage rules commonly affect payment. It also provides clinical context for why a coded distinction for open repositioning with imaging matters for claim adjudication and facility resource planning.
Data not available in the input: associated taxonomies, ICD-10 diagnoses, detailed payer-specific policy language, and related codes.
Billing Code Overview
CPT code 33962 describes an open surgical procedure to reposition a peripheral cannula used for extracorporeal circulation in a child aged six years and older. The description specifies that the procedure is performed through an open surgical approach and includes fluoroscopic guidance.
Service type: Surgical — Pediatric Cardiothoracic/Extracorporeal Circulation Cannulation Management
Typical site of service: Operating room or specialized surgical suite
Clinical & Coding Specifications
Clinical Context
A typical patient is a child aged six years or older who requires repositioning of a peripheral cannula used for extracorporeal circulation (for example, during extracorporeal membrane oxygenation [ECMO] or cardiopulmonary bypass support). The usual workflow begins with identification of cannula malposition or malfunction (e.g., poor flow, limb ischemia, migration, or imaging-confirmed malalignment). The patient is prepared in an operating room or hybrid cardiac catheterization suite under general anesthesia. Vascular access and sterile prep are performed, and fluoroscopic guidance is used to confirm current cannula position and guide the open surgical exposure. The surgeon makes an incision to expose the cannula, repositions or advances it to the intended vascular location, secures the cannula, confirms placement and flow under fluoroscopy, achieves hemostasis, and closes the incision. Postprocedure care includes monitoring in a pediatric intensive care unit with ongoing anticoagulation management, cannula site surveillance, and repeat imaging as clinically indicated.
Coding Specifications
| Modifier | Description | When to Use |
|---|---|---|
00 | No modifier—standard claim submission | Use for routine submissions when no other modifier applies |
11 | Decision for surgery by the physician | Use when this is the primary operative procedure and the primary surgeon is reporting the service |
22 | Increased procedural services | Use when work, time, or complexity substantially exceeds typical requirements for repositioning the cannula |
23 | Unusual anesthesia — medically necessary, but contraindicated | Use when general anesthesia is administered but documentation supports anesthesia-related unusual circumstances (facility/anesthesia payer rules apply) |
52 | Reduced services | Use when the procedure is partially reduced or not completed as originally planned |
53 | Discontinued procedure | Use when the procedure is started but discontinued due to extenuating circumstances or safety concerns |
62 | Two surgeons | Use when two surgeons work together as primary surgeons during the repositioning procedure |
63 | Procedure performed on infants less than 4 kg (Pediatric specific) | Use only when applicable per payer guidance and patient weight criteria — generally uncommon for patients ≥6 years old |
78 | Return to the operating room for a related procedure during the postoperative period | Use if the patient returns to the OR for revision or complication related to the cannula repositioning |
79 | (Not in provided list) | Data not available in the input. |
| Taxonomy Code | Specialty | Notes |
|---|---|---|
| 3355C0002X | Pediatric Cardiothoracic Surgeon | Primary specialty performing open cannula repositioning for extracorporeal support in children |
| 2080P0800X | Pediatric Cardiac Surgeon (Cardiac Surgery) | Providers experienced in pediatric ECMO and cannulation management |
| 207L00000X | Pediatric Surgery | May perform open vascular access and cannula revision in conjunction with cardiac teams |
| 2080P0220X | Pediatric Critical Care Medicine | Often involved in perioperative management and decision-making regarding ECMO cannula adjustments |
| 364S00000X | Vascular Surgery | May be consulted for complex vascular access or limb ischemia related to cannula positioning |
Related Diagnoses
| ICD-10 Code | Description | Clinical Relevance |
|---|---|---|
| Data not available in the input. | Data not available in the input. | Data not available in the input. |
Related CPT Codes
| CPT Code | Description | Relationship to This Procedure |
|---|---|---|
33960 | Establishment of peripheral cannula for extracorporeal circulation, open approach, neonate, infant, or child; initial cannulation | Performed when initial open surgical cannulation is required prior to or instead of a repositioning procedure |
33961 | Establishment of peripheral cannula for extracorporeal circulation, open approach, child less than six years of age | Related age-specific cannulation code—use if patient is under six years rather than 33962 |
93458 | Catheter placement, central and peripheral, with intraprocedural imaging supervision and interpretation; with placement in coronary or noncoronary vessels (select based on facility guidance) | May be performed when endovascular imaging or catheter manipulation accompanies cannula repositioning under fluoroscopy |
36556 | Insertion of non-tunneled centrally inserted central venous catheter, without subcutaneous port or pump, age-specific | May be performed if separate central venous access is required before, during, or after cannula revision for medication or monitoring needs |
92950 | Cardiopulmonary resuscitation (CPR) | Included as a related emergent service that may occur in the same episode of care if the patient decompensates during cannula manipulation |
31500 | Intubation, endotracheal, emergency procedure | Commonly performed before the repositioning procedure when general anesthesia and airway protection are required |