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Code deleted, see 33946, 33947, 33948, 33949

Official Description

Prolonged extracorporeal circulation for cardiopulmonary insufficiency; initial day

© Copyright 2026 American Medical Association. All rights reserved.

Common Language Description

Prolonged extracorporeal circulation for cardiopulmonary insufficiency, as denoted by CPT® Code 33960, refers to a medical procedure commonly known as extracorporeal membrane oxygenation (ECMO). This advanced life-support technique employs a cardiopulmonary bypass circuit to temporarily take over the function of the heart and lungs in patients experiencing reversible cardiac and/or respiratory failure. ECMO is particularly beneficial for neonates, children, and adults whose conditions have not improved with standard medical therapies. During the procedure, a physician is responsible for closely monitoring the patient’s status and making necessary adjustments to the ECMO parameters. This is done to ensure optimal support for both cardiac and respiratory functions, which is assessed through blood gas analyses and other clinical observations. It is important to note that CPT® Code 33960 is specifically designated for billing the initial day of ECMO maintenance, while subsequent days of treatment are billed using CPT® Code 33961.

© Copyright 2026 Coding Ahead. All rights reserved.

1. Indications

Extracorporeal membrane oxygenation (ECMO) is indicated for patients experiencing severe cardiac and/or respiratory failure that is reversible and has not responded adequately to conventional medical therapies. The following conditions may warrant the use of ECMO:

  • Cardiac Failure Patients with significant cardiac dysfunction, such as cardiogenic shock or severe heart failure, may require ECMO to support circulation and oxygenation.
  • Respiratory Failure Individuals suffering from acute respiratory distress syndrome (ARDS) or other severe respiratory conditions may benefit from ECMO to facilitate gas exchange when the lungs are unable to perform this function effectively.
  • Post-Cardiac Surgery Patients who experience complications following cardiac surgery may need ECMO for temporary support while recovering from the surgical procedure.
  • Severe Pneumonia In cases of life-threatening pneumonia that leads to respiratory failure, ECMO can provide critical support until the underlying infection is treated.

2. Procedure

The procedure for initiating ECMO involves several critical steps to ensure the safe and effective support of the patient’s cardiopulmonary function. The following outlines the procedural steps:

  • Step 1: Patient Assessment A thorough evaluation of the patient’s medical history, current condition, and potential contraindications for ECMO is conducted. This assessment includes reviewing laboratory results, imaging studies, and clinical observations to determine the appropriateness of ECMO therapy.
  • Step 2: Cannulation The next step involves the placement of cannulas into the patient’s blood vessels. This is typically done in the femoral vein and artery or the internal jugular vein, depending on the patient's condition and the type of ECMO being performed (venovenous or venoarterial). Proper placement is crucial for effective blood flow and oxygenation.
  • Step 3: Initiation of ECMO Once cannulation is complete, the ECMO circuit is connected, and the machine is activated. Blood is drawn from the patient, passed through an oxygenator where it is oxygenated, and then returned to the patient’s circulation. The physician continuously monitors the flow rates and pressures within the circuit to ensure optimal functioning.
  • Step 4: Monitoring and Adjustment Throughout the ECMO treatment, the physician closely monitors the patient’s vital signs, blood gases, and other relevant parameters. Adjustments to the ECMO settings are made as necessary to maintain adequate oxygenation and perfusion, ensuring the patient remains stable during the procedure.

3. Post-Procedure

After the initiation of ECMO, the patient requires continuous monitoring and care. Post-procedure considerations include regular assessments of hemodynamic stability, oxygenation levels, and potential complications such as bleeding or infection at the cannulation sites. The healthcare team must also evaluate the patient's response to ECMO therapy and determine the appropriate duration of support. Once the underlying condition improves, the ECMO support can be gradually weaned, and the cannulas will be removed following established protocols to ensure patient safety and minimize risks.

Short Descr EXTERNAL CIRCULATION ASSIST
Medium Descr PROLONGED EXTRACORPOREAL CIRCULATION INIT DAY
Long Descr Prolonged extracorporeal circulation for cardiopulmonary insufficiency; initial day
Status Code Active Code
Global Days 000 - Endoscopic or Minor Procedure
PC/TC Indicator (26, TC) 0 - Physician Service Code
Multiple Procedures (51) 0 - No payment adjustment rules for multiple procedures apply.
Bilateral Surgery (50) 0 - 150% payment adjustment for bilateral procedures does NOT apply.
Physician Supervisions 9 - Concept does not apply.
Assistant Surgeon (80, 82) 2 - Payment restriction for assistants at surgery does not apply to this procedure...
Co-Surgeons (62) 1 - Co-surgeons could be paid, though supporting documentation is required...
Team Surgery (66) 0 - Team surgeons not permitted for this procedure.
Diagnostic Imaging Family 99 - Concept Does Not Apply
APC Status Indicator Inpatient Procedures, not paid under OPPS
Type of Service (TOS) 2 - Surgery
Berenson-Eggers TOS (BETOS) P2F - Major procedure, cardiovascular-Other
MUE Not applicable/unspecified.
CCS Clinical Classification 50 - Extracorporeal circulation auxiliary to open heart procedures
Date
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Notes
2015-01-01 Deleted Code deleted, see 33946, 33947, 33948, 33949
2012-01-01 Changed Description Changed
Pre-1990 Added Code added.
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