CPT code 44360: Small-bowel exam, diagnostic, without biopsy2026 Medicare rate & RVUs in Texas
Reports diagnostic enteroscopy beyond the second portion of the duodenum, when the examination evaluates the small bowel without biopsy or therapeutic intervention.
CMS doesn’t publish an office rate for 44360 in Texas.
Medicare allowed amount for participating (non-QP) physicians, before deductible, coinsurance and claim adjustments. Not a patient’s bill or a hospital charge.
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What 44360 covers
This service is a diagnostic endoscopic examination of the small bowel beyond the second portion of the duodenum, without entering the ileum. A gastroenterologist typically performs it in an endoscopy suite or hospital setting to evaluate concerns such as suspected small-bowel bleeding or abnormal findings on prior testing. The code includes specimen collection by brushing or washing when performed; it does not describe tissue sampling by biopsy.
Report this code when the documented examination is diagnostic and does not include a separately specified intervention such as biopsy, lesion removal, or bleeding control. The procedure note should identify the extent reached, findings, and any brushing or washing. CMS assigns a 0-day global period, so same-day preoperative and postoperative care is included. When multiple procedures in the same session qualify for the standard reduction, the highest-valued procedure is paid in full and the others at 50%. Modifier 50 is inappropriate for this single-route anatomy. CMS does not pay an assistant at surgery and does not permit co-surgeon or team-surgery reporting for this service.
This summary was written with AI assistance from CMS physician fee schedule data and checked against the CMS billing rules shown here. Rates on this page come directly from CMS files.
Where 44360 pays more and less in Texas
The same RVUs, adjusted for each area’s costs. Open a locality for its calculation, history and nearby areas.
8 of 8 payment localities
| Payment locality | Office | Facility |
|---|---|---|
| Austin, TX | Unavailable | $128.95 |
| Beaumont, TX | Unavailable | $123.58 |
| Brazoria, TX | Unavailable | $125.99 |
| Dallas, TX | Unavailable | $126.94 |
| Fort Worth, TX | Unavailable | $126.67 |
| Galveston, TX | Unavailable | $126.48 |
| Houston, TX | Unavailable | $131.24 |
| Rest of Texas | Unavailable | $124.82 |
How the 44360 rate is calculated
Each of 44360’s three RVUs is multiplied by a geographic index (GPCI) for the payment locality, added up, and multiplied by the conversion factor. Drag the indexes or enter a ZIP to see what moves the rate.
How the rate is built · 44360
RVUs × geographic indexes × conversion factor
Work2.43
2.43 RVUs× 1.000 GPCI
Practice expense1.13
1.13 RVUs× 1.000 GPCI
Malpractice0.26
0.26 RVUs× 1.000 GPCI
Adjusted RVUs
3.8200
Conversion factor
$33.4009
Medicare rate
$127.59
Every GPCI starts at 1.000, the national rate. Enter a ZIP or drag a slider.
Payment rules and modifiers for 44360
The CMS indicators that decide how 44360 is paid alongside other services.
CMS payment indicators · 44360
Small-bowel exam, diagnostic, without biopsy
| Rule | CMS value | What it means |
|---|---|---|
| Global period | 000 | Same-day global: pre- and post-op care on the day of the procedure is included. |
| Multiple procedures | 2 | Standard reduction: highest-valued procedure at 100%, others at 50%. |
| Bilateral (modifier 50) | 0 | The 150% bilateral adjustment doesn’t apply. |
| Assistant at surgery (80/81/82/AS) | 1 | Not paid (statutory restriction). |
| Co-surgeons (62) | 0 | Not permitted. |
| Team surgery (66) | 0 | Not permitted. |
| Professional/technical | 0 | Physician service: no professional/technical split. |
What modifiers do to the payment
Modifier 51 · payment effect
With and without the modifier
44360 without 51 · national facility
$127.59
Small-bowel exam, diagnostic, without biopsy
44360-51 · Second procedure: 50%
$63.80
When this isn’t the highest-valued procedure in the session, Medicare pays 50% of its fee schedule amount (the highest is paid at 100%).
44360 compared with similar codes
Compare codes · National
4 codes, side by side
How to choose
- 44361Small bowel endoscopyBiopsy, ileum excluded
- Choose 44361 when tissue biopsy is performed during the small-bowel examination. Brushing or washing alone is included in 44360.
- 44363Small bowel endoscopySnare lesion removal
- Choose 44363 when the endoscopist removes a foreign body; 44360 describes a diagnostic examination without that intervention.
- 44364Small-bowel endoscopySnare lesion removal
- Choose 44364 for snare removal of a tumor, polyp, or other lesion during enteroscopy rather than a diagnostic-only examination.
44360 billing questions
When should 44360 be reported instead of 44361?
Use 44360 for a diagnostic examination that may include brushing or washing. Use 44361 when the enteroscopy includes biopsy.
Does brushing or washing require a different code?
No. Collection of specimens by brushing or washing is included in 44360 when performed.
Can 44360 be reported when the endoscopist removes a lesion?
A lesion-removal service is represented by a therapeutic enteroscopy code, such as 44364 for snare removal, rather than this diagnostic code alone.
How many units are generally reported for one examination?
Report one unit for the diagnostic enteroscopy, including any brushing or washing performed during that examination.
What documentation supports 44360?
Document the indication, the small-bowel extent examined, findings, and whether specimens were collected by brushing or washing. If biopsy or therapy was performed, document the specific intervention.
How does the 0-day global period affect same-day care?
Same-day preoperative and postoperative care is included in the procedure's 0-day global period.
Where these rates come from
FeeBase calculates base physician payments from CMS work, practice-expense and malpractice RVUs, adjusted by each locality’s geographic indexes and the conversion factor. Services without a published rate are labeled, never given a made-up amount. Amounts are Medicare allowed amounts before claim adjustments: not a patient’s bill or a commercial rate.
CMS RVU26D · effective Oct 1, 2026 through the day before Jan 1, 2027
Show the CMS file lines behind this rate
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