CPT code 44361: Small bowel endoscopy, biopsy, ileum excluded2026 Medicare rate & RVUs in Utah

Reports enteroscopy into the small bowel beyond the second portion of the duodenum, with tissue biopsy and without examination of the ileum.

CMS RVU26DEffective Oct 1, 2026One payment locality10.5K Medicare services in 2024

In Utah, Medicare pays $137.18 for 44361 in a facility. There’s no office rate.

Not available in this settingOffice (non-facility)
$137.18Hospital or facility

Check a contract rate as a % of Medicare · 44361 nationwide

Medicare allowed amount for participating (non-QP) physicians, before deductible, coinsurance and claim adjustments. Not a patient’s bill or a hospital charge.

We’ll open 44361 for the payment locality that covers the ZIP.

On this page 11 sections
  1. Rate in Utah
  2. What 44361 covers
  3. Compared with other areas
  4. Rate map
  5. How it’s calculated
  6. Payment rules
  7. Related codes
  8. Rate history
  9. Where it applies
  10. Billing questions
  11. Sources

What 44361 covers

A gastroenterologist or other qualified endoscopist advances an enteroscope beyond the second portion of the duodenum to examine the small bowel and obtain tissue samples. The examined segment may include the jejunum, but this code excludes examination of the ileum. Biopsies may be taken from abnormal-appearing mucosa or to investigate suspected small-bowel disease, such as a cause of malabsorption or unexplained anemia. These procedures are commonly performed in a hospital outpatient department or ambulatory endoscopy center.

Report 44361 when the endoscopist obtains one or more tissue biopsies during the qualifying examination; the number of samples does not create separate procedure units. The report should support the route and extent of the examination, the biopsy sites, and the reason for sampling. The code has a 0-day global period, so same-day preoperative and postoperative care is included. When related endoscopies are performed together, CMS endoscopy-family pricing applies. Medicare does not pay an assistant at surgery for this service, and co-surgeons and team surgery are not permitted. Bilateral adjustment does not apply, and modifier 50 is inappropriate.

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.

How Utah compares for 44361

Across 109 of 109 payment localities, the facility rate for 44361 runs from $130.17 in Arkansas to $184.01 in Alaska. Utah pays $137.18. The RVUs are the same everywhere; the geographic indexes change the dollars.

44361 in Utah vs other payment areas
  1. Utah · this page$137.18
  2. Los Angeles, CA · California$148.52+$11.34
  3. Washington, DC area · District of Columbia$153.84+$16.66
  4. Miami, FL · Florida$157.10+$19.92
  5. Chicago, IL · Illinois$154.00+$16.82
  6. Manhattan, NY · New York$158.67+$21.49
  7. Alaska · Alaska$184.01+$46.83

Other areas in Utah first, then benchmark localities. Bars start at $0.

Every other payment area

44361 in every other Medicare payment locality
Payment localityOfficeFacility
AlabamaAlabama—$131.32
ArkansasArkansas—$130.17
ArizonaArizona—$137.96
Bakersfield, CACalifornia—$142.46
Chico, CACalifornia—$141.57
El Centro, CACalifornia—$141.62
Fresno, CACalifornia—$141.57
Hanford, CACalifornia—$141.57

44361 rates by state

Office rate range in each state. Select a state to see its payment localities.

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Local rates. Clear comparisons.

Hover or focus a tile to see its rate range. Select it to open the state’s fee schedule.

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44361 office rate range by state
State / territoryOffice rate rangeLocalities
AKNo published base rate1
ALNo published base rate1
ARNo published base rate1
AZNo published base rate1
CANo published base rate29
CONo published base rate1
CTNo published base rate1
DCNo published base rate1
DENo published base rate1
FLNo published base rate3
GANo published base rate2
GUNo published base rate1
HINo published base rate1
IANo published base rate1
IDNo published base rate1
ILNo published base rate4
INNo published base rate1
KSNo published base rate1
KYNo published base rate1
LANo published base rate2
MANo published base rate2
MDNo published base rate3
MENo published base rate2
MINo published base rate2
MNNo published base rate1
MONo published base rate3
MSNo published base rate1
MTNo published base rate1
NCNo published base rate1
NDNo published base rate1
NENo published base rate1
NHNo published base rate1
NJNo published base rate2
NMNo published base rate1
NVNo published base rate1
NYNo published base rate5
OHNo published base rate1
OKNo published base rate1
ORNo published base rate2
PANo published base rate2
PRNo published base rate1
RINo published base rate1
SCNo published base rate1
SDNo published base rate1
TNNo published base rate1
TXNo published base rate8
UTNo published base rate1
VANo published base rate2
VINo published base rate1
VTNo published base rate1
WANo published base rate2
WINo published base rate1
WVNo published base rate1
WYNo published base rate1

See 44361 in every payment locality

How the 44361 rate is calculated

Each of 44361’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 · 44361

RVUs × geographic indexes × conversion factor

Office or facility?

Work2.70

2.70 RVUs× 1.000 GPCI

Practice expense1.22

1.22 RVUs× 1.000 GPCI

Malpractice0.29

0.29 RVUs× 1.000 GPCI

Adjusted RVUs

4.2100

Conversion factor

$33.4009

Medicare rate

$140.62

Every GPCI starts at 1.000, the national rate. Enter a ZIP or drag a slider.

The exact Utah inputs and CMS source lines

PPRRVU2026_Oct_nonQPP.csv

5,390

Code
44361
Physician work
2.70
Practice expense
1.22
Malpractice
0.29

GPCI2026.csv

104

Locality
Utah
Physician work
1.000
Practice expense
0.940
Malpractice
0.898
Facility calculation for 44361 in Utah
ComponentRVULocality factorAdjusted
Physician work2.70× 1.0002.7000
Practice expense1.22× 0.9401.1468
Malpractice0.29× 0.8980.2604
Total RVUs4.1072
Conversion factor× 33.4009

Facility rate, Utah$137.18

Facility: (2.7 × 1 + 1.22 × 0.94 + 0.29 × 0.898) × $33.4009 = $137.18

Open 44361 in the RVU calculator

Payment rules and modifiers for 44361

The CMS indicators that decide how 44361 is paid alongside other services.

CMS payment indicators · 44361

Small bowel endoscopy, biopsy, ileum excluded

RuleCMS valueWhat it means
Global period000Same-day global: pre- and post-op care on the day of the procedure is included.
Multiple procedures3Endoscopy family rules apply.
Bilateral (modifier 50)0The 150% bilateral adjustment doesn’t apply.
Assistant at surgery (80/81/82/AS)1Not paid (statutory restriction).
Co-surgeons (62)0Not permitted.
Team surgery (66)0Not permitted.
Professional/technical0Physician service: no professional/technical split.

What modifiers do to the payment

Modifier 51 · payment effect

With and without the modifier

44361 without 51 · national facility

$140.62

Small bowel endoscopy, biopsy, ileum excluded

44361-51 · Second procedure: 50%

$70.31

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%).

When to use modifier 51

How 44361 has changed in Utah

44361 · Office / nonfacility

Rate unavailable

Effective 2026-10-01

A rate is unavailable in one of these releases, so a change cannot be calculated.

Base rate by release · bars start at $0 · select a bar to compare

One bar per available release, ordered by effective date. Missing rates remain gaps. These comparisons hold the code, setting and locality identifiers constant; they do not isolate which policy or input caused a change.

What changed, release by release
Rates in every CMS release
Effective fromOfficeFacilityCMS release
2026-10-01Not available in this setting$137.18RVU26D
2026-07-01Not available in this setting$137.18RVU26C
2026-04-01Not available in this setting$137.18RVU26B
2026-01-01Not available in this setting$137.18RVU26A
2025-10-01Not available in this setting$147.81RVU25D
2025-07-01Not available in this setting$147.81RVU25C
2025-04-01Not available in this setting$147.81RVU25B
2025-01-01Not available in this setting$147.81RVU25A
2024-10-01Not available in this setting$151.49RVU24D
2024-07-01Not available in this setting$151.49RVU24C
2024-04-01Not available in this setting$151.49RVU24B
2024-03-09Not available in this setting$151.49RVU24AR
2024-01-01Not available in this setting$149.02RVU24A
2023-10-01Not available in this setting$151.91RVU23D
2023-07-01Not available in this setting$151.91RVU23C
2023-04-01Not available in this setting$151.91RVU23B
2023-01-01Not available in this setting$151.91RVU23A
2022-10-01Not available in this setting$154.04RVU22D
2022-07-01Not available in this setting$154.04RVU22C
2022-04-01Not available in this setting$154.04RVU22B
2022-01-01Not available in this setting$154.04RVU22A
2021-10-01Not available in this setting$154.72RVU21D
2021-07-01Not available in this setting$154.72RVU21C
2021-04-01Not available in this setting$154.72RVU21B
2021-01-01Not available in this setting$154.72RVU21A
2020-10-01Not available in this setting$160.57RVU20D
2020-07-01Not available in this setting$160.57RVU20C
2020-04-01Not available in this setting$160.57RVU20B
2020-01-01Not available in this setting$160.57RVU20A
2019-10-01Not available in this setting$165.72RVU19D
2019-07-01Not available in this setting$165.72RVU19C
2019-04-01Not available in this setting$165.72RVU19B
2019-01-01Not available in this setting$165.72RVU19A
2018-10-01Not available in this setting$165.79RVU18D
2018-07-01Not available in this setting$165.79RVU18C
2018-04-01Not available in this setting$165.79RVU18B
2018-01-01Not available in this setting$165.79RVU18AR1
2017-10-01Not available in this setting$165.53RVU17D
2017-07-01Not available in this setting$165.53RVU17C
2017-04-01Not available in this setting$165.53RVU17B
2017-01-01Not available in this setting$165.53RVU17A
2016-10-01Not available in this setting$170.40RVU16D
2016-07-01Not available in this setting$170.40RVU16C
2016-04-01Not available in this setting$170.40RVU16B
2016-01-01Not available in this setting$170.40RVU16A
2015-10-01Not available in this setting$174.35RVU15D
2015-07-01Not available in this setting$174.35RVU15C
2015-04-01Not available in this setting$173.49RVU15B
2015-01-01Not available in this setting$173.49RVU15A
2014-10-01Not available in this setting$173.00RVU14D
2014-07-01Not available in this setting$173.00RVU14C
2014-04-01Not available in this setting$173.00RVU14B
2014-01-01Not available in this setting$173.00RVU14A
2013-10-01Not available in this setting$171.30RVU13D
2013-07-01Not available in this setting$171.30RVU13C
2013-04-01Not available in this setting$171.30RVU13B
2013-01-01Not available in this setting$171.30RVU13AR

Price 44361 for an earlier date of service

Where the Utah rate applies

Utah is a Medicare payment area, not a city. Our Census mapping connects it to 334 cities and communities in Utah. Some span more than one payment area; confirm with the service ZIP.

  • Alpine
  • Alta
  • Altamont
  • Alton
  • Amalga
  • American Fork
  • Aneth
  • Annabella

Browse all communities in Utah

44361 billing questions

When should 44361 be reported instead of 44360?

Use 44361 when tissue biopsy is obtained during the qualifying small-bowel examination. Use 44360 for the diagnostic examination when no tissue biopsy is performed.

Does the code include multiple biopsy samples?

Yes. One or multiple biopsies during the examination are included in the procedure service; do not report a separate unit for each sample.

Can 44361 be used when the endoscopist examines the ileum?

No. This code describes examination beyond the second portion of the duodenum without including the ileum. For an examination that includes the ileum with biopsy, compare 44377.

How is 44361 handled when another related endoscopy is performed in the same session?

CMS endoscopy-family pricing applies when related endoscopies are performed together. The record should identify each examination and any distinct intervention or biopsy performed.

Is modifier 50 appropriate, and can an assistant or co-surgeon be paid?

No. Bilateral adjustment does not apply, and modifier 50 is inappropriate. Medicare does not pay an assistant at surgery for this service, and co-surgeons and team surgery are not permitted.

What documentation supports reporting 44361?

Document the endoscopic route and extent, the small-bowel segment examined, the biopsy site or sites, and the clinical reason for obtaining tissue.

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
RVUs for 44361PPRRVU2026_Oct_nonQPP.csv, line 5,390 (RVU26D)
Geographic factors for UtahGPCI2026.csv, line 104 (RVU26D)

Open CMS sourceHow we calculate rates

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