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CPT code 44364: Small-bowel endoscopy, snare lesion removal2026 Medicare rate & RVUs

Enteroscopy beyond the duodenum removes small-bowel polyps or other lesions with a snare during the examination.

CMS RVU26DEffective Oct 1, 2026109 payment localities548 Medicare services in 2024

Medicare pays $180.36 for 44364 nationally in a facility.

Medicare rate · 44364

Small-bowel endoscopy, snare lesion removal

Office or facility?

Work RVUs
3.54
Total RVUs
5.40
Global days
000

National rate · 2026

$180.36

Facility setting, before claim adjustments.

See every locality for 44364 →Billed by an NP, PA or therapist? →

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

Your location

Medicare pays by the payment locality where the service is performed.

On this page 10 sections
  1. Medicare rate
  2. What 44364 covers
  3. By payment locality
  4. Rate map
  5. How it’s calculated
  6. Payment rules
  7. Similar codes
  8. Related codes
  9. Billing questions
  10. Sources

What 44364 covers

A gastroenterologist or other endoscopist advances an enteroscope beyond the second portion of the duodenum to examine the small bowel and remove a polyp or other lesion with a snare. The service is typically performed in a hospital outpatient department or ambulatory surgery center when a small-bowel lesion identified during enteroscopy requires endoscopic removal.

Report this code when the documented therapeutic work is snare removal, rather than inspection alone, biopsy, or removal by hot biopsy forceps. The report should identify the small-bowel extent reached, the lesion treated, and the snare technique. CMS applies endoscopy-family pricing when related endoscopies are performed together. The 0-day global period includes same-day preoperative and postoperative care. Modifier 50 is inappropriate. Assistant-at-surgery payment requires documented medical necessity; co-surgeons and team surgery are not permitted.

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 44364 pays more and less

The same RVUs, adjusted for each area’s costs. Open a locality for its calculation, history and nearby areas.

109 of 109 payment localities

44364 office and facility rates by payment locality
Payment localityOfficeFacility
AlabamaUnavailable$168.57
AlaskaUnavailable$236.83
ArizonaUnavailable$176.97
ArkansasUnavailable$167.12
Atlanta, GAUnavailable$184.12
Austin, TXUnavailable$181.96
Bakersfield, CAUnavailable$182.23
Baltimore area, MDUnavailable$188.93
Beaumont, TXUnavailable$175.02
Brazoria, TXUnavailable$178.00

44364 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.

View every state and territory as a table
44364 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

How the 44364 rate is calculated

Each of 44364’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 · 44364

RVUs × geographic indexes × conversion factor

Office or facility?

Work3.54

3.54 RVUs× 1.000 GPCI

Practice expense1.47

1.47 RVUs× 1.000 GPCI

Malpractice0.39

0.39 RVUs× 1.000 GPCI

Adjusted RVUs

5.4000

Conversion factor

$33.4009

Medicare rate

$180.36

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

Payment rules and modifiers for 44364

The CMS indicators that decide how 44364 is paid alongside other services.

CMS payment indicators · 44364

Small-bowel endoscopy, snare lesion removal

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)0Not paid without supporting documentation.
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

44364 without 51 · national facility

$180.36

Small-bowel endoscopy, snare lesion removal

44364-51 · Second procedure: 50%

$90.18

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

44364 compared with similar codes

Compare codes · National

4 codes, side by side

Office or facility?

  • 44364

    Small-bowel endoscopy, snare lesion removal3.54 wRVU

    Not priced

  • 44363

    Small bowel endoscopy, snare lesion removal3.31 wRVU

    Not priced

  • 44361

    Small bowel endoscopy, biopsy, ileum excluded2.7 wRVU

    Not priced

  • 45385

    Snare polypectomy, during colonoscopy4.46 wRVU

    $500.01

How to choose

44363Small bowel endoscopySnare lesion removal
Both involve removal of a small-bowel lesion during enteroscopy. Choose 44364 for snare technique and 44363 for hot biopsy forceps.
44361Small bowel endoscopyBiopsy, ileum excluded
Use 44361 for biopsy during small-bowel enteroscopy; use 44364 when the lesion is removed with a snare.
45385Snare polypectomyDuring colonoscopy
45385 describes snare removal during colonoscopy. This code is for enteroscopy beyond the second portion of the duodenum into the small bowel.

Codes related to 44364

Related codes aren’t interchangeable: bill the code that matches the service performed.

Codes related to 44364
CodeHow it relatesNational office range
Same family
44360Small-bowel exam, diagnostic, without biopsyDiagnostic small-bowel enteroscopy without a separately described therapeutic intervention.No office rate
44361Small bowel endoscopy, biopsy, ileum excludedSmall-bowel enteroscopy with biopsy rather than snare removal.No office rate
44363Small bowel endoscopy, snare lesion removalSmall-bowel lesion removal using hot biopsy forceps.No office rate
44365Small bowel endoscopy, hot forceps or bipolar cauterySmall-bowel enteroscopy for endoscopic control of bleeding.No office rate
44370Small bowel endoscopy, endoscopic stent placementSmall-bowel enteroscopy involving stent placement.No office rate

44364 billing questions

When should this code be chosen over the biopsy code?

Use this code when a small-bowel lesion is removed with a snare. Biopsy without snare removal is represented by the small-bowel endoscopy biopsy code, 44361.

How does this differ from 44363?

Both describe small-bowel lesion removal, but 44364 is for snare technique. Code 44363 represents removal with hot biopsy forceps.

How are related endoscopies priced when performed together?

CMS endoscopy-family pricing applies when related endoscopies are performed together. Report the services supported by the procedure documentation and account for that family pricing.

Can modifier 50 be reported?

No. The descriptor or anatomy makes a bilateral adjustment inappropriate for this service.

What documentation supports reporting this service?

Document the small-bowel extent examined, the lesion removed, and that a snare was used. Same-day preoperative and postoperative care is included in the 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
RVUs for 44364PPRRVU2026_Oct_nonQPP.csv, line 5,392 (RVU26D)

Open CMS sourceHow we calculate rates

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