CPT code 44369: Small-bowel enteroscopy, endoscopic mucosal resection2026 Medicare rate & RVUs in California

CMS doesn’t publish an office rate for 44369 in California.

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

What 44369 covers

This service combines an antegrade examination of the small intestine with endoscopic mucosal resection of a lesion. The endoscope passes through the mouth and beyond the second part of the duodenum, but the examination does not extend into the ileum. A gastroenterologist typically performs the procedure in a hospital outpatient department or ambulatory surgery center. The procedure report should identify the lesion’s location and describe the mucosal resection technique, which may include lifting the lesion and removing it with a snare.

Select this code from the documented technique, rather than from the presence of a polyp or a pathology specimen alone. The 0-day global period includes same-day preoperative and postoperative care. When related endoscopies are performed together, CMS endoscopy family pricing applies. Modifier 50 is inappropriate for this anatomy. Medicare pays an assistant at surgery only when medical necessity is documented; co-surgeon and team-surgery reporting 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 44369 pays more and less in California

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

29 of 29 payment localities

How the 44369 rate is calculated

Each of 44369’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.

Payment rules and modifiers for 44369

The CMS indicators that decide how 44369 is paid alongside other services.

What modifiers do to the payment

When to use modifier 51

44369 compared with similar codes

How to choose

44360Small-bowel examDiagnostic, without biopsy

Choose 44360 for diagnostic enteroscopy without lesion resection. Choose 44369 when the procedure report documents endoscopic mucosal resection.

44361Small bowel endoscopyBiopsy, ileum excluded

A biopsy samples tissue; endoscopic mucosal resection removes a lesion using a resection technique. The documented work distinguishes 44361 from 44369.

44370Small bowel endoscopyEndoscopic stent placement

Code 44370 describes enteroscopic stent placement. Code 44369 describes mucosal resection, not treatment by placing a stent.

Codes related to 44369

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

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

Open CMS sourceHow we calculate rates