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CPT code 44376: Small-bowel enteroscopy, diagnostic, including ileum2026 Medicare rate & RVUs

Reports diagnostic small-intestinal enteroscopy extending beyond the second duodenal portion to include the ileum, with brushing or washing when performed.

CMS RVU26DEffective Oct 1, 2026109 payment localities802 Medicare services in 2024

Medicare pays $248.50 for 44376 nationally in a facility.

Medicare rate · 44376

Small-bowel enteroscopy, diagnostic, including ileum

Office or facility?

Work RVUs
5.02
Total RVUs
7.44
Global days
000

National rate · 2026

$248.50

Facility setting, before claim adjustments.

See every locality for 44376 →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 44376 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 44376 covers

A gastroenterologist or other endoscopist advances an enteroscope through the upper gastrointestinal tract to examine small bowel beyond the second portion of the duodenum, including the ileum. The procedure can help evaluate suspected small-bowel sources of gastrointestinal bleeding or mucosal disease when the area is not accessible with routine upper endoscopy. Brushing or washing specimens may be collected as part of the diagnostic service.

Select this code when the documented examination includes the ileum and no separately described therapeutic maneuver determines a different code. The report should support the route and extent of examination, findings, and any brushing or washing performed. CMS assigns a 0-day global period, so same-day preoperative and postoperative care is included. When multiple procedures are performed in one session, the highest-valued procedure is paid in full and other procedures are subject to the standard 50% multiple-procedure reduction. Assistant-at-surgery payment requires documentation of 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 44376 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

44376 office and facility rates by payment locality
Payment localityOfficeFacility
AlabamaUnavailable$232.83
AlaskaUnavailable$328.32
ArizonaUnavailable$243.96
ArkansasUnavailable$230.90
Atlanta, GAUnavailable$253.64
Austin, TXUnavailable$250.42
Bakersfield, CAUnavailable$250.66
Baltimore area, MDUnavailable$260.04
Beaumont, TXUnavailable$241.57
Brazoria, TXUnavailable$245.31

44376 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
44376 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 44376 rate is calculated

Each of 44376’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 · 44376

RVUs × geographic indexes × conversion factor

Office or facility?

Work5.02

5.02 RVUs× 1.000 GPCI

Practice expense1.88

1.88 RVUs× 1.000 GPCI

Malpractice0.54

0.54 RVUs× 1.000 GPCI

Adjusted RVUs

7.4400

Conversion factor

$33.4009

Medicare rate

$248.50

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

Payment rules and modifiers for 44376

The CMS indicators that decide how 44376 is paid alongside other services.

CMS payment indicators · 44376

Small-bowel enteroscopy, diagnostic, including ileum

RuleCMS valueWhat it means
Global period000Same-day global: pre- and post-op care on the day of the procedure is included.
Multiple procedures2Standard reduction: highest-valued procedure at 100%, others at 50%.
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

44376 without 51 · national facility

$248.50

Small-bowel enteroscopy, diagnostic, including ileum

44376-51 · Second procedure: 50%

$124.25

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

44376 compared with similar codes

Compare codes · National

4 codes, side by side

Office or facility?

  • 44376

    Small-bowel enteroscopy, diagnostic, including ileum5.02 wRVU

    Not priced

  • 44360

    Small-bowel exam, diagnostic, without biopsy2.43 wRVU

    Not priced

  • 44361

    Small bowel endoscopy, biopsy, ileum excluded2.7 wRVU

    Not priced

  • 44377

    Small bowel endoscopy, including ileum, with biopsy5.28 wRVU

    Not priced

How to choose

44360Small-bowel examDiagnostic, without biopsy
Choose 44376 when the diagnostic enteroscopy includes the ileum; 44360 is the related diagnostic code for examination not including the ileum.
44361Small bowel endoscopyBiopsy, ileum excluded
44361 is the biopsy-specific code in the related small-intestinal endoscopy family. Use 44376 for diagnostic examination including the ileum without a separately coded biopsy maneuver.
44377Small bowel endoscopyIncluding ileum, with biopsy
44377 describes enteroscopy including the ileum with biopsy. 44376 is the diagnostic service, including brushing or washing when performed, rather than the biopsy service.

Codes related to 44376

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

Codes related to 44376
CodeHow it relatesNational office range
Same family
44360Small-bowel exam, diagnostic, without biopsyRelated diagnostic enteroscopy code for examination that does not include the ileum.No office rate
44361Small bowel endoscopy, biopsy, ileum excludedBiopsy-specific small-intestinal endoscopy code in the related family.No office rate
44377Small bowel endoscopy, including ileum, with biopsyBiopsy-specific enteroscopy code for examination including the ileum.No office rate

44376 billing questions

How does this differ from 44360?

44376 describes diagnostic enteroscopy that includes the ileum. 44360 is the related diagnostic small-intestinal endoscopy code when the examination does not include the ileum.

Can brushing or washing be reported separately?

Brushing or washing specimen collection, when performed during this diagnostic enteroscopy, is included in the service.

Should I use 44376 when the endoscopist takes a biopsy?

Use the biopsy-specific code when tissue is sampled; 44377 is the related biopsy code for enteroscopy including the ileum. The procedure report should identify the biopsy.

What documentation supports 44376?

Document the enteroscopic route and extent, including examination of the ileum, the diagnostic findings, and any brushing or washing performed.

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.

How are other procedures in the same session paid?

CMS pays the highest-valued procedure in full and applies the standard multiple-procedure reduction to the others, which are paid at 50%.

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 44376PPRRVU2026_Oct_nonQPP.csv, line 5,399 (RVU26D)

Open CMS sourceHow we calculate rates

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