FeeBase
Log inGet started
Menu

CPT code 44377: Small bowel endoscopy, including ileum, with biopsy2026 Medicare rate & RVUs

Reports enteroscopy extending into the ileum when the endoscopist obtains small-bowel tissue samples to evaluate suspected mucosal disease or other abnormalities.

CMS RVU26DEffective Oct 1, 2026109 payment localities576 Medicare services in 2024

Medicare pays $260.86 for 44377 nationally in a facility.

Medicare rate · 44377

Small bowel endoscopy, including ileum, with biopsy

Office or facility?

Work RVUs
5.28
Total RVUs
7.81
Global days
000

National rate · 2026

$260.86

Facility setting, before claim adjustments.

See every locality for 44377 →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 44377 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 44377 covers

A gastroenterologist or other qualified endoscopist examines the small bowel beyond the second portion of the duodenum, including the ileum, and obtains one or more tissue samples through the endoscope. The service may help investigate suspected small-bowel inflammation, unexplained anemia, or an abnormality seen on imaging or prior testing. It is commonly performed in a hospital or ambulatory endoscopy setting.

Choose this code when the documented examination reaches the ileum and includes biopsy; the number of samples does not change the code. The report should support the extent of examination and tissue sampling. Medicare assigns a 0-day global period, so same-day preoperative and postoperative care is included. When related endoscopies are performed together, endoscopy family pricing applies. Modifier 50 is inappropriate for this code. 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 44377 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

44377 office and facility rates by payment locality
Payment localityOfficeFacility
AlabamaUnavailable$244.21
AlaskaUnavailable$344.40
ArizonaUnavailable$256.01
ArkansasUnavailable$242.17
Atlanta, GAUnavailable$266.39
Austin, TXUnavailable$262.73
Bakersfield, CAUnavailable$262.73
Baltimore area, MDUnavailable$273.08
Beaumont, TXUnavailable$253.63
Brazoria, TXUnavailable$257.35

44377 rates by state

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

MEWIVTNHMTNDMNMINYMARIWAIDWYSDIAILINOHPANJCTORNVUTCONEMOKYWVVAMDDECAAZNMKSOKARTNNCSCDCTXLAMSALGAFLAKHI

Explore a state

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
44377 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 44377 rate is calculated

Each of 44377’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 · 44377

RVUs × geographic indexes × conversion factor

Office or facility?

Work5.28

5.28 RVUs× 1.000 GPCI

Practice expense1.94

1.94 RVUs× 1.000 GPCI

Malpractice0.59

0.59 RVUs× 1.000 GPCI

Adjusted RVUs

7.8100

Conversion factor

$33.4009

Medicare rate

$260.86

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

Payment rules and modifiers for 44377

The CMS indicators that decide how 44377 is paid alongside other services.

CMS payment indicators · 44377

Small bowel endoscopy, including ileum, with biopsy

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

44377 without 51 · national facility

$260.86

Small bowel endoscopy, including ileum, with biopsy

44377-51 · Second procedure: 50%

$130.43

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

44377 compared with similar codes

Compare codes · National

5 codes, side by side

Office or facility?

  • 44377

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

    Not priced

  • 44361

    Small bowel endoscopy, biopsy, ileum excluded2.7 wRVU

    Not priced

  • 44376

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

    Not priced

  • 44360

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

    Not priced

  • 44389

    Colonoscopy, through stoma, with biopsy2.94 wRVU

    $457.59

How to choose

44361Small bowel endoscopyBiopsy, ileum excluded
Both include small-bowel biopsy, but 44377 is for an examination that includes the ileum; 44361 is used when the examination does not include it.
44376Small-bowel enteroscopyDiagnostic, including ileum
This is the related enteroscopy including the ileum without biopsy. Choose 44377 when tissue sampling is performed.
44360Small-bowel examDiagnostic, without biopsy
This is diagnostic small-bowel enteroscopy without biopsy and does not include the ileum. It is not the choice when the ileum is examined and sampled.
44389ColonoscopyThrough stoma, with biopsy
This describes colonoscopy with biopsy. Use 44377 for small-bowel enteroscopy including the ileum, not sampling performed during colonoscopy.

Codes related to 44377

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

Codes related to 44377
CodeHow it relatesNational office range
Same family
44361Small bowel endoscopy, biopsy, ileum excludedRelated small-bowel enteroscopy with biopsy when the examination does not include the ileum.No office rate
44376Small-bowel enteroscopy, diagnostic, including ileumEnteroscopy including the ileum without the biopsy service.No office rate
44360Small-bowel exam, diagnostic, without biopsyDiagnostic small-bowel enteroscopy without biopsy, for a related examination not including the ileum.No office rate
44365Small bowel endoscopy, hot forceps or bipolar cauteryRelated small-bowel endoscopy code for endoscopic control of bleeding.No office rate
Used instead
44389Colonoscopy, through stoma, with biopsyColonoscopy with biopsy when the sampled abnormality is in the colon rather than the small bowel.$402.32–$615.14

44377 billing questions

How does this differ from 44361?

Use 44377 when the enteroscopy includes the ileum and biopsy. Code 44361 describes the related biopsy service when the examination does not include the ileum.

Does the number of biopsy samples change the code?

No. The code covers biopsy sampling whether the endoscopist obtains one sample or multiple samples.

Can a separate diagnostic enteroscopy code be reported for the same examination?

Do not report a second endoscopy code solely for the diagnostic examination that accompanies the biopsy. When related endoscopies are performed together, Medicare endoscopy family pricing applies.

Should modifier 50 be used for examination of both sides?

No. The anatomy and descriptor make bilateral adjustment inappropriate for this code.

What documentation supports reporting 44377?

Document that the enteroscope reached the ileum and that tissue was sampled. The note should distinguish this service from an examination that does not include the ileum.

When may an assistant be paid for this service?

Medicare assistant-at-surgery payment is available only when medical necessity is documented. Co-surgeons and team surgery are not permitted.

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 44377PPRRVU2026_Oct_nonQPP.csv, line 5,400 (RVU26D)

Open CMS sourceHow we calculate rates

Did this answer your question about what 44377 pays?

Tell us what you were actually trying to work out. We’ll answer you directly, or build the page that does.

Fee sheets · Coming soon

Put 44377 and the rest of your codes on one sheet

Your codes at your locality, with payer contracts beside Medicare.

Join the waitlist