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Billing code 44361: Small bowel endoscopyMedicare rate & RVUs

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, 2026109 payment localities10.5K Medicare services in 2024

Medicare pays $140.62 for 44361 nationally in a facility.

Medicare rate · 44361

Small bowel endoscopy

Swap in your local Medicare rate.

Work RVUs
2.7
Total RVUs
4.21
Global days
000

National rate · 2026

$140.62

Facility setting, before claim adjustments.

See every locality for 44361 → · 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.

On this page 10 sections
  1. Medicare rate
  2. What 44361 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 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.

Where 44361 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

44361 office and facility rates by payment locality
Payment localityOfficeFacility
AlabamaUnavailable$131.32
Alaska*Unavailable$184.01
ArizonaUnavailable$137.96
ArkansasUnavailable$130.17
AtlantaUnavailable$143.49
AustinUnavailable$142.06
BakersfieldUnavailable$142.46
Baltimore/Surr. CntysUnavailable$147.33
BeaumontUnavailable$136.26
BrazoriaUnavailable$138.84

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.

View every state and territory as a table
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

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

Swap in your local Medicare rate.

Work 2.70Practice expense 1.22Malpractice 0.29

4.2100 adjusted RVUs×$33.4009 conversion factor=$140.62

All indexes start at 1.000 (the national rate). Enter a ZIP or drag a slider.

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

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

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

44361 compared with similar codes

Compare codes

44361 vs 44360 vs 44377 vs 44364 vs 44389: national Medicare rates

Swap in your local Medicare rate.

  • 44361
    Small bowel endoscopy · 2.7 wRVU
    —
  • 44360
    Small-bowel exam · 2.43 wRVU
    —
  • 44377
    Small bowel endoscopy · 5.28 wRVU
    —
  • 44364
    Small-bowel endoscopy · 3.54 wRVU
    —
  • 44389
    Colonoscopy · 2.94 wRVU
    $457.59

How to choose

44360Small-bowel exam
44360 describes the diagnostic examination without tissue biopsy. Choose 44361 when the endoscopist obtains biopsy tissue during the examination.
44377Small bowel endoscopy
Both codes include small-bowel biopsy, but 44377 applies when the examination includes the ileum; 44361 excludes the ileum.
44364Small-bowel endoscopy
44364 describes snare removal of a lesion during small-bowel endoscopy. Report 44361 for biopsy sampling rather than snare excision.
44389Colonoscopy
44389 is a colonoscopy-through-stoma code with biopsy. It does not describe enteroscopy into the small bowel beyond the duodenum.

Codes related to 44361

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

Codes related to 44361
CodeHow it relatesNational office range
Same family
44360Small-bowel examDiagnostic small-bowel enteroscopy without tissue biopsy.No office rate
44363Small bowel endoscopyRelated small-bowel enteroscopy code for control of bleeding.No office rate
44364Small-bowel endoscopyRelated small-bowel enteroscopy code for snare removal of lesions.No office rate
44366Enteroscopy hemostasisRelated small-bowel enteroscopy code for control of bleeding by any method.No office rate
44377Small bowel endoscopySmall-bowel enteroscopy with biopsy when the examination includes the ileum.No office rate

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)

Open CMS sourceHow we calculate rates

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