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CPT 44369: Small-bowel enteroscopyMedicare rate & RVUs

Report this code when a gastroenterologist removes a small-bowel lesion by endoscopic mucosal resection during enteroscopy beyond the second part of the duodenum.

CMS RVU26DEffective Oct 1, 2026109 payment localities2.2K Medicare services in 2024

Medicare pays $215.77 for 44369 nationally in a facility.

Medicare rate · 44369

Small-bowel enteroscopy

Swap in your local Medicare rate.

Work RVUs
4.3
Total RVUs
6.46
Global days
000

National rate · 2026

$215.77

Facility setting, before claim adjustments.

See every locality for 44369 →

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 44369 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 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

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

109 of 109 payment localities

44369 office and facility rates by payment locality
Payment localityOfficeFacility
AlabamaUnavailable$201.90
Alaska*Unavailable$284.20
ArizonaUnavailable$211.76
ArkansasUnavailable$200.20
AtlantaUnavailable$220.26
AustinUnavailable$217.54
BakersfieldUnavailable$217.78
Baltimore/Surr. CntysUnavailable$225.91
BeaumontUnavailable$209.57
BrazoriaUnavailable$212.96

44369 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
44369 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 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.

How the rate is built · 44369

RVUs × geographic indexes × conversion factor

Swap in your local Medicare rate.

Work 4.30Practice expense 1.69Malpractice 0.47

6.4600 adjusted RVUs×$33.4009 conversion factor=$215.77

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

Payment rules and modifiers for 44369

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

CMS payment indicators · 44369

Small-bowel enteroscopy

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

44369 without 51 · national facility

$215.77

Small-bowel enteroscopy

44369-51 · Second procedure: 50%

$107.89

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

44369 compared with similar codes

Compare codes

44369 vs 44360 vs 44361 vs 44370: national Medicare rates

Swap in your local Medicare rate.

  • 44369
    Small-bowel enteroscopy · 4.3 wRVU
    —
  • 44360
    Small-bowel exam · 2.43 wRVU
    —
  • 44361
    Small bowel endoscopy · 2.7 wRVU
    —
  • 44370
    Small bowel endoscopy · 4.57 wRVU
    —

How to choose

44360Small-bowel exam
Choose 44360 for diagnostic enteroscopy without lesion resection. Choose 44369 when the procedure report documents endoscopic mucosal resection.
44361Small bowel endoscopy
A biopsy samples tissue; endoscopic mucosal resection removes a lesion using a resection technique. The documented work distinguishes 44361 from 44369.
44370Small bowel endoscopy
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.

Codes related to 44369
CodeHow it relatesNational office range
Same family
44360Small-bowel examDiagnostic antegrade enteroscopy without mucosal resection.No office rate
44370Small bowel endoscopyTherapeutic enteroscopy involving stent placement rather than mucosal resection.No office rate
Used instead
44361Small bowel endoscopyEnteroscopy with biopsy rather than mucosal resection.No office rate
44363Small bowel endoscopyEnteroscopy to remove a foreign body rather than resect a mucosal lesion.No office rate

44369 billing questions

Does a small-bowel biopsy support 44369?

No. Use 44369 when the report documents endoscopic mucosal resection; 44361 describes enteroscopy with biopsy.

What distinguishes 44369 from diagnostic enteroscopy?

Code 44369 requires documented mucosal resection of a lesion. Code 44360 describes the examination without that therapeutic work.

How is a related diagnostic enteroscopy paid when performed with 44369?

CMS applies endoscopy family pricing when related endoscopies are performed together. Review the procedures documented in the same session rather than treating each endoscopy as independently priced.

Should modifier 50 be added for more than one small-bowel lesion?

No. Modifier 50 is inappropriate for this service; document the lesions and the resection performed without treating them as bilateral sites.

Can an assistant surgeon be reported?

Medicare pays an assistant at surgery only when medical necessity is documented. Co-surgeon and team-surgery reporting 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 44369PPRRVU2026_Oct_nonQPP.csv, line 5,395 (RVU26D)

Open CMS sourceHow we calculate rates

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