No office rate
Choose 44376 when the diagnostic enteroscopy includes the ileum; 44360 is the related diagnostic code for examination not including the ileum.
On this page
CMS RVU26D · Effective 2026-10-01
44376 Small-bowel enteroscopy Medicare reimbursement rates
Reports diagnostic small-intestinal enteroscopy extending beyond the second duodenal portion to include the ileum, with brushing or washing when performed. Compare 44376 office and facility rates across CMS payment localities.
Amounts below use the non-QP conversion factor for participating physicians. These are base physician payments before claim-level adjustments, not patient costs or total hospital charges.
What does Medicare pay for 44376?
The service location and office or facility setting determine which base rate applies. These are the supported base rates for the 109 payment areas shown below, using the same CMS release.
Office / nonfacility
No supported rate
These are locality ranges, not averages or address-specific quotes. A facility-setting amount covers the physician service; it does not include a hospital’s separate bill. Choose a locality below to inspect its calculation, compare other payment areas, or price a percentage of Medicare.
Where 44376 pays more and less
Gastrointestinal endoscopy
About 44376: Diagnostic enteroscopy through the ileum
Reports diagnostic small-intestinal enteroscopy extending beyond the second duodenal portion to include the ileum, with brushing or washing when performed.
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.
CMS billing rules for 44376
- Global period
- Minor procedure with a 0-day global period: same-day preoperative and postoperative care is included.
- Multiple procedures
- Standard multiple procedure reduction: the highest-valued procedure is paid in full and others at 50% when performed in the same session.
- Bilateral procedures
- Bilateral adjustment does not apply; the descriptor or anatomy makes modifier 50 inappropriate.
- Assistant at surgery
- Assistant at surgery is paid only with documentation of medical necessity.
- Co-surgeons
- Co-surgeons not permitted.
- Team surgery
- Team surgery not permitted.
Where the value comes from
- Work RVU5.02 · 67%
- Practice expense (office) RVU1.88 · 25%
- Malpractice RVU0.54 · 7%
802
Medicare services in 2024 · #3146 by national volume
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.
44376 compared with similar codes
Office rate ranges across all CMS payment localities, from the same CMS release.
No office rate
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.
No office rate
44377 describes enteroscopy including the ileum with biopsy. 44376 is the diagnostic service, including brushing or washing when performed, rather than the biopsy service.
See how rates vary across the country
44376 · Office / nonfacility · Non-QP. Choose a state to explore its payment localities. A range means the amount varies within that state.
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 all state and territory rates as a table
| State / territory | Rate range | Localities |
|---|---|---|
| AK | No published base rate | 1 |
| AL | No published base rate | 1 |
| AR | No published base rate | 1 |
| AZ | No published base rate | 1 |
| CA | No published base rate | 29 |
| CO | No published base rate | 1 |
| CT | No published base rate | 1 |
| DC | No published base rate | 1 |
| DE | No published base rate | 1 |
| FL | No published base rate | 3 |
| GA | No published base rate | 2 |
| GU | No published base rate | 1 |
| HI | No published base rate | 1 |
| IA | No published base rate | 1 |
| ID | No published base rate | 1 |
| IL | No published base rate | 4 |
| IN | No published base rate | 1 |
| KS | No published base rate | 1 |
| KY | No published base rate | 1 |
| LA | No published base rate | 2 |
| MA | No published base rate | 2 |
| MD | No published base rate | 3 |
| ME | No published base rate | 2 |
| MI | No published base rate | 2 |
| MN | No published base rate | 1 |
| MO | No published base rate | 3 |
| MS | No published base rate | 1 |
| MT | No published base rate | 1 |
| NC | No published base rate | 1 |
| ND | No published base rate | 1 |
| NE | No published base rate | 1 |
| NH | No published base rate | 1 |
| NJ | No published base rate | 2 |
| NM | No published base rate | 1 |
| NV | No published base rate | 1 |
| NY | No published base rate | 5 |
| OH | No published base rate | 1 |
| OK | No published base rate | 1 |
| OR | No published base rate | 2 |
| PA | No published base rate | 2 |
| PR | No published base rate | 1 |
| RI | No published base rate | 1 |
| SC | No published base rate | 1 |
| SD | No published base rate | 1 |
| TN | No published base rate | 1 |
| TX | No published base rate | 8 |
| UT | No published base rate | 1 |
| VA | No published base rate | 2 |
| VI | No published base rate | 1 |
| VT | No published base rate | 1 |
| WA | No published base rate | 2 |
| WI | No published base rate | 1 |
| WV | No published base rate | 1 |
| WY | No published base rate | 1 |
Compare 44376 by payment locality
Find the payment area for your service address, then open its rate page for calculation inputs, release history and the percentage-of-Medicare tool. A city may cross payment-area boundaries; the ZIP lookup above helps resolve the location.
109 of 109 payment localities
| Payment locality | Office | Facility |
|---|---|---|
| Alabama | Office Unavailable | Facility $232.83 |
| Alaska* | Office Unavailable | Facility $328.32 |
| Arizona | Office Unavailable | Facility $243.96 |
| Arkansas | Office Unavailable | Facility $230.90 |
| Atlanta | Office Unavailable | Facility $253.64 |
| Austin | Office Unavailable | Facility $250.42 |
| Bakersfield | Office Unavailable | Facility $250.66 |
| Baltimore/Surr. Cntys | Office Unavailable | Facility $260.04 |
| Beaumont | Office Unavailable | Facility $241.57 |
| Brazoria | Office Unavailable | Facility $245.31 |
| Chicago | Office Unavailable | Facility $273.35 |
| Chico | Office Unavailable | Facility $249.01 |
| Colorado | Office Unavailable | Facility $250.58 |
| Connecticut | Office Unavailable | Facility $260.48 |
| Dallas | Office Unavailable | Facility $247.20 |
| Dc + Md/Va Suburbs | Office Unavailable | Facility $270.77 |
| Delaware | Office Unavailable | Facility $246.77 |
| Detroit | Office Unavailable | Facility $258.68 |
| East St. Louis | Office Unavailable | Facility $261.77 |
| El Centro | Office Unavailable | Facility $249.10 |
| Fort Lauderdale | Office Unavailable | Facility $263.89 |
| Fort Worth | Office Unavailable | Facility $246.81 |
| Fresno | Office Unavailable | Facility $249.01 |
| Galveston | Office Unavailable | Facility $246.30 |
| Hanford-Corcoran | Office Unavailable | Facility $249.01 |
| Hawaii, Guam | Office Unavailable | Facility $249.51 |
| Houston | Office Unavailable | Facility $256.19 |
| Idaho | Office Unavailable | Facility $233.97 |
| Indiana | Office Unavailable | Facility $234.65 |
| Iowa | Office Unavailable | Facility $232.29 |
| Kansas | Office Unavailable | Facility $233.53 |
| Kentucky | Office Unavailable | Facility $240.00 |
| Los Angeles-Long Beach-Anaheim (Los Angeles/Orange Cnty) | Office Unavailable | Facility $260.81 |
| Madera | Office Unavailable | Facility $249.01 |
| Manhattan | Office Unavailable | Facility $279.98 |
| Merced | Office Unavailable | Facility $249.01 |
| Metropolitan Boston | Office Unavailable | Facility $265.58 |
| Metropolitan Kansas City | Office Unavailable | Facility $244.26 |
| Metropolitan Philadelphia | Office Unavailable | Facility $257.58 |
| Metropolitan St. Louis | Office Unavailable | Facility $245.52 |
| Miami | Office Unavailable | Facility $278.66 |
| Minnesota | Office Unavailable | Facility $237.63 |
| Mississippi | Office Unavailable | Facility $235.07 |
| Modesto | Office Unavailable | Facility $249.01 |
| Montana** | Office Unavailable | Facility $248.47 |
| Napa | Office Unavailable | Facility $270.16 |
| Nebraska | Office Unavailable | Facility $232.45 |
| Nevada** | Office Unavailable | Facility $245.55 |
| New Hampshire | Office Unavailable | Facility $248.82 |
| New Mexico | Office Unavailable | Facility $246.92 |
| New Orleans | Office Unavailable | Facility $247.25 |
| North Carolina | Office Unavailable | Facility $237.78 |
| North Dakota** | Office Unavailable | Facility $237.79 |
| Northern Nj | Office Unavailable | Facility $270.34 |
| Nyc Suburbs/Long Island | Office Unavailable | Facility $286.56 |
| Ohio | Office Unavailable | Facility $243.18 |
| Oklahoma | Office Unavailable | Facility $237.76 |
| Oxnard-Thousand Oaks-Ventura | Office Unavailable | Facility $257.83 |
| Portland | Office Unavailable | Facility $253.54 |
| Poughkpsie/N Nyc Suburbs | Office Unavailable | Facility $265.80 |
| Puerto Rico | Office Unavailable | Facility $248.92 |
| Queens | Office Unavailable | Facility $278.63 |
| Redding | Office Unavailable | Facility $249.01 |
| Rest Of California | Office Unavailable | Facility $249.01 |
| Rest Of Florida | Office Unavailable | Facility $254.81 |
| Rest Of Georgia | Office Unavailable | Facility $245.18 |
| Rest Of Illinois | Office Unavailable | Facility $253.19 |
| Rest Of Louisiana | Office Unavailable | Facility $240.52 |
| Rest Of Maine | Office Unavailable | Facility $236.66 |
| Rest Of Maryland | Office Unavailable | Facility $249.45 |
| Rest Of Massachusetts | Office Unavailable | Facility $250.85 |
| Rest Of Michigan | Office Unavailable | Facility $245.37 |
| Rest Of Missouri | Office Unavailable | Facility $239.37 |
| Rest Of New Jersey | Office Unavailable | Facility $262.74 |
| Rest Of New York | Office Unavailable | Facility $240.01 |
| Rest Of Oregon | Office Unavailable | Facility $242.89 |
| Rest Of Pennsylvania | Office Unavailable | Facility $242.36 |
| Rest Of Texas | Office Unavailable | Facility $243.55 |
| Rest Of Washington | Office Unavailable | Facility $249.70 |
| Rhode Island | Office Unavailable | Facility $251.81 |
| Riverside-San Bernardino-Ontario | Office Unavailable | Facility $254.90 |
| Sacramento-Roseville-Folsom | Office Unavailable | Facility $256.41 |
| Salinas | Office Unavailable | Facility $255.32 |
| San Diego-Chula Vista-Carlsbad | Office Unavailable | Facility $257.58 |
| San Francisco-Oakland-Berkeley (Marin Cnty) | Office Unavailable | Facility $280.42 |
| San Francisco-Oakland-Berkeley (San Francisco/San Mateo/Alameda/Contra Costa Cnty) | Office Unavailable | Facility $279.81 |
| San Jose-Sunnyvale-Santa Clara (San Benito Cnty) | Office Unavailable | Facility $286.33 |
| San Jose-Sunnyvale-Santa Clara (Santa Clara Cnty) | Office Unavailable | Facility $283.83 |
| San Luis Obispo-Paso Robles | Office Unavailable | Facility $251.71 |
| Santa Cruz-Watsonville | Office Unavailable | Facility $257.16 |
| Santa Maria-Santa Barbara | Office Unavailable | Facility $255.25 |
| Santa Rosa-Petaluma | Office Unavailable | Facility $259.48 |
| Seattle (King Cnty) | Office Unavailable | Facility $267.84 |
| South Carolina | Office Unavailable | Facility $241.02 |
| South Dakota** | Office Unavailable | Facility $236.53 |
| Southern Maine | Office Unavailable | Facility $241.28 |
| Stockton | Office Unavailable | Facility $249.01 |
| Suburban Chicago | Office Unavailable | Facility $265.30 |
| Tennessee | Office Unavailable | Facility $234.44 |
| Utah | Office Unavailable | Facility $242.90 |
| Vallejo | Office Unavailable | Facility $269.28 |
| Vermont | Office Unavailable | Facility $238.96 |
| Virgin Islands | Office Unavailable | Facility $248.92 |
| Virginia | Office Unavailable | Facility $242.13 |
| Visalia | Office Unavailable | Facility $249.01 |
| West Virginia | Office Unavailable | Facility $248.05 |
| Wisconsin | Office Unavailable | Facility $233.38 |
| Wyoming** | Office Unavailable | Facility $243.81 |
| Yuba City | Office Unavailable | Facility $249.01 |
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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 indices and the applicable conversion factor. Unavailable or separately priced services are labeled rather than assigned a made-up amount.
Source: RVU26D. Effective 2026-10-01 through the day before 2027-01-01.
5,39644370,,Small bowel endoscopy/stent,A,,4.57,1.99,NA,1.99,,0.49,7.05,7.05,0,000,0.00,0.00,0.00,3,0,0,0,0,9,44360,33.4009,09,0,99,0.00,0.00,0.00
5,39744372,,Small bowel endoscopy,A,,4.19,1.61,NA,1.61,,0.55,6.35,6.35,0,000,0.00,0.00,0.00,3,0,1,0,0,9,44360,33.4009,09,0,99,0.00,0.00,0.00
5,39844373,,Small bowel endoscopy,A,,3.31,1.36,NA,1.36,,0.43,5.10,5.10,0,000,0.00,0.00,0.00,3,0,1,0,0,9,44360,33.4009,09,0,99,0.00,0.00,0.00
5,39944376,,Small bowel endoscopy,A,,5.02,1.88,NA,1.88,,0.54,7.44,7.44,0,000,0.00,0.00,0.00,2,0,0,0,0,9,,33.4009,09,0,99,0.00,0.00,0.00
5,40044377,,Small bowel endoscopy/biopsy,A,,5.28,1.94,NA,1.94,,0.59,7.81,7.81,0,000,0.00,0.00,0.00,3,0,0,0,0,9,44376,33.4009,09,0,99,0.00,0.00,0.00
5,40144378,,Small bowel endoscopy,A,,6.84,2.43,NA,2.43,,0.76,10.03,10.03,0,000,0.00,0.00,0.00,3,0,0,0,0,9,44376,33.4009,09,0,99,0.00,0.00,0.00
5,40244379,,S bowel endoscope w/stent,A,,7.18,2.75,NA,2.75,,0.81,10.74,10.74,0,000,0.00,0.00,0.00,3,0,0,0,0,9,44376,33.4009,09,0,99,0.00,0.00,0.00