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 in Connecticut
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 in Connecticut.
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 in Connecticut?
Connecticut has 1 payment locality in this comparison. Use the service location to choose the applicable amount. These are the supported base rates for the payment area shown below, using the same CMS release.
Office / nonfacility
No supported rate
Facility setting
$260.48
1 of 1 localities have a supported rate.
Payment area: Connecticut
One mapped payment locality.
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.
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 rates for Connecticut, 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.
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.
1 of 1 payment localities
Connecticut →
Office / nonfacility
Unavailable
Facility
$260.48
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How this local rate is calculated
Each RVU component is multiplied by its own geographic practice cost index (GPCI). The three adjusted components are added, then multiplied by the conversion factor. These are the inputs used for 44376 in Connecticut.
PPRRVU2026_Oct_nonQPP.csv
5,399
- Code
- 44376
- Physician work
- 5.02
- Practice expense
- 1.88
- Malpractice
- 0.54
GPCI2026.csv
38
- Locality
- Connecticut
- Physician work
- 1.020
- Practice expense
- 1.077
- Malpractice
- 1.210
| Component | RVU | Locality factor | Adjusted |
|---|---|---|---|
| Physician work | 5.02 | × 1.020 | 5.1204 |
| Practice expense | 1.88 | × 1.077 | 2.0248 |
| Malpractice | 0.54 | × 1.210 | 0.6534 |
| Total RVUs | 7.7986 | ||
| Conversion factor | × 33.4009 | ||
Facility rate, Connecticut$260.48
Explore RVUs, geographic factors and the full formula
Facility
| Component | RVU | Local GPCI |
|---|---|---|
| Work | 5.02 | 1.02 |
| Practice expense | 1.88 | 1.077 |
| Malpractice | 0.54 | 1.21 |
(5.02 × 1.02 + 1.88 × 1.077 + 0.54 × 1.21) × $33.4009 = $260.48
The office and facility calculations use their respective practice-expense RVUs. The facility amount here is the physician fee, not a separate hospital or facility bill.
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
3501112,CA,70,YUBA CITY,1.017,1.096,0.536
3601112,CA,75,REST OF CALIFORNIA,1.017,1.096,0.536
3704112,CO,01,COLORADO,1.012,1.064,0.781
3813102,CT,00,CONNECTICUT,1.020,1.077,1.210
3912202,DC,01,DC + MD/VA SUBURBS,1.054,1.178,1.113
4012102,DE,01,DELAWARE,1.005,0.988,0.899
4109102,FL,03,FORT LAUDERDALE,1.000,1.013,1.808