Billing code 44364: Small-bowel endoscopyMedicare rate & RVUs in Delaware
Enteroscopy beyond the duodenum removes small-bowel polyps or other lesions with a snare during the examination.
CMS doesn’t publish an office rate for 44364 in Delaware.
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 9 sections
What 44364 covers
A gastroenterologist or other endoscopist advances an enteroscope beyond the second portion of the duodenum to examine the small bowel and remove a polyp or other lesion with a snare. The service is typically performed in a hospital outpatient department or ambulatory surgery center when a small-bowel lesion identified during enteroscopy requires endoscopic removal.
Report this code when the documented therapeutic work is snare removal, rather than inspection alone, biopsy, or removal by hot biopsy forceps. The report should identify the small-bowel extent reached, the lesion treated, and the snare technique. CMS applies endoscopy-family pricing when related endoscopies are performed together. The 0-day global period includes same-day preoperative and postoperative care. Modifier 50 is inappropriate. 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.
44364 in Delaware
| Payment locality | Office | Facility |
|---|---|---|
| Delaware | Unavailable | $179.05 |
How the 44364 rate is calculated
Each of 44364’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 · 44364
RVUs × geographic indexes × conversion factor
Swap in your local Medicare rate.
Work 3.54Practice expense 1.47Malpractice 0.39
All indexes start at 1.000 (the national rate). Enter a ZIP or drag a slider.
Payment rules and modifiers for 44364
The CMS indicators that decide how 44364 is paid alongside other services.
CMS payment indicators · 44364
Small-bowel endoscopy
| Rule | CMS value | What it means |
|---|---|---|
| Global period | 000 | Same-day global: pre- and post-op care on the day of the procedure is included. |
| Multiple procedures | 3 | Endoscopy family rules apply. |
| Bilateral (modifier 50) | 0 | The 150% bilateral adjustment doesn’t apply. |
| Assistant at surgery (80/81/82/AS) | 0 | Not paid without supporting documentation. |
| Co-surgeons (62) | 0 | Not permitted. |
| Team surgery (66) | 0 | Not permitted. |
| Professional/technical | 0 | Physician service: no professional/technical split. |
What modifiers do to the payment
Modifier 51 · payment effect
With and without the modifier
44364 without 51 · national facility
$180.36
Small-bowel endoscopy
44364-51 · Second procedure: 50%
$90.18
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%).
44364 compared with similar codes
Compare codes
44364 vs 44363 vs 44361 vs 45385: national Medicare rates
Swap in your local Medicare rate.
How to choose
- 44363Small bowel endoscopy
- Both involve removal of a small-bowel lesion during enteroscopy. Choose 44364 for snare technique and 44363 for hot biopsy forceps.
- 44361Small bowel endoscopy
- Use 44361 for biopsy during small-bowel enteroscopy; use 44364 when the lesion is removed with a snare.
- 45385Snare polypectomy
- 45385 describes snare removal during colonoscopy. This code is for enteroscopy beyond the second portion of the duodenum into the small bowel.
44364 billing questions
When should this code be chosen over the biopsy code?
Use this code when a small-bowel lesion is removed with a snare. Biopsy without snare removal is represented by the small-bowel endoscopy biopsy code, 44361.
How does this differ from 44363?
Both describe small-bowel lesion removal, but 44364 is for snare technique. Code 44363 represents removal with hot biopsy forceps.
How are related endoscopies priced when performed together?
CMS endoscopy-family pricing applies when related endoscopies are performed together. Report the services supported by the procedure documentation and account for that family pricing.
Can modifier 50 be reported?
No. The descriptor or anatomy makes a bilateral adjustment inappropriate for this service.
What documentation supports reporting this service?
Document the small-bowel extent examined, the lesion removed, and that a snare was used. Same-day preoperative and postoperative care is included in the 0-day global period.
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
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