No office rate
Use for diagnostic enteroscopy beyond the second portion of the duodenum, excluding the ileum, when no tube or catheter is placed.
On this page
CMS RVU26D · Effective 2026-10-01
44372 Small bowel endoscopy Medicare reimbursement rates in Illinois
Reports enteroscopy beyond the second portion of the duodenum, excluding the ileum, when the endoscopist places a tube or catheter. Compare 44372 office and facility rates across CMS payment localities in Illinois.
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 44372 in Illinois?
Illinois has 4 payment localities in this comparison. Use the service location to choose the applicable amount. These are the supported base rates for the 4 payment areas shown below, using the same CMS release.
Office / nonfacility
No supported rate
Facility setting
$217.76–$237.13
4 of 4 localities have a 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 44372 pays more and less in Illinois
Gastrointestinal endoscopy
About 44372: Small bowel enteroscopy with tube placement
Reports enteroscopy beyond the second portion of the duodenum, excluding the ileum, when the endoscopist places a tube or catheter.
This service involves advancing an endoscope beyond the second portion of the duodenum, without entering the ileum, and placing a tube or catheter through the endoscope. Gastroenterologists typically perform it in a hospital or ambulatory endoscopy setting when endoscopic guidance is needed to position the device in the small bowel. The report should establish the extent of examination and describe the placement performed; routine diagnostic inspection alone does not capture the tube-placement service.
Select this code when the documented intervention is tube or catheter insertion, rather than biopsy, stent placement, or dilation. Record the indication, endoscopic route and extent, device placed, and its final position. CMS assigns a 0-day global period, so same-day preoperative and postoperative care is included. When related endoscopies are performed together, endoscopy family pricing applies. Modifier 50 is inappropriate for this anatomy and descriptor. Medicare does not pay an assistant at surgery, co-surgeons, or a team of surgeons for this service.
CMS billing rules for 44372
- Global period
- Minor procedure with a 0-day global period: same-day preoperative and postoperative care is included.
- Multiple procedures
- Endoscopy family pricing applies when related endoscopies are performed together.
- Bilateral procedures
- Bilateral adjustment does not apply; the descriptor or anatomy makes modifier 50 inappropriate.
- Assistant at surgery
- Statutory restriction: assistant at surgery is not paid.
- Co-surgeons
- Co-surgeons not permitted.
- Team surgery
- Team surgery not permitted.
Where the value comes from
- Work RVU4.19 · 66%
- Practice expense (office) RVU1.61 · 25%
- Malpractice RVU0.55 · 9%
519
Medicare services in 2024 · #3532 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.
44372 compared with similar codes
Office rates for Illinois, from the same CMS release.
No office rate
Use when the endoscopic intervention is stent placement, rather than placement of a tube or catheter.
No office rate
Use when the enteroscopy includes dilation of the small intestine rather than tube or catheter placement.
No office rate
This related enteroscopy code includes the ileum; 44372 describes an examination that does not include it and includes tube or catheter placement.
Compare 44372 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.
4 of 4 payment localities
Chicago →
Office / nonfacility
Unavailable
Facility
$237.13
East St. Louis →
Office / nonfacility
Unavailable
Facility
$226.42
Rest Of Illinois →
Office / nonfacility
Unavailable
Facility
$217.76
Suburban Chicago →
Office / nonfacility
Unavailable
Facility
$228.71
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44372 billing questions
How is this different from diagnostic small-bowel enteroscopy?
This code is for enteroscopy beyond the second portion of the duodenum, excluding the ileum, with tube or catheter placement. Use the diagnostic code when the service is inspection without that placement.
Does tube placement support this code if the endoscopist also examines the bowel?
The defining intervention is endoscopic tube or catheter placement. Document the examination extent and device placement; inspection alone is not enough.
Can modifier 50 be reported?
No. CMS identifies bilateral adjustment as inappropriate for this code’s anatomy and descriptor.
How are related endoscopies priced when performed together?
CMS applies endoscopy family pricing when related endoscopies are performed together. The applicable pricing reflects the family rule rather than treating every related endoscopy as an independent full service.
Can an assistant or another surgeon be billed for this procedure?
CMS does not pay an assistant at surgery for this code, and co-surgeons and team surgery are not permitted.
What is included in the global period?
The code has a 0-day global period. Same-day preoperative and postoperative care is included.
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.
5,39444366,,Small bowel endoscopy,A,,4.19,1.66,NA,1.66,,0.45,6.30,6.30,0,000,0.00,0.00,0.00,3,0,1,0,0,9,44360,33.4009,09,0,99,0.00,0.00,0.00
5,39544369,,Small bowel endoscopy,A,,4.30,1.69,NA,1.69,,0.47,6.46,6.46,0,000,0.00,0.00,0.00,3,0,0,0,0,9,44360,33.4009,09,0,99,0.00,0.00,0.00
5,39644370,,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