No office rate
44360 describes the diagnostic examination without tissue biopsy. Choose 44361 when the endoscopist obtains biopsy tissue during the examination.
On this page
CMS RVU26D · Effective 2026-10-01
44361 Small bowel endoscopy Medicare reimbursement rates in Massachusetts
Reports enteroscopy into the small bowel beyond the second portion of the duodenum, with tissue biopsy and without examination of the ileum. Compare 44361 office and facility rates across CMS payment localities in Massachusetts.
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 44361 in Massachusetts?
Massachusetts has 2 payment localities in this comparison. Use the service location to choose the applicable amount. These are the supported base rates for the 2 payment areas shown below, using the same CMS release.
Office / nonfacility
No supported rate
Facility setting
$142.25–$151.16
2 of 2 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.
Gastrointestinal endoscopy
About 44361: Small bowel enteroscopy with biopsy
Reports enteroscopy into the small bowel beyond the second portion of the duodenum, with tissue biopsy and without examination of the ileum.
A gastroenterologist or other qualified endoscopist advances an enteroscope beyond the second portion of the duodenum to examine the small bowel and obtain tissue samples. The examined segment may include the jejunum, but this code excludes examination of the ileum. Biopsies may be taken from abnormal-appearing mucosa or to investigate suspected small-bowel disease, such as a cause of malabsorption or unexplained anemia. These procedures are commonly performed in a hospital outpatient department or ambulatory endoscopy center.
Report 44361 when the endoscopist obtains one or more tissue biopsies during the qualifying examination; the number of samples does not create separate procedure units. The report should support the route and extent of the examination, the biopsy sites, and the reason for sampling. The code has a 0-day global period, so same-day preoperative and postoperative care is included. When related endoscopies are performed together, CMS endoscopy-family pricing applies. Medicare does not pay an assistant at surgery for this service, and co-surgeons and team surgery are not permitted. Bilateral adjustment does not apply, and modifier 50 is inappropriate.
CMS billing rules for 44361
- 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 RVU2.70 · 64%
- Practice expense (office) RVU1.22 · 29%
- Malpractice RVU0.29 · 7%
10.5K
Medicare services in 2024 · #1445 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.
44361 compared with similar codes
Office rates for Massachusetts, from the same CMS release.
No office rate
Both codes include small-bowel biopsy, but 44377 applies when the examination includes the ileum; 44361 excludes the ileum.
No office rate
44364 describes snare removal of a lesion during small-bowel endoscopy. Report 44361 for biopsy sampling rather than snare excision.
$474.79–$527.28
44389 is a colonoscopy-through-stoma code with biopsy. It does not describe enteroscopy into the small bowel beyond the duodenum.
Compare 44361 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.
2 of 2 payment localities
Metropolitan Boston →
Office / nonfacility
Unavailable
Facility
$151.16
Rest Of Massachusetts →
Office / nonfacility
Unavailable
Facility
$142.25
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44361 billing questions
When should 44361 be reported instead of 44360?
Use 44361 when tissue biopsy is obtained during the qualifying small-bowel examination. Use 44360 for the diagnostic examination when no tissue biopsy is performed.
Does the code include multiple biopsy samples?
Yes. One or multiple biopsies during the examination are included in the procedure service; do not report a separate unit for each sample.
Can 44361 be used when the endoscopist examines the ileum?
No. This code describes examination beyond the second portion of the duodenum without including the ileum. For an examination that includes the ileum with biopsy, compare 44377.
How is 44361 handled when another related endoscopy is performed in the same session?
CMS endoscopy-family pricing applies when related endoscopies are performed together. The record should identify each examination and any distinct intervention or biopsy performed.
Is modifier 50 appropriate, and can an assistant or co-surgeon be paid?
No. Bilateral adjustment does not apply, and modifier 50 is inappropriate. Medicare does not pay an assistant at surgery for this service, and co-surgeons and team surgery are not permitted.
What documentation supports reporting 44361?
Document the endoscopic route and extent, the small-bowel segment examined, the biopsy site or sites, and the clinical reason for obtaining tissue.
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.
5,38744345,,Revision of colostomy,A,,16.79,9.00,NA,9.00,,3.75,29.54,29.54,0,090,0.09,0.81,0.10,2,0,2,1,0,9,,33.4009,09,0,99,0.00,0.00,0.00
5,38844346,,Revision of colostomy,A,,19.14,9.58,NA,9.58,,4.22,32.94,32.94,0,090,0.09,0.81,0.10,2,0,2,1,0,9,,33.4009,09,0,99,0.00,0.00,0.00
5,38944360,,Small bowel endoscopy,A,,2.43,1.13,NA,1.13,,0.26,3.82,3.82,0,000,0.00,0.00,0.00,2,0,1,0,0,9,,33.4009,09,0,99,0.00,0.00,0.00
5,39044361,,Small bowel endoscopy/biopsy,A,,2.70,1.22,NA,1.22,,0.29,4.21,4.21,0,000,0.00,0.00,0.00,3,0,1,0,0,9,44360,33.4009,09,0,99,0.00,0.00,0.00
5,39144363,,Small bowel endoscopy,A,,3.31,1.39,NA,1.39,,0.38,5.08,5.08,0,000,0.00,0.00,0.00,3,0,0,0,0,9,44360,33.4009,09,0,99,0.00,0.00,0.00
5,39244364,,Small bowel endoscopy,A,,3.54,1.47,NA,1.47,,0.39,5.40,5.40,0,000,0.00,0.00,0.00,3,0,0,0,0,9,44360,33.4009,09,0,99,0.00,0.00,0.00
5,39344365,,Small bowel endoscopy,A,,3.13,1.34,NA,1.34,,0.35,4.82,4.82,0,000,0.00,0.00,0.00,3,0,0,0,0,9,44360,33.4009,09,0,99,0.00,0.00,0.00