No office rate
Both involve removal of a small-bowel lesion during enteroscopy. Choose 44364 for snare technique and 44363 for hot biopsy forceps.
On this page
CMS RVU26D · Effective 2026-10-01
44364 Small-bowel endoscopy Medicare reimbursement rates in Massachusetts
Enteroscopy beyond the duodenum removes small-bowel polyps or other lesions with a snare during the examination. Compare 44364 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 44364 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
$182.21–$193.31
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 44364: Small-bowel lesion removal by snare
Enteroscopy beyond the duodenum removes small-bowel polyps or other lesions with a snare during the examination.
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.
CMS billing rules for 44364
- 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
- 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 RVU3.54 · 66%
- Practice expense (office) RVU1.47 · 27%
- Malpractice RVU0.39 · 7%
548
Medicare services in 2024 · #3473 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.
44364 compared with similar codes
Office rates for Massachusetts, from the same CMS release.
No office rate
Use 44361 for biopsy during small-bowel enteroscopy; use 44364 when the lesion is removed with a snare.
$516.64–$569.04
45385 describes snare removal during colonoscopy. This code is for enteroscopy beyond the second portion of the duodenum into the small bowel.
Compare 44364 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
$193.31
Rest Of Massachusetts →
Office / nonfacility
Unavailable
Facility
$182.21
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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 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.
5,38944360,,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
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