No office rate
Report 44361 for biopsy sampling during small-bowel enteroscopy. Report 44363 when a lesion is removed using a snare.
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CMS RVU26D · Effective 2026-10-01
44363 Small bowel endoscopy Medicare reimbursement rates in Nebraska
Reports deep small-bowel enteroscopy when the endoscopist removes a polyp, tumor, or other lesion using a snare during the procedure. Compare 44363 office and facility rates across CMS payment localities in Nebraska.
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 44363 in Nebraska?
Nebraska 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
$158.21
1 of 1 localities have a supported rate.
Payment area: Nebraska
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 44363: Small bowel enteroscopy with snare removal
Reports deep small-bowel enteroscopy when the endoscopist removes a polyp, tumor, or other lesion using a snare during the procedure.
A gastroenterologist or other qualified endoscopist advances an enteroscope beyond the second portion of the duodenum to examine the small bowel and remove a lesion with a snare. The service is commonly performed in a hospital or ambulatory endoscopy setting when a small-bowel lesion has been identified or is encountered during enteroscopy. The report should identify the extent of examination, the lesion treated, and the snare technique used.
Choose this code for snare removal, not for diagnostic examination alone, tissue sampling, or removal by another method. Document the target and treatment performed; the record should support that the instrument reached the small bowel beyond the second duodenal portion. 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 documentation of medical necessity; co-surgeons and team surgery are not permitted.
CMS billing rules for 44363
- 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 RVU3.31 · 65%
- Practice expense (office) RVU1.39 · 27%
- Malpractice RVU0.38 · 7%
184
Medicare services in 2024 · #4394 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.
44363 compared with similar codes
Office rates for Nebraska, from the same CMS release.
No office rate
44364 represents lesion removal by hot biopsy forceps or bipolar cautery; 44363 is distinguished by snare removal.
No office rate
44366 is for lesion ablation rather than snare excision. Select according to the endoscopic treatment actually performed.
Compare 44363 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
Nebraska →
Office / nonfacility
Unavailable
Facility
$158.21
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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 44363 in Nebraska.
PPRRVU2026_Oct_nonQPP.csv
5,391
- Code
- 44363
- Physician work
- 3.31
- Practice expense
- 1.39
- Malpractice
- 0.38
GPCI2026.csv
72
- Locality
- Nebraska
- Physician work
- 1.000
- Practice expense
- 0.923
- Malpractice
- 0.378
| Component | RVU | Locality factor | Adjusted |
|---|---|---|---|
| Physician work | 3.31 | × 1.000 | 3.3100 |
| Practice expense | 1.39 | × 0.923 | 1.2830 |
| Malpractice | 0.38 | × 0.378 | 0.1436 |
| Total RVUs | 4.7366 | ||
| Conversion factor | × 33.4009 | ||
Facility rate, Nebraska$158.21
Explore RVUs, geographic factors and the full formula
Facility
| Component | RVU | Local GPCI |
|---|---|---|
| Work | 3.31 | 1 |
| Practice expense | 1.39 | 0.923 |
| Malpractice | 0.38 | 0.378 |
(3.31 × 1 + 1.39 × 0.923 + 0.38 × 0.378) × $33.4009 = $158.21
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.
44363 billing questions
How does this differ from 44361?
44363 is for snare removal of a lesion. 44361 describes small-bowel endoscopy with biopsy, so use it when tissue is sampled rather than removed by snare.
When should 44364 be considered instead?
Use 44364 when the lesion is removed with hot biopsy forceps or bipolar cautery rather than a snare. The documented removal method distinguishes these codes.
Can diagnostic enteroscopy be reported separately with 44363?
The examination is part of the therapeutic enteroscopy. When related endoscopies are performed together, CMS endoscopy-family pricing applies.
Can modifier 50 be used?
No. CMS identifies bilateral adjustment as inappropriate for this code because of its descriptor or anatomy.
What does the 0-day global period include?
Same-day preoperative and postoperative care is included. The global period is limited to the procedure date.
What documentation supports assistant-at-surgery payment?
The record must document medical necessity for the assistant. CMS does not permit co-surgeons or team surgery for this service.
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.
5,38844346,,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
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
6905302,MO,01,METROPOLITAN ST. LOUIS,1.000,0.952,1.002
7005302,MO,99,REST OF MISSOURI,1.000,0.862,0.974
7103202,MT,01,MONTANA**,1.000,1.000,0.998
7205402,NE,00,NEBRASKA,1.000,0.923,0.378
7301312,NV,00,NEVADA**,1.000,1.001,0.833
7414312,NH,40,NEW HAMPSHIRE,1.000,1.041,0.875
7512402,NJ,01,NORTHERN NJ,1.063,1.160,1.068