No office rate
Choose 44376 for diagnostic enteroscopy extending into the ileum when no endoscopic bleeding treatment is performed. Use 44378 when the physician controls bleeding during the examination.
On this page
CMS RVU26D · Effective 2026-10-01
44378 Small-bowel enteroscopy Medicare reimbursement rates in New Mexico
Reports small-bowel enteroscopy extending into the ileum when the endoscopist treats an identified bleeding site during the procedure. Compare 44378 office and facility rates across CMS payment localities in New Mexico.
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 44378 in New Mexico?
New Mexico 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
$333.38
1 of 1 localities have a supported rate.
Payment area: New Mexico
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 44378: Small-bowel enteroscopy with hemostasis
Reports small-bowel enteroscopy extending into the ileum when the endoscopist treats an identified bleeding site during the procedure.
A gastroenterologist or other qualified endoscopist advances an enteroscope beyond the second portion of the duodenum, including into the ileum, to find and treat a source of bleeding. Typical situations include evaluation of suspected small-bowel bleeding and endoscopic treatment of a bleeding lesion such as an angioectasia. Hemostasis may be achieved by methods such as injection or cautery. This is an endoscopic treatment service, not a diagnostic-only examination or a capsule study.
Report this code when the documented enteroscopy reaches the described small-bowel extent and the physician performs endoscopic bleeding control. The report should identify the treated site and the hemostatic method. 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 service. Assistant-at-surgery payment requires documentation of medical necessity; co-surgeons and team surgery are not permitted.
CMS billing rules for 44378
- 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 RVU6.84 · 68%
- Practice expense (office) RVU2.43 · 24%
- Malpractice RVU0.76 · 8%
788
Medicare services in 2024 · #3163 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.
44378 compared with similar codes
Office rates for New Mexico, from the same CMS release.
No office rate
Code 44377 applies when the enteroscopy includes biopsy. Code 44378 applies when the physician performs endoscopic hemostasis.
No office rate
Both codes describe enteroscopic bleeding control, but 44378 includes examination into the ileum; 44366 is the related code without that extent.
No office rate
Use 44379 when the enteroscopy includes stent placement. Use 44378 when the documented therapeutic service is control of bleeding.
Compare 44378 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
New Mexico →
Office / nonfacility
Unavailable
Facility
$333.38
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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 44378 in New Mexico.
PPRRVU2026_Oct_nonQPP.csv
5,401
- Code
- 44378
- Physician work
- 6.84
- Practice expense
- 2.43
- Malpractice
- 0.76
GPCI2026.csv
77
- Locality
- New Mexico
- Physician work
- 1.000
- Practice expense
- 0.917
- Malpractice
- 1.201
| Component | RVU | Locality factor | Adjusted |
|---|---|---|---|
| Physician work | 6.84 | × 1.000 | 6.8400 |
| Practice expense | 2.43 | × 0.917 | 2.2283 |
| Malpractice | 0.76 | × 1.201 | 0.9128 |
| Total RVUs | 9.9811 | ||
| Conversion factor | × 33.4009 | ||
Facility rate, New Mexico$333.38
Explore RVUs, geographic factors and the full formula
Facility
| Component | RVU | Local GPCI |
|---|---|---|
| Work | 6.84 | 1 |
| Practice expense | 2.43 | 0.917 |
| Malpractice | 0.76 | 1.201 |
(6.84 × 1 + 2.43 × 0.917 + 0.76 × 1.201) × $33.4009 = $333.38
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.
44378 billing questions
When should this be chosen over 44376?
Use 44378 when the enteroscopy extends into the ileum and the physician performs endoscopic control of bleeding. Code 44376 describes the corresponding diagnostic enteroscopy without that hemostatic treatment.
Can diagnostic enteroscopy be reported separately with this service?
The diagnostic examination is part of the enteroscopy that identifies and treats the bleeding source. When related endoscopies are performed together, CMS endoscopy family pricing applies.
What documentation supports reporting 44378?
Document the extent of the enteroscopy, the bleeding site or lesion treated, and the method used to control bleeding, such as injection or cautery.
Should modifier 50 be appended?
No. Bilateral adjustment does not apply to this small-bowel endoscopy, and modifier 50 is inappropriate.
Can an assistant surgeon be paid for this procedure?
Assistant-at-surgery payment is available only when the record supports medical necessity. Co-surgeons and team surgery are not permitted.
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.
5,39844373,,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
5,40144378,,Small bowel endoscopy,A,,6.84,2.43,NA,2.43,,0.76,10.03,10.03,0,000,0.00,0.00,0.00,3,0,0,0,0,9,44376,33.4009,09,0,99,0.00,0.00,0.00
5,40244379,,S bowel endoscope w/stent,A,,7.18,2.75,NA,2.75,,0.81,10.74,10.74,0,000,0.00,0.00,0.00,3,0,0,0,0,9,44376,33.4009,09,0,99,0.00,0.00,0.00
5,40344380,,Small bowel endoscopy br/wa,A,,0.85,5.76,,0.65,,0.09,6.70,1.59,0,000,0.00,0.00,0.00,2,0,1,0,0,9,,33.4009,09,0,99,0.00,0.00,0.00
5,40444381,,Small bowel endoscopy br/wa,A,,1.35,30.44,,0.80,,0.17,31.96,2.32,0,000,0.00,0.00,0.00,3,0,1,0,0,9,44380,33.4009,09,0,99,0.00,0.00,0.00
7414312,NH,40,NEW HAMPSHIRE,1.000,1.041,0.875
7512402,NJ,01,NORTHERN NJ,1.063,1.160,1.068
7612402,NJ,99,REST OF NEW JERSEY,1.040,1.092,1.097
7704212,NM,05,NEW MEXICO,1.000,0.917,1.201
7813202,NY,01,MANHATTAN,1.064,1.162,1.586
7913202,NY,02,NYC SUBURBS/LONG ISLAND,1.064,1.189,1.857
8013202,NY,03,POUGHKPSIE/N NYC SUBURBS,1.045,1.095,1.210