Billing code 44378: Small-bowel enteroscopyMedicare rate & RVUs in Oregon
Reports small-bowel enteroscopy extending into the ileum when the endoscopist treats an identified bleeding site during the procedure.
CMS doesn’t publish an office rate for 44378 in Oregon.
Medicare allowed amount for participating (non-QP) physicians, before deductible, coinsurance and claim adjustments. Not a patient’s bill or a hospital charge.
On this page 9 sections
What 44378 covers
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.
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.
Where 44378 pays more and less in Oregon
| Payment locality | Office | Facility |
|---|---|---|
| Portland | Unavailable | $341.18 |
| Rest Of Oregon | Unavailable | $327.15 |
How the 44378 rate is calculated
Each of 44378’s three RVUs is multiplied by a geographic index (GPCI) for the payment locality, added up, and multiplied by the conversion factor. Drag the indexes or enter a ZIP to see what moves the rate.
How the rate is built · 44378
RVUs × geographic indexes × conversion factor
Work6.84
6.84 RVUs× 1.000 GPCI
Practice expense2.43
2.43 RVUs× 1.000 GPCI
Malpractice0.76
0.76 RVUs× 1.000 GPCI
Adjusted RVUs
10.0300
Conversion factor
$33.4009
Medicare rate
$335.01
Every GPCI starts at 1.000, the national rate. Enter a ZIP or drag a slider.
Payment rules and modifiers for 44378
The CMS indicators that decide how 44378 is paid alongside other services.
CMS payment indicators · 44378
Small-bowel enteroscopy
| Rule | CMS value | What it means |
|---|---|---|
| Global period | 000 | Same-day global: pre- and post-op care on the day of the procedure is included. |
| Multiple procedures | 3 | Endoscopy family rules apply. |
| Bilateral (modifier 50) | 0 | The 150% bilateral adjustment doesn’t apply. |
| Assistant at surgery (80/81/82/AS) | 0 | Not paid without supporting documentation. |
| Co-surgeons (62) | 0 | Not permitted. |
| Team surgery (66) | 0 | Not permitted. |
| Professional/technical | 0 | Physician service: no professional/technical split. |
What modifiers do to the payment
Modifier 51 · payment effect
With and without the modifier
44378 without 51 · national facility
$335.01
Small-bowel enteroscopy
44378-51 · Second procedure: 50%
$167.51
When this isn’t the highest-valued procedure in the session, Medicare pays 50% of its fee schedule amount (the highest is paid at 100%).
44378 compared with similar codes
Compare codes · National
5 codes, side by side
How to choose
- 44376Small-bowel enteroscopy
- 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.
- 44377Small bowel endoscopy
- Code 44377 applies when the enteroscopy includes biopsy. Code 44378 applies when the physician performs endoscopic hemostasis.
- 44366Enteroscopy hemostasis
- Both codes describe enteroscopic bleeding control, but 44378 includes examination into the ileum; 44366 is the related code without that extent.
- 44379Small bowel enteroscopy
- Use 44379 when the enteroscopy includes stent placement. Use 44378 when the documented therapeutic service is control of bleeding.
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 indexes and the conversion factor. Services without a published rate are labeled, never given a made-up amount. Amounts are Medicare allowed amounts before claim adjustments: not a patient’s bill or a commercial rate.
CMS RVU26D · effective Oct 1, 2026 through the day before Jan 1, 2027
Show the CMS file lines behind this rate
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