No office rate
Both include small-bowel biopsy, but 44377 is for an examination that includes the ileum; 44361 is used when the examination does not include it.
On this page
CMS RVU26D · Effective 2026-10-01
44377 Small bowel endoscopy Medicare reimbursement rates in Wisconsin
Reports enteroscopy extending into the ileum when the endoscopist obtains small-bowel tissue samples to evaluate suspected mucosal disease or other abnormalities. Compare 44377 office and facility rates across CMS payment localities in Wisconsin.
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 44377 in Wisconsin?
Wisconsin 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
$244.50
1 of 1 localities have a supported rate.
Payment area: Wisconsin
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 44377: Small bowel enteroscopy with biopsy
Reports enteroscopy extending into the ileum when the endoscopist obtains small-bowel tissue samples to evaluate suspected mucosal disease or other abnormalities.
A gastroenterologist or other qualified endoscopist examines the small bowel beyond the second portion of the duodenum, including the ileum, and obtains one or more tissue samples through the endoscope. The service may help investigate suspected small-bowel inflammation, unexplained anemia, or an abnormality seen on imaging or prior testing. It is commonly performed in a hospital or ambulatory endoscopy setting.
Choose this code when the documented examination reaches the ileum and includes biopsy; the number of samples does not change the code. The report should support the extent of examination and tissue sampling. Medicare 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 code. Assistant-at-surgery payment requires documented medical necessity; co-surgeons and team surgery are not permitted.
CMS billing rules for 44377
- 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 RVU5.28 · 68%
- Practice expense (office) RVU1.94 · 25%
- Malpractice RVU0.59 · 8%
576
Medicare services in 2024 · #3436 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.
44377 compared with similar codes
Office rates for Wisconsin, from the same CMS release.
No office rate
This is the related enteroscopy including the ileum without biopsy. Choose 44377 when tissue sampling is performed.
No office rate
This is diagnostic small-bowel enteroscopy without biopsy and does not include the ileum. It is not the choice when the ileum is examined and sampled.
$433.81
This describes colonoscopy with biopsy. Use 44377 for small-bowel enteroscopy including the ileum, not sampling performed during colonoscopy.
Compare 44377 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
Wisconsin →
Office / nonfacility
Unavailable
Facility
$244.50
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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 44377 in Wisconsin.
PPRRVU2026_Oct_nonQPP.csv
5,400
- Code
- 44377
- Physician work
- 5.28
- Practice expense
- 1.94
- Malpractice
- 0.59
GPCI2026.csv
111
- Locality
- Wisconsin
- Physician work
- 1.000
- Practice expense
- 0.958
- Malpractice
- 0.308
| Component | RVU | Locality factor | Adjusted |
|---|---|---|---|
| Physician work | 5.28 | × 1.000 | 5.2800 |
| Practice expense | 1.94 | × 0.958 | 1.8585 |
| Malpractice | 0.59 | × 0.308 | 0.1817 |
| Total RVUs | 7.3202 | ||
| Conversion factor | × 33.4009 | ||
Facility rate, Wisconsin$244.50
Explore RVUs, geographic factors and the full formula
Facility
| Component | RVU | Local GPCI |
|---|---|---|
| Work | 5.28 | 1 |
| Practice expense | 1.94 | 0.958 |
| Malpractice | 0.59 | 0.308 |
(5.28 × 1 + 1.94 × 0.958 + 0.59 × 0.308) × $33.4009 = $244.50
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.
44377 billing questions
How does this differ from 44361?
Use 44377 when the enteroscopy includes the ileum and biopsy. Code 44361 describes the related biopsy service when the examination does not include the ileum.
Does the number of biopsy samples change the code?
No. The code covers biopsy sampling whether the endoscopist obtains one sample or multiple samples.
Can a separate diagnostic enteroscopy code be reported for the same examination?
Do not report a second endoscopy code solely for the diagnostic examination that accompanies the biopsy. When related endoscopies are performed together, Medicare endoscopy family pricing applies.
Should modifier 50 be used for examination of both sides?
No. The anatomy and descriptor make bilateral adjustment inappropriate for this code.
What documentation supports reporting 44377?
Document that the enteroscope reached the ileum and that tissue was sampled. The note should distinguish this service from an examination that does not include the ileum.
When may an assistant be paid for this service?
Medicare assistant-at-surgery payment is available only when medical necessity is documented. 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.
5,39744372,,Small bowel endoscopy,A,,4.19,1.61,NA,1.61,,0.55,6.35,6.35,0,000,0.00,0.00,0.00,3,0,1,0,0,9,44360,33.4009,09,0,99,0.00,0.00,0.00
5,39844373,,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
10802402,WA,02,SEATTLE (KING CNTY),1.050,1.227,0.817
10902402,WA,99,REST OF WASHINGTON,1.013,1.053,0.761
11011402,WV,16,WEST VIRGINIA,1.000,0.869,1.431
11106302,WI,00,WISCONSIN,1.000,0.958,0.308
11203602,WY,21,WYOMING**,1.000,1.000,0.740
113"MAC Assignments as of November 22, 2023",,,,,,
114,,,,,,