Home / Medicare fees / 44376

44376 Small bowel endoscopy

What 44376 is

CMS fee schedule short descriptor: Small bowel endoscopy.

Full CPT long descriptions are licensed by the American Medical Association and are not published on this site; the short descriptor above is the one CMS prints in its own fee schedule file. See About CPT.

Medicare payment for 44376 (CY2026)

Work RVUPractice expense RVUMalpractice RVUTotalMedicare rate
Non-facility (office)5.021.880.547.44$248.50
Facility (hospital, ASC)5.021.880.547.44$248.50

National rates: total RVUs x the CY2026 conversion factor of 33.4009 (non-QP), before geographic adjustment. Actual Medicare payment is 80% of the rate shown after the deductible; the patient or secondary payer owes the 20% coinsurance.


Status: Active - payable under the Physician Fee Schedule. Global period: Global concept does not apply (endoscopic or minor procedure: global period is the day of the procedure).

Advertisement

Medically Unlikely Edit (MUE)

Medicare caps 44376 at 1 unit per date of service for practitioner claims (MAI 3 - date of service edit (clinical): units above the MUE may pay with documentation on appeal), rationale: Anatomic Consideration. Units above the cap are denied unless the edit's adjudication rules allow an appeal with documentation.

Billed with 44376? These codes are bundled into it

44376 is a Column 1 code in 259 active NCCI PTP edits. When one of these Column 2 codes is reported on the same date of service, it is denied as bundled - unless the edit's modifier indicator is 1 and documentation supports a distinct service with an NCCI-associated modifier.

Column 2 codeShort descriptionModifier indicator
00731Anes upr gi ndsc px nos0 - no modifier bypassCheck pair
00732Anes upr gi ndsc px ercp0 - no modifier bypassCheck pair
00811Anes lwr intst ndsc nos0 - no modifier bypassCheck pair
00812Anes lwr intst scr colsc0 - no modifier bypassCheck pair
00813Anes upr lwr gi ndsc px0 - no modifier bypassCheck pair
0213TNjx paravert w/us cer/thor0 - no modifier bypassCheck pair
0216TNjx paravert w/us lumb/sac0 - no modifier bypassCheck pair
0596TTemp fml iu vlv-pmp 1st insj1 - modifier may bypassCheck pair
0597TTemp fml iu valve-pmp rplcmt1 - modifier may bypassCheck pair
0632TPerq tcat us abltj nrv p-art1 - modifier may bypassCheck pair
0652TEgd flx transnasal dx br/wa1 - modifier may bypassCheck pair
0708TId ca immntx prep & 1st njx1 - modifier may bypassCheck pair
0709TId ca immntx each addl njx1 - modifier may bypassCheck pair
0903TEcg alg 12 lead reduced i&r1 - modifier may bypassCheck pair
0904TEcg alg 12 ld rdcd trcg only1 - modifier may bypassCheck pair
0905TEcg alg 12 ld rdcd i&r only1 - modifier may bypassCheck pair
12001Rpr s/n/ax/gen/trnk 2.5cm/<1 - modifier may bypassCheck pair
12002Rpr s/n/ax/gen/trnk2.6-7.5cm1 - modifier may bypassCheck pair
12004Rpr s/n/ax/gen/trk7.6-12.5cm1 - modifier may bypassCheck pair
12005Rpr s/n/a/gen/trk12.6-20.0cm1 - modifier may bypassCheck pair
12006Rpr s/n/a/gen/trk20.1-30.0cm1 - modifier may bypassCheck pair
12007Rpr s/n/ax/gen/trnk >30.0 cm1 - modifier may bypassCheck pair
12011Rpr f/e/e/n/l/m 2.5 cm/<1 - modifier may bypassCheck pair
12013Rpr f/e/e/n/l/m 2.6-5.0 cm1 - modifier may bypassCheck pair
12014Rpr f/e/e/n/l/m 5.1-7.5 cm1 - modifier may bypassCheck pair
12015Rpr f/e/e/n/l/m 7.6-12.5 cm1 - modifier may bypassCheck pair
12016Rpr fe/e/en/l/m 12.6-20.0 cm1 - modifier may bypassCheck pair
12017Rpr fe/e/en/l/m 20.1-30.0 cm1 - modifier may bypassCheck pair
12018Rpr f/e/e/n/l/m >30.0 cm1 - modifier may bypassCheck pair
12020Tx supfc wnd dehsn smpl clsr1 - modifier may bypassCheck pair

Showing 30 of 259 column 2 codes. Use the pair checker for any specific combination.

44376 is bundled into these codes

44376 appears as a Column 2 code in 68 active edits. Reported with one of these Column 1 codes on the same date of service, 44376 is the code that denies.

Column 1 codeShort descriptionModifier indicator
0653TEgd flx transnasal bx 1/mlt0Check pair
0654TEgd flx transnasal tube/cath0Check pair
0884TEsphgsc flx 1st tndsc dilat1Check pair
43180Esophagoscopy rigid trnso0Check pair
43192Esophagoscp rig trnso inject1Check pair
43193Esophagoscp rig trnso biopsy0Check pair
43194Esophagoscp rig trnso rem fb0Check pair
43195Esophagoscopy rigid balloon0Check pair
43196Esophagoscp guide wire dilat0Check pair
43198Esophagosc flex trnsn biopsy0Check pair
43201Esoph scope w/submucous inj1Check pair
43202Esophagoscopy flex biopsy0Check pair
43204Esoph scope w/sclerosis inj0Check pair
43205Esophagus endoscopy/ligation0Check pair
43206Esoph optical endomicroscopy0Check pair

Data: CMS CY2026 Physician Fee Schedule RVU file (October release, RVU26D) and Medicare NCCI PTP practitioner edits v32.3 (2026 Q4). Verify against the official files before billing or contracting decisions.