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See a sample rate comparisonCPT 44363 Fee Schedule
Last Verified: October 2026
Healthcare providers use this code to document and receive reimbursement for visits that address moderate-level medical decision-making, often including multiple diagnoses or prescription management.
Small Intestinal Endoscopy En, Small Intestinal Endoscopy Enteroscopy Beyond Second Portion Of Duodenum Not Including Ileum Withremoval Of Foreign Body(S)
| Key Fact | Detail |
|---|---|
| Service Type | Surgery Surgical Procedures on the Digestive System |
| Common Place of Service | 22 - On Campus Outpatient Hospital 21 - Inpatient Hospital |
| Common Modifiers | 59 - Distinct Procedural Service 51 - Multiple procedures |
| Complexity Level | Moderate |
| Medicare Fee Schedule | $169.68 national non-facility rate (2026) · View Medicare rates for 44363 |
| Medicaid Fee Schedule | $149.465 median of the 8 states in the free preview · View Medicaid rates for 44363 |
National average reimbursement for CPT 44363 by major payers:
$255.88
$266.43
$275.84
$319.80
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CPT 44363
5 of 25 sample ratesHigher to lower in this preview
Performance Health Surgicenter, LLC
Performance Health Surgicenter LLC
$5,532.00Published rateWilmington Ambulatory Surgical Center, LLC, American Surgery Center
Wilmington Ambulatory Surgical Center LLC
$1,320.00Published rateCentric Ambulatory Surgery Center LLC
$800.00Published rateSouth County Outpatient Surgery Center, LLC
South County Outpatient Surgery Center LLC
$447.00Published rateTushar Nayar
Deaconess Hospital Inc
$159.02Published rate
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See a sample payer proposalCPT 44363 vs. Other Surgical Procedures on the Digestive System Codes
The CPT 44363 code is part of the Surgery services used for Surgical Procedures on the Digestive System. It represents a moderate-complexity encounter and is one of several codes that vary based on time spent, level of medical decision-making, and documentation requirements.
The CPT 44363 code involves more provider time and moderate medical decision-making, unlike lower-level codes that require less time and simpler assessments. It typically includes multiple diagnoses, medication management, or test interpretation, leading to higher reimbursement and more detailed documentation requirements.
| Code | Complexity | Description |
|---|---|---|
| 44360-CPT | Low | Small Intestinal Endoscopy Enteroscopy Beyond Second Portion Of Duodenum Not Including Ileum; Diagnostic Including Collection Of Specimen(S) By Brushing Or Washing When Performed (Separate Procedure) (Desc Revised 01/01/15) |
| 44361-CPT | Moderate | Small Bowel Endoscopy Biopsy, Small Intestinal Endoscopy Enteroscopy Beyond Second Portion Of Duodenum Not Including Ileum With Biopsy Single Or Multiple |
| 44363-CPT | Moderate | Small Intestinal Endoscopy En, Small Intestinal Endoscopy Enteroscopy Beyond Second Portion Of Duodenum Not Including Ileum Withremoval Of Foreign Body(S) |
| 44364-CPT | Moderate | Small Intestinal Endoscopy En, Small Intestinal Endoscopy Enteroscopy Beyond Secondportion Of Duodenum Not Including Ileum With Removal Of Tumor(S) Polyp(S) Or Other Lesion(S)By Snare Technique |
What is a fee schedule?
A fee schedule is a list of fixed prices that healthcare providers charge for specific services, including CPT 44363. These prices vary depending on payer type (Medicare, Medicaid, private insurance), geographic location, and provider contracts.
Understanding the 44363 fee schedule helps patients estimate costs and providers optimize billing for accurate reimbursements.
Factors that affect fee schedules
Medicare & Medicaid Rates
Government-set reimbursement amounts
Private Insurance Rates
Negotiated rates between providers and insurance companies
Geographic Location
Costs may be higher in urban areas.
Provider Type
Hospital providers may have different rates than private practice.
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