CPT 44372 Endoscopic Jejunostomy — Reimbursement | OpenPayer

Summary & Overview

CPT 44372: Endoscopic Jejunostomy Tube Placement for Enteral Nutrition

CPT code 44372 describes endoscopic placement of a jejunostomy tube for enteral nutritional support, typically used when bypassing the stomach or protecting the esophagus is clinically indicated. The procedure involves endoscopic evaluation of the upper digestive tract (excluding the ileum), advancement of a feeding tube into the jejunum, and externalization of the tube through a small abdominal incision. Nationally, this procedure is important for patients requiring long-term or protected enteral access after disease or surgery affecting the esophagus, stomach, or proximal small bowel.

Key payers covered in this analysis include Aetna, Blue Cross Blue Shield, Cigna Health, UnitedHealthcare, and Medicare. Readers will find context on clinical indications, typical sites of service (inpatient or outpatient endoscopy suites or operating rooms), common billing modifiers, and related coding considerations. The publication highlights nationally relevant benchmarks and policy updates that affect coverage and billing practices, clarifies service-line implications for gastroenterology and surgical practices, and provides concise coding guidance where available. Data not available in the input will be noted where applicable.

AetnaBlue Cross Blue ShieldCigna HealthUnitedHealthcareMedicareCPT 44372jejunal feeding tubeenteral nutritionendoscopic jejunostomygastroenterologysurgical procedureshospital servicesendoscopy suite

Billing Code Overview

CPT code 44372 describes an endoscopic placement of a jejunostomy tube. The provider examines the upper digestive tract (excluding the ileum) with an endoscope, advances a jejunostomy tube into the jejunum, and exteriorizes the tube through a small abdominal stab incision to provide enteral nutritional support.

Service type: Endoscopic jejunostomy tube placement for enteral nutrition
Typical site of service: Hospital operating room or endoscopy suite (inpatient or outpatient procedural setting)

Clinical & Coding Specifications

Clinical Context

A 57-year-old male with a history of esophageal carcinoma treated with neoadjuvant chemoradiation and recent partial esophagectomy is admitted for enteral access because of prolonged dysphagia and inability to maintain adequate oral intake. The surgical and gastroenterology teams determine that post‑operative healing of the esophagus requires long‑term distal small bowel feeding. After preoperative evaluation and informed consent, the patient is taken to the endoscopy suite. Under monitored anesthesia care, the gastroenterologist performs an upper endoscopic exploration of the esophagus, stomach and proximal small bowel to identify a safe transgastric/jejunal insertion site. Using endoscopic guidance, a jejunostomy tube is advanced through the endoscope into the jejunum and externalized through a small abdominal stab incision, secured to the abdominal wall, and flushed to confirm placement. The procedure is documented with indication, technique, findings, tube type and size, verification of intraluminal position, any complications, estimated blood loss (if applicable), and post‑procedure feeding instructions. Typical site of service is an endoscopy suite, ambulatory surgery center, or inpatient operating room/OR depending on patient acuity. Service type is an endoscopic enteral access procedure (endoscopic jejunostomy placement) performed for nutritional support and avoidance of gastric feeding when gastric route is contraindicated.

Coding Specifications

Modifier	Description	When to Use
`00`	Standard preassigned (no modifier)

CPT 44363: Endoscopic Examination and Foreign-Body Removal, Proximal Small Intestine

CPT-44365-SMALL-INTESTINE-ENDOSCOPY-LESION-REMOVAL

CPT 44365: Small Intestine Endoscopy with Lesion Removal

CPT-44360-UPPER-SMALL-BOWEL-ENDOSCOPY-JEJUNUM-BRUSHING

CPT 44360: Diagnostic Upper Small Bowel Endoscopy with Brushing

CPT-44361-ENDOSCOPY-PROXIMAL-SMALL-INTESTINE-BIOPSY

CPT 44361: Endoscopic Examination of Proximal Small Intestine with Biopsy

CPT-44378-UPPER-GI-ENDOSCOPY-BLEEDING-CONTROL

CPT 44378: Upper GI Endoscopy with Bleeding Control

CPT-44370-UPPER-GI-ENDOSCOPY-DILATION-STENT-PLACEMENT

CPT 44370: Upper GI Endoscopy with Dilation and Stent Placement

CPT-44379-UPPER-ENDOSCOPY-WITH-DILATION-AND-STENT-PLACEMENT

CPT 44379: Upper Endoscopy with Dilation and Stent Placement

CPT-44366-UPPER-SMALL-BOWEL-ENDOSCOPY-HEMOSTASIS

CPT 44366: Upper Small Bowel Endoscopy with Hemostasis

CPT-44364-SMALL-BOWEL-ENDOSCOPY-SNARE-POLYPECTOMY

CPT 44364: Small-Bowel Endoscopy with Snare Lesion Removal

CPT-44373-GASTROSTOMY-TO-JEJUNOSTOMY-CONVERSION-ENDOSCOPIC

CPT 44373: Endoscopic Conversion of Gastrostomy to Jejunostomy

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Taxonomy Code	Specialty	Notes
`334600000X`	Gastroenterology	Endoscopic placement of jejunostomy tubes is commonly performed by gastroenterologists experienced in advanced endoscopy.
`207L00000X`	General Surgery	General surgeons perform enteral access in operative and hybrid endoscopic‑surgical settings.
`207K00000X`	Colon & Rectal Surgery	Colorectal surgeons may be involved when complex abdominal access or adhesiolysis is required.
`208000000X`	Family Medicine (Hospitalist procedures)	Hospitalists may coordinate care but do not typically perform; included for inpatient procedural coordination.
`208600000X`	Internal Medicine	Advanced practice within inpatient teams coordinating nutritional management and referrals.

Related Diagnoses

ICD-10 Code	Description	Clinical Relevance
`K91.83`	Enterostomy malfunction	Reflects complications or dysfunction of prior enteral access; may prompt jejunostomy placement or revision.
`K91.84`	Gastrectomy status	Patients with altered gastric anatomy may require jejunal feeding access when the stomach is not available for feeding.
`C15.9`	Malignant neoplasm of esophagus, unspecified	Esophageal malignancy causing dysphagia or obstruction often necessitates post‑operative or bypass enteral feeding via jejunostomy.
`K22.2`	Esophageal stricture	Severe strictures impair oral intake and can be an indication for enteral jejunal access.
`R63.4`	Abnormal weight loss	Patients with significant weight loss requiring long‑term nutritional support are candidates for jejunostomy placement.

Related CPT Codes

CPT Code	Description	Relationship to This Procedure
`43239`	Upper gastrointestinal endoscopy with directed placement of a feeding tube (e.g., nasojejunal) beyond the stomach; with endoscopic guidance	May be used when feeding tube is placed endoscopically beyond the stomach but not exteriorized through the abdominal wall; represents alternative endoscopic jejunal access technique.
`49440`	Insertion of tunneled or non-tunneled jejunostomy, open; without intraperitoneal reservoir	Surgical open jejunostomy placement; used when a purely surgical approach is selected instead of endoscopic jejunostomy.
`49441`	Insertion of tunneled or non-tunneled jejunostomy, open; with intraperitoneal reservoir	Surgical variant with reservoir; alternative surgical option in workflow for enteral access.
`47531`	Laparoscopic placement of gastrostomy tube (percutaneous endoscopic gastrostomy [PEG] not included)	Laparoscopic gastrostomy/jejunostomy may be performed when endoscopic approach is not feasible; often coordinated with surgical team.
`43760`	Change of gastrostomy tube through existing stoma	Post‑placement care procedure for tube replacement or exchange; performed during follow‑up or when tube malfunction occurs.
`43246`	Upper GI endoscopy with biopsy, single or multiple	Diagnostic endoscopy performed before or during procedure to assess mucosa or rule out pathology that might affect placement.

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