CPT 44373 Gastrostomy→Jejunostomy Reimbursement | OpenPayer

Summary & Overview

CPT 44373: Endoscopic Conversion of Gastrostomy to Jejunostomy

CPT code 44373 represents an endoscopic evaluation of the upper gastrointestinal tract (excluding the ileum) combined with conversion of an existing gastrostomy tube to a jejunostomy tube through an abdominal approach. The procedure is clinically significant because it establishes a post-pyloric route for enteral nutrition in patients who cannot safely use gastric feeding, reducing aspiration risk and supporting nutritional needs during recovery. Nationally, this code is relevant across hospital-based and outpatient endoscopy settings where multidisciplinary teams coordinate nutritional support and procedural care.

Key payers examined include Aetna, Blue Cross Blue Shield, Cigna Health, UnitedHealthcare, and Medicare. Readers will find a concise description of the clinical context and service setting, typical billing and coding considerations associated with this therapeutic endoscopic conversion, and guidance on where to find additional reimbursement and documentation resources. The publication covers expected use cases, common modifiers encountered in claims (listed separately), and benchmarking considerations for utilization and payment patterns. Data not available in the input is noted where applicable. This summary is intended for clinical administrators, coding professionals, and revenue cycle staff seeking a clear, national-level overview of CPT code 44373 and its role in enteral access management.

AetnaBlue Cross Blue ShieldCigna HealthUnitedHealthcareMedicare44373CPTenteral-nutritiongastrostomy-to-jejunostomyendoscopyprocedural-codinghospital-servicesnutritional-support

Billing Code Overview

CPT code 44373 describes an endoscopic examination of the upper gastrointestinal tract (excluding the ileum) followed by conversion of an existing gastrostomy tube to a jejunostomy tube via an abdominal approach. The procedure evaluates the interior structure of the esophagus, stomach, and proximal small bowel for abnormalities, then establishes a jejunostomy tube to provide enteral nutritional support until oral intake is resumed.

Service type: Therapeutic endoscopy with percutaneous conversion of enteric access (gastrostomy-to-jejunostomy conversion)
Typical site of service: Hospital operating room or endoscopy suite with abdominal access (inpatient or outpatient procedural setting)

Clinical & Coding Specifications

Clinical Context

A typical patient is an adult with an existing gastrostomy tube who now requires postpyloric enteral access due to persistent gastric intolerance, high aspiration risk, or need for prolonged jejunal feeding. The patient commonly presents after failure of gastric feeding (vomiting, aspiration, or severe gastroparesis) or after complicated upper GI surgery. The interventional gastroenterologist or general surgeon evaluates the patient preoperatively with history, physical exam, and review of prior imaging and endoscopy. Under moderate sedation or general anesthesia in an ambulatory surgical center or hospital operating room, the provider performs upper endoscopy to examine the esophagus, stomach, and proximal duodenum, then converts the existing gastrostomy tube to a jejunostomy tube via the abdominal tract and advances it into the jejunum for enteral nutrition. Post‑procedure monitoring includes confirmation of tube position (radiograph or fluoroscopy), assessment for immediate complications (bleeding, infection, tube dislodgement, or bowel injury), and initiation of jejunal feeding per nutrition orders once position and tolerance are confirmed. Typical sites of service are the hospital operating room, ambulatory surgical center, or endoscopy suite depending on patient acuity and anesthesia requirements.

Coding Specifications

Modifier	Description	When to Use
`11`	Normal, baseline service	Use when the procedure is the standard planned procedure and no unusual circumstances apply.

CPT 44366: Upper Small Bowel Endoscopy with Hemostasis

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

CPT 44370: Upper GI Endoscopy with Dilation and Stent Placement

CPT-44372-ENDOSCOPIC-JEJUNAL-FEEDING-TUBE-PLACEMENT

CPT 44372: Endoscopic Jejunostomy Tube Placement for Enteral Nutrition

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

CPT 44365: Small Intestine Endoscopy with Lesion Removal

CPT-44377-UPPER-GI-ENDOSCOPY-WITH-BIOPSY

CPT 44377: Upper Gastrointestinal Endoscopy with Biopsy

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

CPT 44364: Small-Bowel Endoscopy with Snare Lesion Removal

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

CPT 44378: Upper GI Endoscopy with Bleeding Control

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

CPT 44361: Endoscopic Examination of Proximal Small Intestine with Biopsy

CPT-44369-ENDOSCOPIC-LASER-RADIOFREQUENCY-ABLATION-SMALL-BOWEL

CPT 44369: Endoscopic Laser/Radiofrequency Ablation of Upper Small Bowel Lesions

CPT-44376-DIAGNOSTIC-UPPER-ENDOSCOPY-BRUSHING-LAVAGE

CPT 44376: Diagnostic Upper GI Endoscopy with Brushing or Lavage

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Taxonomy Code	Specialty	Notes
207L00000X	General Surgery	General surgeons commonly perform enteral tube conversions in operative settings.
207V00000X	Gastroenterology	Gastroenterologists perform endoscopic evaluation and assist with tube conversions.
207K00000X	Colon & Rectal Surgery	Colorectal surgeons may manage complex abdominal access or postoperative patients.
363LP0800X	Hospitalist Medicine	Hospitalists coordinate perioperative care and nutrition planning.
208D00000X	Critical Care Medicine	Intensivists manage critically ill patients requiring jejunal feeding access.

Related Diagnoses

ICD-10 Code	Description	Clinical Relevance
`K31.89`	Other diseases of stomach and duodenum	May reflect disorders leading to intolerance of gastric feeding requiring jejunal access.
`K31.3`	Dysphagia, unspecified	Swallowing dysfunction sometimes necessitates postpyloric feeding.
`K91.2`	Esophageal stricture and stenosis (postprocedural)	Structural issues leading to gastrostomy dependence and need for jejunal feeding.
`R13.10`	Dysphagia, unspecified	Indicates feeding difficulty prompting enteral tube placement or conversion.
`J69.0`	Pneumonitis due to inhalation of food and vomitus	Recurrent aspiration pneumonia is an indication for postpyloric feeding to reduce aspiration risk.
`K57.20`	Diverticulitis of large intestine without perforation or abscess	Example abdominal pathology where gastric feeding may be contraindicated and jejunal feeding chosen.
`E86.0`	Dehydration	Patients with poor oral intake may require enteral support via jejunostomy for hydration and nutrition.
`K56.69`	Other intestinal obstruction	Obstruction distal to stomach can necessitate bypassing the stomach for nutrition via jejunostomy.

Related CPT Codes

CPT Code	Description	Relationship to This Procedure
`43239`	Upper gastrointestinal endoscopy with biopsy, single or multiple	Often performed to evaluate mucosa and obtain biopsies during diagnostic endoscopy prior to or concurrent with tube conversion.
`49440`	Insertion of tunneled intraperitoneal catheter, percutaneous; with subcutaneous port	Alternate enteral access procedures for long‑term needs, may be considered when jejunostomy is contraindicated.
`43760`	Change of gastrostomy tube under fluoroscopic guidance	Performed when gastrostomy tubes are exchanged or repositioned; initial step before conversion to jejunostomy in some workflows.
`44370`	Endoscopic placement of jejunostomy tube, percutaneous, without radiologic guidance	Closely related endoscopic jejunostomy placement technique often used as an alternative to conversion procedures.
`49422`	Replacement of gastrostomy tube, percutaneous, without imaging guidance	Performed when the gastrostomy tube is removed or replaced prior to conversion to a jejunal tube.

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