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CPT code 44385: Pouch endoscopy, without tissue biopsy2026 Medicare rate & RVUs in Detroit, MI

Endoscopic inspection of an ileal pouch is reported for evaluation when the examination does not include tissue biopsy.

CMS RVU26DEffective Oct 1, 2026One payment locality1.1K Medicare services in 2024

In Detroit, MI, Medicare pays $242.04 for 44385 in the office and $70.57 when it’s performed in a hospital or facility.

$242.04Office (non-facility)
$70.57Hospital or facility
−1.3%vs the national office rate ($245.16)

Check a contract rate as a % of Medicare · 44385 nationwide

Medicare allowed amount for participating (non-QP) physicians, before deductible, coinsurance and claim adjustments. Not a patient’s bill or a hospital charge.

We’ll open 44385 for the payment locality that covers the ZIP.

On this page 11 sections
  1. Rate in Detroit, MI
  2. What 44385 covers
  3. Compared with other areas
  4. Rate map
  5. How it’s calculated
  6. Payment rules
  7. Related codes
  8. Rate history
  9. Where it applies
  10. Billing questions
  11. Sources

What 44385 covers

This service examines an ileal reservoir with an endoscope, such as a pouch created after restorative proctocolectomy. Gastroenterologists and colorectal surgeons commonly perform it to evaluate symptoms such as pouch-related inflammation, bleeding, or altered bowel function. The examination may include collecting cells or fluid by brushing or washing; those methods do not make it a biopsy service.

Report this code when the pouch is examined without tissue sampling. If the endoscopist takes tissue biopsies, use the related biopsy code instead. The report should identify the pouch examined, the examination findings, and any specimen collection method. CMS assigns a 0-day global period, so same-day preoperative and postoperative care is included. When performed with other procedures in the same session, the highest-valued procedure is paid in full and the others are subject to the standard 50% multiple-procedure reduction. Modifier 50 is inappropriate. Assistant-at-surgery payment is restricted, and co-surgeons and team surgery are not permitted.

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.

How Detroit, MI compares for 44385

Across 109 of 109 payment localities, the office rate for 44385 runs from $214.15 in Arkansas to $335.41 in San Benito County, CA. Detroit, MI pays $242.04. The RVUs are the same everywhere; the geographic indexes change the dollars.

44385 in Detroit, MI vs other payment areas
  1. Detroit, MI · this page$242.04
  2. Rest of Michigan · Michigan$228.46−$13.58
  3. Los Angeles, CA · California$281.53+$39.49
  4. Washington, DC area · District of Columbia$283.59+$41.55
  5. Miami, FL · Florida$262.06+$20.02
  6. Chicago, IL · Illinois$253.79+$11.75
  7. Manhattan, NY · New York$283.46+$41.42

Other areas in Michigan first, then benchmark localities. Bars start at $0.

Every other payment area

44385 in every other Medicare payment locality
Payment localityOfficeFacility
AlaskaAlaska$275.18$85.94
AlabamaAlabama$217.65$62.17
ArkansasArkansas$214.15$61.51
ArizonaArizona$238.13$65.95
Bakersfield, CACalifornia$262.92$68.17
Chico, CACalifornia$262.43$67.68
El Centro, CACalifornia$262.46$67.71
Fresno, CACalifornia$262.43$67.68

44385 rates by state

Office rate range in each state. Select a state to see its payment localities.

MEWIVTNHMTNDMNMINYMARIWAIDWYSDIAILINOHPANJCTORNVUTCONEMOKYWVVAMDDECAAZNMKSOKARTNNCSCDCTXLAMSALGAFLAKHI

Explore a state

Local rates. Clear comparisons.

Hover or focus a tile to see its rate range. Select it to open the state’s fee schedule.

$214.15

$298.92

Color shows the midpoint of each state’s locality range.

View every state and territory as a table
44385 office rate range by state
State / territoryOffice rate rangeLocalities
AK$275.181
AL$217.651
AR$214.151
AZ$238.131
CA$262.43–$335.4129
CO$257.211
CT$262.571
DC$283.591
DE$242.381
FL$239.20–$262.063
GA$224.61–$249.632
GU$270.231
HI$270.231
IA$224.701
ID$226.141
IL$230.92–$255.234
IN$227.611
KS$223.111
KY$222.431
LA$221.88–$234.112
MA$255.26–$285.022
MD$247.49–$283.593
ME$226.98–$241.262
MI$228.46–$242.042
MN$246.981
MO$217.36–$235.553
MS$215.821
MT$245.151
NC$229.691
ND$241.791
NE$226.201
NH$252.671
NJ$265.71–$280.082
NM$229.671
NV$244.411
NY$233.46–$290.415
OH$227.771
OK$222.451
OR$242.67–$266.582
PA$228.42–$255.182
PR$247.281
RI$251.911
SC$229.081
SD$241.391
TN$224.301
TX$226.72–$256.228
UT$232.561
VA$240.09–$283.592
VI$247.281
VT$240.351
WA$254.94–$291.572
WI$232.821
WV$221.361
WY$243.691

See 44385 in every payment locality

How the 44385 rate is calculated

Each of 44385’s three RVUs is multiplied by a geographic index (GPCI) for the payment locality, added up, and multiplied by the conversion factor. Drag the indexes or enter a ZIP to see what moves the rate.

How the rate is built · 44385

RVUs × geographic indexes × conversion factor

Office or facility?

Work1.17

1.17 RVUs× 1.000 GPCI

Practice expense6.00

6.00 RVUs× 1.000 GPCI

Malpractice0.17

0.17 RVUs× 1.000 GPCI

Adjusted RVUs

7.3400

Conversion factor

$33.4009

Medicare rate

$245.16

Every GPCI starts at 1.000, the national rate. Enter a ZIP or drag a slider.

The exact Detroit, MI inputs and CMS source lines

PPRRVU2026_Oct_nonQPP.csv

5,407

Code
44385
Physician work
1.17
Practice expense
6.00
Malpractice
0.17

GPCI2026.csv

64

Locality
Detroit, MI
Physician work
1.000
Practice expense
0.965
Malpractice
1.686
Office calculation for 44385 in Detroit, MI
ComponentRVULocality factorAdjusted
Physician work1.17× 1.0001.1700
Practice expense6.00× 0.9655.7900
Malpractice0.17× 1.6860.2866
Total RVUs7.2466
Conversion factor× 33.4009

Office rate, Detroit, MI$242.04

Office: (1.17 × 1 + 6 × 0.965 + 0.17 × 1.686) × $33.4009 = $242.04

Facility: (1.17 × 1 + 0.68 × 0.965 + 0.17 × 1.686) × $33.4009 = $70.57

Open 44385 in the RVU calculator

Payment rules and modifiers for 44385

The CMS indicators that decide how 44385 is paid alongside other services.

CMS payment indicators · 44385

Pouch endoscopy, without tissue biopsy

RuleCMS valueWhat it means
Global period000Same-day global: pre- and post-op care on the day of the procedure is included.
Multiple procedures2Standard reduction: highest-valued procedure at 100%, others at 50%.
Bilateral (modifier 50)0The 150% bilateral adjustment doesn’t apply.
Assistant at surgery (80/81/82/AS)1Not paid (statutory restriction).
Co-surgeons (62)0Not permitted.
Team surgery (66)0Not permitted.
Professional/technical0Physician service: no professional/technical split.

What modifiers do to the payment

Modifier 51 · payment effect

With and without the modifier

44385 without 51 · national office

$245.16

Pouch endoscopy, without tissue biopsy

44385-51 · Second procedure: 50%

$122.58

When this isn’t the highest-valued procedure in the session, Medicare pays 50% of its fee schedule amount (the highest is paid at 100%).

When to use modifier 51

Codes related to 44385

Related codes aren’t interchangeable: bill the code that matches the service performed.

Codes related to 44385
CodeHow it relatesOffice range, Detroit, MI
Same family
44386Pouch endoscopy, with biopsyPouch endoscopy when tissue biopsy is performed.$341.58
Used instead
44388Colonoscopy, diagnostic, through stomaColonoscopy through a stoma when the colon, rather than the pouch, is examined.$354.31
44389Colonoscopy, through stoma, with biopsyColonoscopy through a stoma with biopsy when the sampled site is in the colon.$454.65

How 44385 has changed in Detroit, MI

44385 · Office / nonfacility

$242.04

Effective 2026-10-01

The base rate is $31.88 higher than on 2025-10-01, moving from $210.16 to $242.04 (15.2%).

It is unchanged from the immediately preceding available release, effective 2026-07-01.

Base rate by release · bars start at $0 · select a bar to compare

One bar per available release, ordered by effective date. Missing rates remain gaps. These comparisons hold the code, setting and locality identifiers constant; they do not isolate which policy or input caused a change.

What changed, release by release

  1. January 1, 2026

    RVU26A

    $210.16changed to$242.04

    • Conversion factor 32.3465 changed to 33.4009
    • Work RVU 1.20 changed to 1.17
    • Practice expense RVU 5.09 changed to 6.00
    • Malpractice RVU 0.16 changed to 0.17
    • Work GPCI 1.003 changed to 1.000
    • Practice expense GPCI 0.986 changed to 0.965
    • Malpractice GPCI 1.718 changed to 1.686

    Held through RVU26B, RVU26C, RVU26D.

  2. January 1, 2025

    RVU25A

    $217.83changed to$210.16

    • Conversion factor 33.2875 changed to 32.3465
    • Practice expense RVU 5.12 changed to 5.09
    • Malpractice RVU 0.17 changed to 0.16

    Held through RVU25B, RVU25C, RVU25D.

  3. March 9, 2024

    RVU24AR

    $214.28changed to$217.83

    • Conversion factor 32.7442 changed to 33.2875

    Held through RVU24B, RVU24C, RVU24D.

  4. January 1, 2024

    RVU24A

    $222.97changed to$214.28

    • Conversion factor 33.8872 changed to 32.7442
    • Malpractice RVU 0.18 changed to 0.17
    • Work GPCI 1.000 changed to 1.003
    • Practice expense GPCI 0.992 changed to 0.986
    • Malpractice GPCI 1.670 changed to 1.718

  5. January 1, 2023

    RVU23A

    $229.79changed to$222.97

    • Conversion factor 34.6062 changed to 33.8872
    • Practice expense RVU 5.18 changed to 5.12
    • Malpractice RVU 0.17 changed to 0.18
    • Practice expense GPCI 0.997 changed to 0.992
    • Malpractice GPCI 1.622 changed to 1.670

    Held through RVU23B, RVU23C, RVU23D.

  6. January 1, 2022

    RVU22A

    $227.43changed to$229.79

    • Conversion factor 34.8931 changed to 34.6062
    • Practice expense RVU 5.09 changed to 5.18
    • Malpractice RVU 0.15 changed to 0.17

    Held through RVU22B, RVU22C, RVU22D.

  7. January 1, 2021

    RVU21A

    $208.53changed to$227.43

    • Conversion factor 36.0896 changed to 34.8931
    • Practice expense RVU 4.36 changed to 5.09
    • Practice expense GPCI 0.993 changed to 0.997
    • Malpractice GPCI 1.657 changed to 1.622

    Held through RVU21B, RVU21C, RVU21D.

  8. January 1, 2020

    RVU20A

    $204.38changed to$208.53

    • Conversion factor 36.0391 changed to 36.0896
    • Practice expense RVU 4.23 changed to 4.36
    • Malpractice RVU 0.17 changed to 0.15
    • Practice expense GPCI 0.989 changed to 0.993
    • Malpractice GPCI 1.691 changed to 1.657

    Held through RVU20B, RVU20C, RVU20D.

  9. January 1, 2019

    RVU19A

    $199.88changed to$204.38

    • Conversion factor 35.9996 changed to 36.0391
    • Practice expense RVU 4.11 changed to 4.23

    Held through RVU19B, RVU19C, RVU19D.

  10. January 1, 2018

    RVU18AR1

    $196.47changed to$199.88

    • Conversion factor 35.8887 changed to 35.9996
    • Practice expense RVU 4.05 changed to 4.11
    • Practice expense GPCI 0.992 changed to 0.989
    • Malpractice GPCI 1.510 changed to 1.691

    Held through RVU18B, RVU18C, RVU18D.

  11. January 1, 2017

    RVU17A

    $248.00changed to$196.47

    • Conversion factor 35.8043 changed to 35.8887
    • Work RVU 1.30 changed to 1.20
    • Practice expense RVU 5.42 changed to 4.05
    • Malpractice RVU 0.18 changed to 0.17
    • Practice expense GPCI 0.994 changed to 0.992
    • Malpractice GPCI 1.328 changed to 1.510

    Held through RVU17B, RVU17C, RVU17D.

  12. January 1, 2016

    RVU16A

    $274.25changed to$248.00

    • Conversion factor 35.9335 changed to 35.8043
    • Work RVU 1.82 changed to 1.30
    • Practice expense RVU 5.50 changed to 5.42
    • Malpractice RVU 0.26 changed to 0.18

    Held through RVU16B, RVU16C, RVU16D.

  13. July 1, 2015

    RVU15C

    $272.89changed to$274.25

    • Conversion factor 35.7547 changed to 35.9335

    Held through RVU15D.

  14. January 1, 2015

    RVU15A

    $274.38changed to$272.89

    • Conversion factor 35.8228 changed to 35.7547
    • Practice expense RVU 5.38 changed to 5.50
    • Malpractice RVU 0.25 changed to 0.26
    • Work GPCI 1.010 changed to 1.000
    • Practice expense GPCI 1.009 changed to 0.994
    • Malpractice GPCI 1.571 changed to 1.328

    Held through RVU15B.

  15. January 1, 2014

    RVU14A

    $290.25changed to$274.38

    • Conversion factor 34.0230 changed to 35.8228
    • Practice expense RVU 6.06 changed to 5.38
    • Malpractice RVU 0.26 changed to 0.25
    • Work GPCI 1.022 changed to 1.010
    • Practice expense GPCI 1.023 changed to 1.009
    • Malpractice GPCI 1.814 changed to 1.571

    Held through RVU14B, RVU14C, RVU14D.

  16. January 1, 2013

    RVU13AR

    Earliest loaded release: $290.25

    Held through RVU13B, RVU13C, RVU13D.

Rates in every CMS release
Effective fromOfficeFacilityCMS release
2026-10-01$242.04$70.57RVU26D
2026-07-01$242.04$70.57RVU26C
2026-04-01$242.04$70.57RVU26B
2026-01-01$242.04$70.57RVU26A
2025-10-01$210.16$73.66RVU25D
2025-07-01$210.16$73.66RVU25C
2025-04-01$210.16$73.66RVU25B
2025-01-01$210.16$73.66RVU25A
2024-10-01$217.83$76.04RVU24D
2024-07-01$217.83$76.04RVU24C
2024-04-01$217.83$76.04RVU24B
2024-03-09$217.83$76.04RVU24AR
2024-01-01$214.28$74.80RVU24A
2023-10-01$222.97$77.07RVU23D
2023-07-01$222.97$77.07RVU23C
2023-04-01$222.97$77.07RVU23B
2023-01-01$222.97$77.07RVU23A
2022-10-01$229.79$77.29RVU22D
2022-07-01$229.79$77.29RVU22C
2022-04-01$229.79$77.29RVU22B
2022-01-01$229.79$77.29RVU22A
2021-10-01$227.43$76.10RVU21D
2021-07-01$227.43$76.10RVU21C
2021-04-01$227.43$76.10RVU21B
2021-01-01$227.43$76.10RVU21A
2020-10-01$208.53$78.44RVU20D
2020-07-01$208.53$78.44RVU20C
2020-04-01$208.53$78.44RVU20B
2020-01-01$208.53$78.44RVU20A
2019-10-01$204.38$79.27RVU19D
2019-07-01$204.38$79.27RVU19C
2019-04-01$204.38$79.27RVU19B
2019-01-01$204.38$79.27RVU19A
2018-10-01$199.88$79.89RVU18D
2018-07-01$199.88$79.89RVU18C
2018-04-01$199.88$79.89RVU18B
2018-01-01$199.88$79.89RVU18AR1
2017-10-01$196.47$78.62RVU17D
2017-07-01$196.47$78.62RVU17C
2017-04-01$196.47$78.62RVU17B
2017-01-01$196.47$78.62RVU17A
2016-10-01$248.00$82.15RVU16D
2016-07-01$248.00$82.15RVU16C
2016-04-01$248.00$82.15RVU16B
2016-01-01$248.00$82.15RVU16A
2015-10-01$274.25$114.24RVU15D
2015-07-01$274.25$114.24RVU15C
2015-04-01$272.89$113.67RVU15B
2015-01-01$272.89$113.67RVU15A
2014-10-01$274.38$116.79RVU14D
2014-07-01$274.38$116.79RVU14C
2014-04-01$274.38$116.79RVU14B
2014-01-01$274.38$116.79RVU14A
2013-10-01$290.25$117.96RVU13D
2013-07-01$290.25$117.96RVU13C
2013-04-01$290.25$117.96RVU13B
2013-01-01$290.25$117.96RVU13AR

Price 44385 for an earlier date of service

Where the Detroit, MI rate applies

Detroit, MI is a Medicare payment area, not a city. Our Census mapping connects it to 98 cities and communities in Michigan. Some span more than one payment area; confirm with the service ZIP.

  • Detroit
  • Allen Park
  • Ann Arbor
  • Armada
  • Auburn Hills
  • Barton Hills
  • Belleville
  • Berkley

Browse all communities in Michigan

44385 billing questions

When should 44385 be used instead of 44386?

Use 44385 for pouch examination without tissue biopsy, including when brushing or washing is performed. Use 44386 when tissue is sampled by biopsy.

Are brushing and washing included in 44385?

Yes. Specimen collection by brushing or washing, when performed during the pouch examination, is included in this service.

Is modifier 50 appropriate for pouch endoscopy?

No. CMS identifies bilateral adjustment as inappropriate for this code.

How does the multiple-procedure reduction affect 44385?

When it is performed in the same session as other procedures, the highest-valued procedure is paid in full and the others are subject to the standard 50% reduction.

What care is included in the global period?

The 0-day global period includes same-day preoperative and postoperative care.

Where these rates come from

FeeBase calculates base physician payments from CMS work, practice-expense and malpractice RVUs, adjusted by each locality’s geographic indexes and the conversion factor. Services without a published rate are labeled, never given a made-up amount. Amounts are Medicare allowed amounts before claim adjustments: not a patient’s bill or a commercial rate.

CMS RVU26D · effective Oct 1, 2026 through the day before Jan 1, 2027

Show the CMS file lines behind this rate
RVUs for 44385PPRRVU2026_Oct_nonQPP.csv, line 5,407 (RVU26D)
Geographic factors for Detroit, MIGPCI2026.csv, line 64 (RVU26D)

Open CMS sourceHow we calculate rates

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