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CPT code 44385: Pouch endoscopy, without tissue biopsy2026 Medicare rate & RVUs in Queens, NY

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 Queens, NY, Medicare pays $286.65 for 44385 in the office and $76.61 when it’s performed in a hospital or facility.

$286.65Office (non-facility)
$76.61Hospital or facility
+16.9%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 Queens, NY
  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 Queens, NY 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. Queens, NY pays $286.65. The RVUs are the same everywhere; the geographic indexes change the dollars.

44385 in Queens, NY vs other payment areas
  1. Queens, NY · this page$286.65
  2. Manhattan, NY · New York$283.46−$3.19
  3. NYC suburbs and Long Island, NY · New York$290.41+$3.76
  4. Poughkeepsie and northern NYC suburbs, NY · New York$267.15−$19.50
  5. Rest of New York · New York$233.46−$53.19
  6. Los Angeles, CA · California$281.53−$5.12
  7. Washington, DC area · District of Columbia$283.59−$3.06

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

Every other payment area

44385 in every other Medicare payment locality
Payment localityOfficeFacility
Miami, FLFlorida$262.06$77.08
Chicago, ILIllinois$253.79$75.21
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

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 Queens, NY 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

81

Locality
Queens, NY
Physician work
1.064
Practice expense
1.182
Malpractice
1.442
Office calculation for 44385 in Queens, NY
ComponentRVULocality factorAdjusted
Physician work1.17× 1.0641.2449
Practice expense6.00× 1.1827.0920
Malpractice0.17× 1.4420.2451
Total RVUs8.5820
Conversion factor× 33.4009

Office rate, Queens, NY$286.65

Office: (1.17 × 1.064 + 6 × 1.182 + 0.17 × 1.442) × $33.4009 = $286.65

Facility: (1.17 × 1.064 + 0.68 × 1.182 + 0.17 × 1.442) × $33.4009 = $76.61

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, Queens, NY
Same family
44386Pouch endoscopy, with biopsyPouch endoscopy when tissue biopsy is performed.$406.79
Used instead
44388Colonoscopy, diagnostic, through stomaColonoscopy through a stoma when the colon, rather than the pouch, is examined.$411.21
44389Colonoscopy, through stoma, with biopsyColonoscopy through a stoma with biopsy when the sampled site is in the colon.$532.76

How 44385 has changed in Queens, NY

44385 · Office / nonfacility

$286.65

Effective 2026-10-01

The base rate is $41.00 higher than on 2025-10-01, moving from $245.65 to $286.65 (16.7%).

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

    $245.65changed to$286.65

    • 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 1.065 changed to 1.064
    • Practice expense GPCI 1.195 changed to 1.182
    • Malpractice GPCI 1.462 changed to 1.442

    Held through RVU26B, RVU26C, RVU26D.

  2. January 1, 2025

    RVU25A

    $254.48changed to$245.65

    • 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

    $250.33changed to$254.48

    • Conversion factor 32.7442 changed to 33.2875

    Held through RVU24B, RVU24C, RVU24D.

  4. January 1, 2024

    RVU24A

    $266.00changed to$250.33

    • Conversion factor 33.8872 changed to 32.7442
    • Malpractice RVU 0.18 changed to 0.17
    • Work GPCI 1.061 changed to 1.065
    • Practice expense GPCI 1.212 changed to 1.195
    • Malpractice GPCI 2.061 changed to 1.462

  5. January 1, 2023

    RVU23A

    $279.64changed to$266.00

    • 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
    • Work GPCI 1.056 changed to 1.061
    • Practice expense GPCI 1.228 changed to 1.212
    • Malpractice GPCI 2.661 changed to 2.061

    Held through RVU23B, RVU23C, RVU23D.

  6. January 1, 2022

    RVU22A

    $276.24changed to$279.64

    • 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

    $249.61changed to$276.24

    • Conversion factor 36.0896 changed to 34.8931
    • Practice expense RVU 4.36 changed to 5.09
    • Work GPCI 1.054 changed to 1.056
    • Practice expense GPCI 1.214 changed to 1.228
    • Malpractice GPCI 2.391 changed to 2.661

    Held through RVU21B, RVU21C, RVU21D.

  8. January 1, 2020

    RVU20A

    $241.42changed to$249.61

    • 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
    • Work GPCI 1.052 changed to 1.054
    • Practice expense GPCI 1.200 changed to 1.214
    • Malpractice GPCI 2.121 changed to 2.391

    Held through RVU20B, RVU20C, RVU20D.

  9. January 1, 2019

    RVU19A

    $235.98changed to$241.42

    • 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

    $232.85changed to$235.98

    • Conversion factor 35.8887 changed to 35.9996
    • Practice expense RVU 4.05 changed to 4.11
    • Malpractice GPCI 2.151 changed to 2.121

    Held through RVU18B, RVU18C, RVU18D.

  11. January 1, 2017

    RVU17A

    $295.70changed to$232.85

    • 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 1.199 changed to 1.200
    • Malpractice GPCI 2.181 changed to 2.151

    Held through RVU17B, RVU17C, RVU17D.

  12. January 1, 2016

    RVU16A

    $326.14changed to$295.70

    • 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

    $324.52changed to$326.14

    • Conversion factor 35.7547 changed to 35.9335

    Held through RVU15D.

  14. January 1, 2015

    RVU15A

    $316.05changed to$324.52

    • 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 1.057 changed to 1.052
    • Practice expense GPCI 1.197 changed to 1.199
    • Malpractice GPCI 1.836 changed to 2.181

    Held through RVU15B.

  15. January 1, 2014

    RVU14A

    $325.33changed to$316.05

    • 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 1.062 changed to 1.057
    • Practice expense GPCI 1.195 changed to 1.197
    • Malpractice GPCI 1.491 changed to 1.836

    Held through RVU14B, RVU14C, RVU14D.

  16. January 1, 2013

    RVU13AR

    Earliest loaded release: $325.33

    Held through RVU13B, RVU13C, RVU13D.

Rates in every CMS release
Effective fromOfficeFacilityCMS release
2026-10-01$286.65$76.61RVU26D
2026-07-01$286.65$76.61RVU26C
2026-04-01$286.65$76.61RVU26B
2026-01-01$286.65$76.61RVU26A
2025-10-01$245.65$80.22RVU25D
2025-07-01$245.65$80.22RVU25C
2025-04-01$245.65$80.22RVU25B
2025-01-01$245.65$80.22RVU25A
2024-10-01$254.48$82.64RVU24D
2024-07-01$254.48$82.64RVU24C
2024-04-01$254.48$82.64RVU24B
2024-03-09$254.48$82.64RVU24AR
2024-01-01$250.33$81.29RVU24A
2023-10-01$266.00$87.75RVU23D
2023-07-01$266.00$87.75RVU23C
2023-04-01$266.00$87.75RVU23B
2023-01-01$266.00$87.75RVU23A
2022-10-01$279.64$91.81RVU22D
2022-07-01$279.64$91.81RVU22C
2022-04-01$279.64$91.81RVU22B
2022-01-01$279.64$91.81RVU22A
2021-10-01$276.24$89.85RVU21D
2021-07-01$276.24$89.85RVU21C
2021-04-01$276.24$89.85RVU21B
2021-01-01$276.24$89.85RVU21A
2020-10-01$249.61$90.57RVU20D
2020-07-01$249.61$90.57RVU20C
2020-04-01$249.61$90.57RVU20B
2020-01-01$249.61$90.57RVU20A
2019-10-01$241.42$89.63RVU19D
2019-07-01$241.42$89.63RVU19C
2019-04-01$241.42$89.63RVU19B
2019-01-01$241.42$89.63RVU19A
2018-10-01$235.98$90.39RVU18D
2018-07-01$235.98$90.39RVU18C
2018-04-01$235.98$90.39RVU18B
2018-01-01$235.98$90.39RVU18AR1
2017-10-01$232.85$90.30RVU17D
2017-07-01$232.85$90.30RVU17C
2017-04-01$232.85$90.30RVU17B
2017-01-01$232.85$90.30RVU17A
2016-10-01$295.70$95.65RVU16D
2016-07-01$295.70$95.65RVU16C
2016-04-01$295.70$95.65RVU16B
2016-01-01$295.70$95.65RVU16A
2015-10-01$326.14$133.12RVU15D
2015-07-01$326.14$133.12RVU15C
2015-04-01$324.52$132.46RVU15B
2015-01-01$324.52$132.46RVU15A
2014-10-01$316.05$129.09RVU14D
2014-07-01$316.05$129.09RVU14C
2014-04-01$316.05$129.09RVU14B
2014-01-01$316.05$129.09RVU14A
2013-10-01$325.33$124.08RVU13D
2013-07-01$325.33$124.08RVU13C
2013-04-01$325.33$124.08RVU13B
2013-01-01$325.33$124.08RVU13AR

Price 44385 for an earlier date of service

Where the Queens, NY rate applies

Queens, NY is a Medicare payment area, not a city. Our Census mapping connects it to 1 cities and communities in New York. Some span more than one payment area; confirm with the service ZIP.

Browse all communities in New York

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 Queens, NYGPCI2026.csv, line 81 (RVU26D)

Open CMS sourceHow we calculate rates

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