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CPT code 44386: Pouch endoscopy, with biopsy2026 Medicare rate & RVUs in Nevada

Reports endoscopic examination of a surgically created small-intestinal pouch when one or more tissue biopsies are obtained during the procedure.

CMS RVU26DEffective Oct 1, 2026One payment locality2.6K Medicare services in 2024

In Nevada, Medicare pays $346.99 for 44386 in the office and $80.19 when it’s performed in a hospital or facility.

$346.99Office (non-facility)
$80.19Hospital or facility
−0.2%vs the national office rate ($347.70)

Check a contract rate as a % of Medicare · 44386 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 44386 for the payment locality that covers the ZIP.

On this page 11 sections
  1. Rate in Nevada
  2. What 44386 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 44386 covers

A gastroenterologist or colorectal surgeon uses an endoscope to examine a surgically created small-intestinal pouch, such as an ileal pouch or continent ileostomy reservoir, and takes tissue samples. The examination may assess symptoms or findings such as pouch inflammation, bleeding, or suspected Crohn disease. The route depends on the pouch anatomy: an ileal pouch may be reached through the anus, while a continent reservoir may be entered through its stoma.

Report this code when the pouch examination includes one or more biopsies; the number of samples does not create additional units. Document the pouch examined, the endoscopic findings, and biopsy sites or specimens. The procedure has a 0-day global period, so same-day preoperative and postoperative care are included. If multiple procedures are performed in the same session, the highest-valued procedure is paid in full and other procedures are subject to the standard 50% multiple-procedure reduction. Modifier 50 is inappropriate for this anatomy. Medicare does not pay an assistant at surgery for this service, and co-surgeon and team-surgery billing 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 Nevada compares for 44386

Across 109 of 109 payment localities, the office rate for 44386 runs from $303.48 in Arkansas to $479.75 in San Benito County, CA. Nevada pays $346.99. The RVUs are the same everywhere; the geographic indexes change the dollars.

44386 in Nevada vs other payment areas
  1. Nevada · this page$346.99
  2. Los Angeles, CA · California$401.29+$54.30
  3. Washington, DC area · District of Columbia$403.16+$56.17
  4. Miami, FL · Florida$368.91+$21.92
  5. Chicago, IL · Illinois$357.30+$10.31
  6. Manhattan, NY · New York$401.80+$54.81
  7. Alaska · Alaska$388.43+$41.44

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

Every other payment area

44386 in every other Medicare payment locality
Payment localityOfficeFacility
AlabamaAlabama$308.48$75.26
ArkansasArkansas$303.48$74.53
ArizonaArizona$337.76$79.48
Bakersfield, CACalifornia$374.40$82.27
Chico, CACalifornia$373.86$81.74
El Centro, CACalifornia$373.89$81.77
Fresno, CACalifornia$373.86$81.74
Hanford, CACalifornia$373.86$81.74

44386 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.

$303.48

$426.81

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

View every state and territory as a table
44386 office rate range by state
State / territoryOffice rate rangeLocalities
AK$388.431
AL$308.481
AR$303.481
AZ$337.761
CA$373.86–$479.7529
CO$365.721
CT$372.501
DC$403.161
DE$343.821
FL$337.84–$368.913
GA$317.22–$353.742
GU$385.301
HI$385.301
IA$319.181
ID$321.101
IL$325.60–$360.604
IN$323.231
KS$316.601
KY$314.681
LA$313.76–$331.242
MA$362.79–$405.872
MD$351.21–$403.163
ME$322.00–$342.852
MI$322.99–$341.582
MN$351.971
MO$307.12–$333.653
MS$305.421
MT$347.691
NC$325.911
ND$344.131
NE$321.411
NH$358.961
NJ$377.19–$398.052
NM$324.601
NV$346.991
NY$331.27–$411.345
OH$322.271
OK$315.021
OR$344.75–$379.462
PA$323.35–$361.752
PR$350.841
RI$357.651
SC$324.541
SD$343.711
TN$318.261
TX$320.91–$364.118
UT$329.511
VA$340.96–$403.162
VI$350.841
VT$341.801
WA$362.43–$415.542
WI$331.241
WV$311.921
WY$346.141

See 44386 in every payment locality

How the 44386 rate is calculated

Each of 44386’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 · 44386

RVUs × geographic indexes × conversion factor

Office or facility?

Work1.46

1.46 RVUs× 1.000 GPCI

Practice expense8.77

8.77 RVUs× 1.000 GPCI

Malpractice0.18

0.18 RVUs× 1.000 GPCI

Adjusted RVUs

10.4100

Conversion factor

$33.4009

Medicare rate

$347.70

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

The exact Nevada inputs and CMS source lines

PPRRVU2026_Oct_nonQPP.csv

5,408

Code
44386
Physician work
1.46
Practice expense
8.77
Malpractice
0.18

GPCI2026.csv

73

Locality
Nevada
Physician work
1.000
Practice expense
1.001
Malpractice
0.833
Office calculation for 44386 in Nevada
ComponentRVULocality factorAdjusted
Physician work1.46× 1.0001.4600
Practice expense8.77× 1.0018.7788
Malpractice0.18× 0.8330.1499
Total RVUs10.3887
Conversion factor× 33.4009

Office rate, Nevada$346.99

Office: (1.46 × 1 + 8.77 × 1.001 + 0.18 × 0.833) × $33.4009 = $346.99

Facility: (1.46 × 1 + 0.79 × 1.001 + 0.18 × 0.833) × $33.4009 = $80.19

Open 44386 in the RVU calculator

Payment rules and modifiers for 44386

The CMS indicators that decide how 44386 is paid alongside other services.

CMS payment indicators · 44386

Pouch endoscopy, with 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

44386 without 51 · national office

$347.70

Pouch endoscopy, with biopsy

44386-51 · Second procedure: 50%

$173.85

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 44386

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

Codes related to 44386
CodeHow it relatesOffice range, Nevada
Same family
44385Pouch endoscopy, without tissue biopsyPouch endoscopy without biopsy; this code includes biopsy.$244.41
Used instead
44388Colonoscopy, diagnostic, through stomaColonoscopy through a stoma when the service examines the colon rather than a small-intestinal pouch.$351.68
44389Colonoscopy, through stoma, with biopsyColonoscopy through a stoma with biopsy when the target is the colon, not a pouch.$455.71

How 44386 has changed in Nevada

44386 · Office / nonfacility

$346.99

Effective 2026-10-01

The base rate is $53.55 higher than on 2025-10-01, moving from $293.44 to $346.99 (18.2%).

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

    $293.44changed to$346.99

    • Conversion factor 32.3465 changed to 33.4009
    • Work RVU 1.50 changed to 1.46
    • Practice expense RVU 7.42 changed to 8.77
    • Practice expense GPCI 1.000 changed to 1.001
    • Malpractice GPCI 0.844 changed to 0.833

    Held through RVU26B, RVU26C, RVU26D.

  2. January 1, 2025

    RVU25A

    $308.59changed to$293.44

    • Conversion factor 33.2875 changed to 32.3465
    • Practice expense RVU 7.61 changed to 7.42
    • Malpractice RVU 0.19 changed to 0.18

    Held through RVU25B, RVU25C, RVU25D.

  3. March 9, 2024

    RVU24AR

    $303.55changed to$308.59

    • Conversion factor 32.7442 changed to 33.2875

    Held through RVU24B, RVU24C, RVU24D.

  4. January 1, 2024

    RVU24A

    $318.49changed to$303.55

    • Conversion factor 33.8872 changed to 32.7442
    • Practice expense RVU 7.69 changed to 7.61
    • Malpractice GPCI 1.098 changed to 0.844

  5. January 1, 2023

    RVU23A

    $335.60changed to$318.49

    • Conversion factor 34.6062 changed to 33.8872
    • Practice expense RVU 7.92 changed to 7.69
    • Malpractice RVU 0.20 changed to 0.19
    • Work GPCI 1.005 changed to 1.000
    • Malpractice GPCI 1.351 changed to 1.098

    Held through RVU23B, RVU23C, RVU23D.

  6. January 1, 2022

    RVU22A

    $335.22changed to$335.60

    • Conversion factor 34.8931 changed to 34.6062
    • Practice expense RVU 7.87 changed to 7.92
    • Malpractice RVU 0.17 changed to 0.20

    Held through RVU22B, RVU22C, RVU22D.

  7. January 1, 2021

    RVU21A

    $309.27changed to$335.22

    • Conversion factor 36.0896 changed to 34.8931
    • Practice expense RVU 6.86 changed to 7.87
    • Malpractice RVU 0.18 changed to 0.17
    • Work GPCI 1.004 changed to 1.005
    • Malpractice GPCI 1.130 changed to 1.351

    Held through RVU21B, RVU21C, RVU21D.

  8. January 1, 2020

    RVU20A

    $304.78changed to$309.27

    • Conversion factor 36.0391 changed to 36.0896
    • Practice expense RVU 6.65 changed to 6.86
    • Malpractice RVU 0.21 changed to 0.18
    • Work GPCI 1.002 changed to 1.004
    • Practice expense GPCI 1.017 changed to 1.000
    • Malpractice GPCI 0.909 changed to 1.130

    Held through RVU20B, RVU20C, RVU20D.

  9. January 1, 2019

    RVU19A

    $297.12changed to$304.78

    • Conversion factor 35.9996 changed to 36.0391
    • Practice expense RVU 6.45 changed to 6.65

    Held through RVU19B, RVU19C, RVU19D.

  10. January 1, 2018

    RVU18AR1

    $298.30changed to$297.12

    • Conversion factor 35.8887 changed to 35.9996
    • Practice expense RVU 6.39 changed to 6.45
    • Work GPCI 1.004 changed to 1.002
    • Practice expense GPCI 1.034 changed to 1.017
    • Malpractice GPCI 0.946 changed to 0.909

    Held through RVU18B, RVU18C, RVU18D.

  11. January 1, 2017

    RVU17A

    $362.21changed to$298.30

    • Conversion factor 35.8043 changed to 35.8887
    • Work RVU 1.60 changed to 1.50
    • Practice expense RVU 7.89 changed to 6.39
    • Malpractice RVU 0.22 changed to 0.21
    • Work GPCI 1.005 changed to 1.004
    • Practice expense GPCI 1.051 changed to 1.034
    • Malpractice GPCI 0.982 changed to 0.946

    Held through RVU17B, RVU17C, RVU17D.

  12. January 1, 2016

    RVU16A

    $377.16changed to$362.21

    • Conversion factor 35.9335 changed to 35.8043
    • Work RVU 2.12 changed to 1.60
    • Practice expense RVU 7.67 changed to 7.89
    • Malpractice RVU 0.31 changed to 0.22

    Held through RVU16B, RVU16C, RVU16D.

  13. July 1, 2015

    RVU15C

    $375.29changed to$377.16

    • Conversion factor 35.7547 changed to 35.9335

    Held through RVU15D.

  14. January 1, 2015

    RVU15A

    $373.67changed to$375.29

    • Conversion factor 35.8228 changed to 35.7547
    • Practice expense RVU 7.54 changed to 7.67
    • Malpractice RVU 0.32 changed to 0.31
    • Work GPCI 1.001 changed to 1.005
    • Practice expense GPCI 1.055 changed to 1.051
    • Malpractice GPCI 1.107 changed to 0.982

    Held through RVU15B.

  15. January 1, 2014

    RVU14A

    $397.69changed to$373.67

    • Conversion factor 34.0230 changed to 35.8228
    • Practice expense RVU 8.66 changed to 7.54
    • Malpractice RVU 0.33 changed to 0.32
    • Work GPCI 1.000 changed to 1.001
    • Practice expense GPCI 1.058 changed to 1.055
    • Malpractice GPCI 1.232 changed to 1.107

    Held through RVU14B, RVU14C, RVU14D.

  16. October 1, 2013

    RVU13D

    No ratechanged to$397.69

  17. January 1, 2013

    RVU13AR

    Earliest loaded release: No rate

    Held through RVU13B, RVU13C.

Rates in every CMS release
Effective fromOfficeFacilityCMS release
2026-10-01$346.99$80.19RVU26D
2026-07-01$346.99$80.19RVU26C
2026-04-01$346.99$80.19RVU26B
2026-01-01$346.99$80.19RVU26A
2025-10-01$293.44$84.81RVU25D
2025-07-01$293.44$84.81RVU25C
2025-04-01$293.44$84.81RVU25B
2025-01-01$293.44$84.81RVU25A
2024-10-01$308.59$87.23RVU24D
2024-07-01$308.59$87.23RVU24C
2024-04-01$308.59$87.23RVU24B
2024-03-09$308.59$87.23RVU24AR
2024-01-01$303.55$85.80RVU24A
2023-10-01$318.49$89.75RVU23D
2023-07-01$318.49$89.75RVU23C
2023-04-01$318.49$89.75RVU23B
2023-01-01$318.49$89.75RVU23A
2022-10-01$335.60$93.36RVU22D
2022-07-01$335.60$93.36RVU22C
2022-04-01$335.60$93.36RVU22B
2022-01-01$335.60$93.36RVU22A
2021-10-01$335.22$92.37RVU21D
2021-07-01$335.22$92.37RVU21C
2021-04-01$335.22$92.37RVU21B
2021-01-01$335.22$92.37RVU21A
2020-10-01$309.27$93.81RVU20D
2020-07-01$309.27$93.81RVU20C
2020-04-01$309.27$93.81RVU20B
2020-01-01$309.27$93.81RVU20A
2019-10-01$304.78$93.67RVU19D
2019-07-01$304.78$93.67RVU19C
2019-04-01$304.78$93.67RVU19B
2019-01-01$304.78$93.67RVU19A
2018-10-01$297.12$93.93RVU18D
2018-07-01$297.12$93.93RVU18C
2018-04-01$297.12$93.93RVU18B
2018-01-01$297.12$93.93RVU18AR1
2017-10-01$298.30$94.58RVU17D
2017-07-01$298.30$94.58RVU17C
2017-04-01$298.30$94.58RVU17B
2017-01-01$298.30$94.58RVU17A
2016-10-01$362.21$100.30RVU16D
2016-07-01$362.21$100.30RVU16C
2016-04-01$362.21$100.30RVU16B
2016-01-01$362.21$100.30RVU16A
2015-10-01$377.16$133.95RVU15D
2015-07-01$377.16$133.95RVU15C
2015-04-01$375.29$133.28RVU15B
2015-01-01$375.29$133.28RVU15A
2014-10-01$373.67$135.20RVU14D
2014-07-01$373.67$135.20RVU14C
2014-04-01$373.67$135.20RVU14B
2014-01-01$373.67$135.20RVU14A
2013-10-01$397.69$135.64RVU13D
2013-07-01Rate data unavailableRate data unavailableRVU13C
2013-04-01Rate data unavailableRate data unavailableRVU13B
2013-01-01Rate data unavailableRate data unavailableRVU13AR

Price 44386 for an earlier date of service

Where the Nevada rate applies

Nevada is a Medicare payment area, not a city. Our Census mapping connects it to 138 cities and communities in Nevada. Some span more than one payment area; confirm with the service ZIP.

  • Alamo
  • Amargosa Valley
  • Austin
  • Baker
  • Battle Mountain
  • Beatty
  • Beaverdam
  • Bennett Springs

Browse all communities in Nevada

44386 billing questions

How does this differ from 44385?

Use 44386 when the pouch endoscopy includes biopsy. Code 44385 describes pouch endoscopy without biopsy.

Can multiple biopsy samples be reported as multiple units?

No. This code covers the pouch examination with one or more biopsies; multiple samples during the same procedure do not make multiple units.

Is biopsy included in the service?

Yes. The pouch examination and biopsy are represented together by this code. A separate pathology service may be reported by the provider who performs the tissue analysis.

Should modifier 50 be appended?

No. The pouch anatomy makes bilateral adjustment inappropriate, so modifier 50 is not appropriate for this service.

Can an assistant surgeon or co-surgeon be billed?

Medicare does not pay an assistant at surgery for this code, and co-surgeon and team-surgery billing are not permitted.

How does the multiple-procedure reduction work?

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

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 44386PPRRVU2026_Oct_nonQPP.csv, line 5,408 (RVU26D)
Geographic factors for NevadaGPCI2026.csv, line 73 (RVU26D)

Open CMS sourceHow we calculate rates

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