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CMS RVU26D · Effective 2026-10-01

44386 in Modesto

Office / nonfacility

$373.86

Base rate per service

Facility setting

$81.74

Base rate per service

Amounts below use the non-QP conversion factor for participating physicians. These are base physician payments before claim-level adjustments, not patient costs or total hospital charges.

Gastrointestinal endoscopy

About 44386: Small intestinal pouch endoscopy with biopsy

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

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.

CMS billing rules for 44386

Global period
Minor procedure with a 0-day global period: same-day preoperative and postoperative care is included.
Multiple procedures
Standard multiple procedure reduction: the highest-valued procedure is paid in full and others at 50% when performed in the same session.
Bilateral procedures
Bilateral adjustment does not apply; the descriptor or anatomy makes modifier 50 inappropriate.
Assistant at surgery
Statutory restriction: assistant at surgery is not paid.
Co-surgeons
Co-surgeons not permitted.
Team surgery
Team surgery not permitted.

Where the value comes from

  • Work RVU1.46 · 14%
  • Practice expense (office) RVU8.77 · 84%
  • Malpractice RVU0.18 · 2%

2.6K

Medicare services in 2024 · #2267 by national volume

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.

44386 compared with similar codes

Office rates for Modesto, from the same CMS release.

44385

Pouch endoscopy

Without tissue biopsy

$262.43

Both address endoscopic examination of a surgically created small-intestinal pouch. Choose 44386 when biopsy is performed; 44385 is for examination without biopsy.

44388

Colonoscopy

Diagnostic, through stoma

$373.01

44388 describes colonoscopy through a stoma, rather than endoscopic examination of a small-intestinal pouch.

44389

Colonoscopy

Through stoma, with biopsy

$486.28

44389 is colonoscopy through a stoma with biopsy. Use 44386 when the examined structure is a surgically created small-intestinal pouch.

The same code, a different location

How does Modesto compare?

In Bakersfield, the office rate for 44386 is $374.40—$0.54 higher than the $373.86 rate in Modesto. Both use the same code, release and participation basis.

44386 across payment areas

Same release and payment basis · bars start at $0

  1. Modesto · This locality

    $373.86

  2. Bakersfield

    $374.40

    $0.54 higher than Modesto

  3. Chico

    $373.86

    The same base rate than Modesto

  4. El Centro

    $373.89

    $0.03 higher than Modesto

  5. Fresno

    $373.86

    The same base rate than Modesto

  6. Hanford-Corcoran

    $373.86

    The same base rate than Modesto

  7. Los Angeles-Long Beach-Anaheim (Los Angeles/Orange Cnty)

    $401.29

    $27.43 higher than Modesto

Other payment areas listed in California appear first, followed by selected cross-country examples. The chart compares amounts, not distance.

Across 109 of 109 CMS payment localities with a supported office rate, 44386 ranges from $303.48 in Arkansas to $479.75 in San Jose-Sunnyvale-Santa Clara (San Benito Cnty). This is a geographic range, not an average.

The code’s RVUs stay the same in these comparisons. Geographic adjustments to work, practice expense and malpractice change the dollar amount. A city name alone may not identify the payment area for a service address.

Compare all 108 other payment areas

  • Madera

    California · 44386

    Office

    $373.86

    Facility

    $81.74

    The same base rate than Modesto for the office setting.

  • Merced

    California · 44386

    Office

    $373.86

    Facility

    $81.74

    The same base rate than Modesto for the office setting.

  • Napa

    California · 44386

    Office

    $440.97

    Facility

    $89.67

    $67.11 higher than Modesto for the office setting.

  • Oxnard-Thousand Oaks-Ventura

    California · 44386

    Office

    $400.11

    Facility

    $85.07

    $26.25 higher than Modesto for the office setting.

  • Redding

    California · 44386

    Office

    $373.86

    Facility

    $81.74

    The same base rate than Modesto for the office setting.

  • Rest Of California

    California · 44386

    Office

    $373.86

    Facility

    $81.74

    The same base rate than Modesto for the office setting.

  • Riverside-San Bernardino-Ontario

    California · 44386

    Office

    $375.82

    Facility

    $83.69

    $1.96 higher than Modesto for the office setting.

  • Sacramento-Roseville-Folsom

    California · 44386

    Office

    $394.42

    Facility

    $84.43

    $20.56 higher than Modesto for the office setting.

  • Salinas

    California · 44386

    Office

    $393.00

    Facility

    $84.08

    $19.14 higher than Modesto for the office setting.

  • San Diego-Chula Vista-Carlsbad

    California · 44386

    Office

    $403.83

    Facility

    $85.05

    $29.97 higher than Modesto for the office setting.

  • San Francisco-Oakland-Berkeley (Marin Cnty)

    California · 44386

    Office

    $469.18

    Facility

    $93.36

    $95.32 higher than Modesto for the office setting.

  • San Francisco-Oakland-Berkeley (San Francisco/San Mateo/Alameda/Contra Costa Cnty)

    California · 44386

    Office

    $468.98

    Facility

    $93.16

    $95.12 higher than Modesto for the office setting.

  • San Jose-Sunnyvale-Santa Clara (San Benito Cnty)

    California · 44386

    Office

    $479.75

    Facility

    $95.40

    $105.89 higher than Modesto for the office setting.

  • San Jose-Sunnyvale-Santa Clara (Santa Clara Cnty)

    California · 44386

    Office

    $478.92

    Facility

    $94.57

    $105.06 higher than Modesto for the office setting.

  • San Luis Obispo-Paso Robles

    California · 44386

    Office

    $386.46

    Facility

    $82.87

    $12.60 higher than Modesto for the office setting.

  • Santa Cruz-Watsonville

    California · 44386

    Office

    $408.92

    Facility

    $85.07

    $35.06 higher than Modesto for the office setting.

  • Santa Maria-Santa Barbara

    California · 44386

    Office

    $394.90

    Facility

    $84.12

    $21.04 higher than Modesto for the office setting.

  • Santa Rosa-Petaluma

    California · 44386

    Office

    $413.16

    Facility

    $85.85

    $39.30 higher than Modesto for the office setting.

  • Stockton

    California · 44386

    Office

    $373.86

    Facility

    $81.74

    The same base rate than Modesto for the office setting.

  • Vallejo

    California · 44386

    Office

    $440.67

    Facility

    $89.37

    $66.81 higher than Modesto for the office setting.

  • Visalia

    California · 44386

    Office

    $373.86

    Facility

    $81.74

    The same base rate than Modesto for the office setting.

  • Yuba City

    California · 44386

    Office

    $373.86

    Facility

    $81.74

    The same base rate than Modesto for the office setting.

  • Dc + Md/Va Suburbs

    District of Columbia · 44386

    Office

    $403.16

    Facility

    $89.17

    $29.30 higher than Modesto for the office setting.

  • Miami

    Florida · 44386

    Office

    $368.91

    Facility

    $91.44

    $4.95 lower than Modesto for the office setting.

  • Chicago

    Illinois · 44386

    Office

    $357.30

    Facility

    $89.42

    $16.56 lower than Modesto for the office setting.

  • Manhattan

    New York · 44386

    Office

    $401.80

    Facility

    $92.08

    $27.94 higher than Modesto for the office setting.

  • Alaska*

    Alaska · 44386

    Office

    $388.43

    Facility

    $104.56

    $14.57 higher than Modesto for the office setting.

  • Alabama

    Alabama · 44386

    Office

    $308.48

    Facility

    $75.26

    $65.38 lower than Modesto for the office setting.

  • Arkansas

    Arkansas · 44386

    Office

    $303.48

    Facility

    $74.53

    $70.38 lower than Modesto for the office setting.

  • Arizona

    Arizona · 44386

    Office

    $337.76

    Facility

    $79.48

    $36.10 lower than Modesto for the office setting.

  • Colorado

    Colorado · 44386

    Office

    $365.72

    Facility

    $82.12

    $8.14 lower than Modesto for the office setting.

  • Connecticut

    Connecticut · 44386

    Office

    $372.50

    Facility

    $85.43

    $1.36 lower than Modesto for the office setting.

  • Delaware

    Delaware · 44386

    Office

    $343.82

    Facility

    $80.48

    $30.04 lower than Modesto for the office setting.

  • Fort Lauderdale

    Florida · 44386

    Office

    $356.37

    Facility

    $86.37

    $17.49 lower than Modesto for the office setting.

  • Rest Of Florida

    Florida · 44386

    Office

    $337.84

    Facility

    $83.03

    $36.02 lower than Modesto for the office setting.

  • Atlanta

    Georgia · 44386

    Office

    $353.74

    Facility

    $82.94

    $20.12 lower than Modesto for the office setting.

  • Rest Of Georgia

    Georgia · 44386

    Office

    $317.22

    Facility

    $79.47

    $56.64 lower than Modesto for the office setting.

  • Hawaii, Guam

    Hawaii · 44386

    Office

    $385.30

    Facility

    $82.25

    $11.44 higher than Modesto for the office setting.

  • Iowa

    Iowa · 44386

    Office

    $319.18

    Facility

    $75.30

    $54.68 lower than Modesto for the office setting.

  • Idaho

    Idaho · 44386

    Office

    $321.10

    Facility

    $75.88

    $52.76 lower than Modesto for the office setting.

  • East St. Louis

    Illinois · 44386

    Office

    $330.37

    Facility

    $85.15

    $43.49 lower than Modesto for the office setting.

  • Rest Of Illinois

    Illinois · 44386

    Office

    $325.60

    Facility

    $82.25

    $48.26 lower than Modesto for the office setting.

  • Suburban Chicago

    Illinois · 44386

    Office

    $360.60

    Facility

    $86.86

    $13.26 lower than Modesto for the office setting.

  • Indiana

    Indiana · 44386

    Office

    $323.23

    Facility

    $76.15

    $50.63 lower than Modesto for the office setting.

  • Kansas

    Kansas · 44386

    Office

    $316.60

    Facility

    $75.65

    $57.26 lower than Modesto for the office setting.

  • Kentucky

    Kentucky · 44386

    Office

    $314.68

    Facility

    $77.72

    $59.18 lower than Modesto for the office setting.

  • New Orleans

    Louisiana · 44386

    Office

    $331.24

    Facility

    $80.43

    $42.62 lower than Modesto for the office setting.

  • Rest Of Louisiana

    Louisiana · 44386

    Office

    $313.76

    Facility

    $77.88

    $60.10 lower than Modesto for the office setting.

  • Metropolitan Boston

    Massachusetts · 44386

    Office

    $405.87

    Facility

    $87.62

    $32.01 higher than Modesto for the office setting.

  • Rest Of Massachusetts

    Massachusetts · 44386

    Office

    $362.79

    Facility

    $82.12

    $11.07 lower than Modesto for the office setting.

  • Baltimore/Surr. Cntys

    Maryland · 44386

    Office

    $371.29

    Facility

    $85.30

    $2.57 lower than Modesto for the office setting.

  • Rest Of Maryland

    Maryland · 44386

    Office

    $351.21

    Facility

    $81.48

    $22.65 lower than Modesto for the office setting.

  • Rest Of Maine

    Maine · 44386

    Office

    $322.00

    Facility

    $76.78

    $51.86 lower than Modesto for the office setting.

  • Southern Maine

    Maine · 44386

    Office

    $342.85

    Facility

    $78.71

    $31.01 lower than Modesto for the office setting.

  • Detroit

    Michigan · 44386

    Office

    $341.58

    Facility

    $84.36

    $32.28 lower than Modesto for the office setting.

  • Rest Of Michigan

    Michigan · 44386

    Office

    $322.99

    Facility

    $79.64

    $50.87 lower than Modesto for the office setting.

  • Minnesota

    Minnesota · 44386

    Office

    $351.97

    Facility

    $77.70

    $21.89 lower than Modesto for the office setting.

  • Metropolitan Kansas City

    Missouri · 44386

    Office

    $329.70

    Facility

    $79.42

    $44.16 lower than Modesto for the office setting.

  • Metropolitan St. Louis

    Missouri · 44386

    Office

    $333.65

    Facility

    $79.91

    $40.21 lower than Modesto for the office setting.

  • Rest Of Missouri

    Missouri · 44386

    Office

    $307.12

    Facility

    $77.37

    $66.74 lower than Modesto for the office setting.

  • Mississippi

    Mississippi · 44386

    Office

    $305.42

    Facility

    $75.93

    $68.44 lower than Modesto for the office setting.

  • Montana**

    Montana · 44386

    Office

    $347.69

    Facility

    $81.15

    $26.17 lower than Modesto for the office setting.

  • North Carolina

    North Carolina · 44386

    Office

    $325.91

    Facility

    $77.23

    $47.95 lower than Modesto for the office setting.

  • North Dakota**

    North Dakota · 44386

    Office

    $344.13

    Facility

    $77.59

    $29.73 lower than Modesto for the office setting.

  • Nebraska

    Nebraska · 44386

    Office

    $321.41

    Facility

    $75.39

    $52.45 lower than Modesto for the office setting.

  • New Hampshire

    New Hampshire · 44386

    Office

    $358.96

    Facility

    $81.49

    $14.90 lower than Modesto for the office setting.

  • Northern Nj

    New Jersey · 44386

    Office

    $398.05

    Facility

    $88.87

    $24.19 higher than Modesto for the office setting.

  • Rest Of New Jersey

    New Jersey · 44386

    Office

    $377.19

    Facility

    $86.13

    $3.33 higher than Modesto for the office setting.

  • New Mexico

    New Mexico · 44386

    Office

    $324.60

    Facility

    $80.18

    $49.26 lower than Modesto for the office setting.

  • Nevada**

    Nevada · 44386

    Office

    $346.99

    Facility

    $80.19

    $26.87 lower than Modesto for the office setting.

  • Nyc Suburbs/Long Island

    New York · 44386

    Office

    $411.34

    Facility

    $94.42

    $37.48 higher than Modesto for the office setting.

  • Poughkpsie/N Nyc Suburbs

    New York · 44386

    Office

    $378.99

    Facility

    $87.13

    $5.13 higher than Modesto for the office setting.

  • Queens

    New York · 44386

    Office

    $406.79

    Facility

    $91.74

    $32.93 higher than Modesto for the office setting.

  • Rest Of New York

    New York · 44386

    Office

    $331.27

    Facility

    $78.06

    $42.59 lower than Modesto for the office setting.

  • Ohio

    Ohio · 44386

    Office

    $322.27

    Facility

    $78.92

    $51.59 lower than Modesto for the office setting.

  • Oklahoma

    Oklahoma · 44386

    Office

    $315.02

    Facility

    $77.00

    $58.84 lower than Modesto for the office setting.

  • Portland

    Oregon · 44386

    Office

    $379.46

    Facility

    $83.33

    $5.60 higher than Modesto for the office setting.

  • Rest Of Oregon

    Oregon · 44386

    Office

    $344.75

    Facility

    $79.27

    $29.11 lower than Modesto for the office setting.

  • Metropolitan Philadelphia

    Pennsylvania · 44386

    Office

    $361.75

    Facility

    $84.28

    $12.11 lower than Modesto for the office setting.

  • Rest Of Pennsylvania

    Pennsylvania · 44386

    Office

    $323.35

    Facility

    $78.67

    $50.51 lower than Modesto for the office setting.

  • Puerto Rico

    Puerto Rico · 44386

    Office

    $350.84

    Facility

    $81.36

    $23.02 lower than Modesto for the office setting.

  • Rhode Island

    Rhode Island · 44386

    Office

    $357.65

    Facility

    $82.31

    $16.21 lower than Modesto for the office setting.

  • South Carolina

    South Carolina · 44386

    Office

    $324.54

    Facility

    $78.26

    $49.32 lower than Modesto for the office setting.

  • South Dakota**

    South Dakota · 44386

    Office

    $343.71

    Facility

    $77.17

    $30.15 lower than Modesto for the office setting.

  • Tennessee

    Tennessee · 44386

    Office

    $318.26

    Facility

    $75.98

    $55.60 lower than Modesto for the office setting.

  • Austin

    Texas · 44386

    Office

    $364.11

    Facility

    $82.11

    $9.75 lower than Modesto for the office setting.

  • Beaumont

    Texas · 44386

    Office

    $320.91

    Facility

    $78.36

    $52.95 lower than Modesto for the office setting.

  • Brazoria

    Texas · 44386

    Office

    $344.13

    Facility

    $79.99

    $29.73 lower than Modesto for the office setting.

  • Dallas

    Texas · 44386

    Office

    $346.12

    Facility

    $80.64

    $27.74 lower than Modesto for the office setting.

  • Fort Worth

    Texas · 44386

    Office

    $343.27

    Facility

    $80.46

    $30.59 lower than Modesto for the office setting.

  • Galveston

    Texas · 44386

    Office

    $345.01

    Facility

    $80.34

    $28.85 lower than Modesto for the office setting.

  • Houston

    Texas · 44386

    Office

    $348.30

    Facility

    $83.63

    $25.56 lower than Modesto for the office setting.

  • Rest Of Texas

    Texas · 44386

    Office

    $332.18

    Facility

    $79.24

    $41.68 lower than Modesto for the office setting.

  • Utah

    Utah · 44386

    Office

    $329.51

    Facility

    $78.97

    $44.35 lower than Modesto for the office setting.

  • Virginia

    Virginia · 44386

    Office

    $340.96

    Facility

    $78.95

    $32.90 lower than Modesto for the office setting.

  • Virgin Islands

    United States Virgin Islands · 44386

    Office

    $350.84

    Facility

    $81.36

    $23.02 lower than Modesto for the office setting.

  • Vermont

    Vermont · 44386

    Office

    $341.80

    Facility

    $77.93

    $32.06 lower than Modesto for the office setting.

  • Rest Of Washington

    Washington · 44386

    Office

    $362.43

    Facility

    $81.76

    $11.43 lower than Modesto for the office setting.

  • Seattle (King Cnty)

    Washington · 44386

    Office

    $415.54

    Facility

    $88.49

    $41.68 higher than Modesto for the office setting.

  • Wisconsin

    Wisconsin · 44386

    Office

    $331.24

    Facility

    $75.90

    $42.62 lower than Modesto for the office setting.

  • West Virginia

    West Virginia · 44386

    Office

    $311.92

    Facility

    $80.30

    $61.94 lower than Modesto for the office setting.

  • Wyoming**

    Wyoming · 44386

    Office

    $346.14

    Facility

    $79.60

    $27.72 lower than Modesto for the office setting.

See how rates vary across the country

44386 · Office / nonfacility · Non-QP. Choose a state to explore its payment localities. A range means the amount varies within that state.

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 all state and territory rates as a table
State / territoryRate 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

Explore 44386 on the national rate map →

Where does this rate apply?

Modesto is a Medicare payment area. Our Census mapping connects it to 33 cities and communities in California, including the examples shown here.

Some communities span more than one payment area. Follow a city link to compare all of its mapped areas, or check the service-location ZIP above for an address-level starting point.

Browse all communities in California →

Why are the office and facility amounts different?

For 44386 in Modesto, the physician’s office rate is $373.86 and the facility-setting rate is $81.74: a difference of $292.12.

The calculation uses a different practice-expense RVU for each setting. Both amounts here are physician fee-schedule amounts. The facility figure does not include a hospital’s separate charges, so this comparison does not tell you the total cost of receiving care in each setting.

See the inputs behind this difference →

Use this rate

What is a percentage of Medicare worth?

Turn a percentage into dollars for 44386 in Modesto. This uses the base rate on this page, so the locality and release stay consistent.

Reference amount per service

$411.25

$373.86 × 110% = $411.25

A contract may specify another Medicare year or additional adjustments. This is percentage arithmetic on the displayed base rate, not a claim adjudication.

Working with a whole code list?

Compare an offer across your annual code mix, including an older Medicare schedule or flat per-code rates.

Compare your contract offer →

How this local rate is calculated

Each RVU component is multiplied by its own geographic practice cost index (GPCI). The three adjusted components are added, then multiplied by the conversion factor. These are the inputs used for 44386 in Modesto.

PPRRVU2026_Oct_nonQPP.csv

5,408

Code
44386
Physician work
1.46
Practice expense
8.77
Malpractice
0.18

GPCI2026.csv

16

Locality
Modesto
Physician work
1.017
Practice expense
1.096
Malpractice
0.536
Office / nonfacility calculation for 44386 in Modesto
ComponentRVULocality factorAdjusted
Physician work1.46× 1.0171.4848
Practice expense8.77× 1.0969.6119
Malpractice0.18× 0.5360.0965
Total RVUs11.1932
Conversion factor× 33.4009

Office / nonfacility rate, Modesto$373.86

Values as parsed from CMS release RVU26D, effective 2026-10-01. The amount is rounded to the nearest cent only at the end.

Open 44386 in the RVU calculator →

Explore RVUs, geographic factors and the full formula

Office / nonfacility

Office / nonfacility calculation inputs
ComponentRVULocal GPCI
Work1.461.017
Practice expense8.771.096
Malpractice0.180.536

(1.46 × 1.017 + 8.77 × 1.096 + 0.18 × 0.536) × $33.4009 = $373.86

Facility

Facility calculation inputs
ComponentRVULocal GPCI
Work1.461.017
Practice expense0.791.096
Malpractice0.180.536

(1.46 × 1.017 + 0.79 × 1.096 + 0.18 × 0.536) × $33.4009 = $81.74

The office and facility calculations use their respective practice-expense RVUs. The facility amount here is the physician fee, not a separate hospital or facility bill.

How this rate has changed

44386 · Office / nonfacility

$373.86

Effective 2026-10-01

The base rate is $59.07 higher than on 2025-10-01, moving from $314.79 to $373.86 (18.8%).

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

    $314.79changed to$373.86

    • 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
    • Work GPCI 1.014 changed to 1.017
    • Practice expense GPCI 1.093 changed to 1.096
    • Malpractice GPCI 0.560 changed to 0.536

    Held through RVU26B, RVU26C, RVU26D.

  2. January 1, 2025

    RVU25A

    Earliest loaded release: $314.79

    Held through RVU25B, RVU25C, RVU25D.

Explore release dates and calculate this code in an earlier period →

Each row uses the accepted CMS release effective on that date and the same contractor and locality identifiers. Missing rates stay visible. Historical boundaries may differ; verify the service address for an older claim.

Inspect every release and its CMS source
Effective fromOffice / nonfacilityFacilityCMS release
2026-10-01$373.86$81.74RVU26D
2026-07-01$373.86$81.74RVU26C
2026-04-01$373.86$81.74RVU26B
2026-01-01$373.86$81.74RVU26A
2025-10-01$314.79$86.75RVU25D
2025-07-01$314.79$86.75RVU25C
2025-04-01$314.79$86.75RVU25B
2025-01-01$314.79$86.75RVU25A

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 indices and the applicable conversion factor. Unavailable or separately priced services are labeled rather than assigned a made-up amount.

Source: RVU26D. Effective 2026-10-01 through the day before 2027-01-01.

RVUs for 44386PPRRVU2026_Oct_nonQPP.csv, line 5,408 (RVU26D)
Geographic factors for ModestoGPCI2026.csv, line 16 (RVU26D)
Open CMS sourceHow this rate is calculatedBuild a fee sheet