$204.89
Both describe ileoscopy through a stoma. Report 44381 when tissue is biopsied; 44380 is the diagnostic examination without biopsy.
On this page
CMS RVU26D · Effective 2026-10-01
44381 Ileoscopy Medicare reimbursement rates in Tennessee
Reports ileal examination through an existing stoma when the endoscopist obtains one or more tissue samples for diagnostic evaluation. Compare 44381 office and facility rates across CMS payment localities in Tennessee.
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.
What does Medicare pay for 44381 in Tennessee?
Tennessee has 1 payment locality in this comparison. Use the service location to choose the applicable amount. These are the supported base rates for the payment area shown below, using the same CMS release.
Office / nonfacility
$972.34
1 of 1 localities have a supported rate.
Payment area: Tennessee
One mapped payment locality.
Facility setting
$72.43
1 of 1 localities have a supported rate.
Payment area: Tennessee
One mapped payment locality.
These are locality ranges, not averages or address-specific quotes. A facility-setting amount covers the physician service; it does not include a hospital’s separate bill. Choose a locality below to inspect its calculation, compare other payment areas, or price a percentage of Medicare.
Gastrointestinal endoscopy
About 44381: Ileoscopy through stoma with biopsy
Reports ileal examination through an existing stoma when the endoscopist obtains one or more tissue samples for diagnostic evaluation.
A flexible endoscope is passed through an existing ileostomy or other small-bowel stoma to examine the ileum and obtain one or more mucosal biopsies. Gastroenterologists and surgeons commonly perform this procedure in a hospital outpatient department or ambulatory surgery center. Biopsies may support evaluation of suspected inflammation, unexplained symptoms, or a known small-bowel condition; the report should identify the route, examined anatomy, and biopsy performed.
Choose this code when the examination is through a stoma and tissue is sampled, rather than reporting the diagnostic stoma ileoscopy code alone. Document the indication, findings, and biopsy site or sites. CMS assigns a 0-day global period, so same-day preoperative and postoperative care is included. When related endoscopies are performed together, endoscopy-family pricing applies. Do not use modifier 50; CMS identifies bilateral adjustment as inappropriate for this anatomy and service. CMS payment is restricted for an assistant at surgery, and co-surgeon and team-surgery payment is not permitted.
CMS billing rules for 44381
- Global period
- Minor procedure with a 0-day global period: same-day preoperative and postoperative care is included.
- Multiple procedures
- Endoscopy family pricing applies when related endoscopies are performed together.
- 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 RVU1.35 · 4%
- Practice expense (office) RVU30.44 · 95%
- Malpractice RVU0.17 · 1%
136
Medicare services in 2024 · #4629 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.
44381 compared with similar codes
Office rates for Tennessee, from the same CMS release.
No office rate
Both involve small-bowel endoscopy with biopsy, but 44381 is specifically performed through a stoma; 44361 describes enteroscopy beyond the second portion of the duodenum.
$224.30
44385 examines an ileal pouch. Use 44381 for ileal examination through a stoma with biopsy, not examination of a pouch.
Compare 44381 by payment locality
Find the payment area for your service address, then open its rate page for calculation inputs, release history and the percentage-of-Medicare tool. A city may cross payment-area boundaries; the ZIP lookup above helps resolve the location.
1 of 1 payment localities
Tennessee →
Office / nonfacility
$972.34
Facility
$72.43
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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 44381 in Tennessee.
PPRRVU2026_Oct_nonQPP.csv
5,404
- Code
- 44381
- Physician work
- 1.35
- Practice expense
- 30.44
- Malpractice
- 0.17
GPCI2026.csv
95
- Locality
- Tennessee
- Physician work
- 1.000
- Practice expense
- 0.909
- Malpractice
- 0.537
| Component | RVU | Locality factor | Adjusted |
|---|---|---|---|
| Physician work | 1.35 | × 1.000 | 1.3500 |
| Practice expense | 30.44 | × 0.909 | 27.6700 |
| Malpractice | 0.17 | × 0.537 | 0.0913 |
| Total RVUs | 29.1113 | ||
| Conversion factor | × 33.4009 | ||
Office / nonfacility rate, Tennessee$972.34
Explore RVUs, geographic factors and the full formula
Office / nonfacility
| Component | RVU | Local GPCI |
|---|---|---|
| Work | 1.35 | 1 |
| Practice expense | 30.44 | 0.909 |
| Malpractice | 0.17 | 0.537 |
(1.35 × 1 + 30.44 × 0.909 + 0.17 × 0.537) × $33.4009 = $972.34
Facility
| Component | RVU | Local GPCI |
|---|---|---|
| Work | 1.35 | 1 |
| Practice expense | 0.8 | 0.909 |
| Malpractice | 0.17 | 0.537 |
(1.35 × 1 + 0.8 × 0.909 + 0.17 × 0.537) × $33.4009 = $72.43
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.
44381 billing questions
How does this differ from 44380?
44381 is for ileoscopy through a stoma when one or more biopsies are obtained. Use 44380 for the diagnostic stoma examination without biopsy.
Can the biopsy be billed separately?
The biopsy is part of the service represented by 44381; do not report a separate biopsy procedure for the sampling included in this endoscopy.
Is modifier 50 appropriate for an examination of both sides?
No. CMS identifies bilateral adjustment as inappropriate for this code and anatomy.
What happens when another related endoscopy is performed in the same session?
CMS endoscopy-family pricing applies when related endoscopies are performed together. Document each procedure and its distinct work.
What documentation supports reporting 44381?
Document that the endoscope passed through a stoma, the ileal examination and findings, and that tissue was obtained, including the biopsy site or sites when known.
Can an assistant surgeon or co-surgeon be paid for this service?
CMS restricts payment for an assistant at surgery and does not permit co-surgeon or team-surgery payment for this code.
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.
5,40144378,,Small bowel endoscopy,A,,6.84,2.43,NA,2.43,,0.76,10.03,10.03,0,000,0.00,0.00,0.00,3,0,0,0,0,9,44376,33.4009,09,0,99,0.00,0.00,0.00
5,40244379,,S bowel endoscope w/stent,A,,7.18,2.75,NA,2.75,,0.81,10.74,10.74,0,000,0.00,0.00,0.00,3,0,0,0,0,9,44376,33.4009,09,0,99,0.00,0.00,0.00
5,40344380,,Small bowel endoscopy br/wa,A,,0.85,5.76,,0.65,,0.09,6.70,1.59,0,000,0.00,0.00,0.00,2,0,1,0,0,9,,33.4009,09,0,99,0.00,0.00,0.00
5,40444381,,Small bowel endoscopy br/wa,A,,1.35,30.44,,0.80,,0.17,31.96,2.32,0,000,0.00,0.00,0.00,3,0,1,0,0,9,44380,33.4009,09,0,99,0.00,0.00,0.00
5,40544382,,Small bowel endoscopy,A,,1.14,8.75,,0.76,,0.13,10.02,2.03,0,000,0.00,0.00,0.00,3,0,1,0,0,9,44380,33.4009,09,0,99,0.00,0.00,0.00
5,40644384,,Small bowel endoscopy,A,,2.78,0.90,NA,0.90,,0.36,4.04,4.04,0,000,0.00,0.00,0.00,3,0,1,0,0,9,44380,33.4009,09,0,99,0.00,0.00,0.00
5,40744385,,Endoscopy of bowel pouch,A,,1.17,6.00,,0.68,,0.17,7.34,2.02,0,000,0.00,0.00,0.00,2,0,1,0,0,9,,33.4009,09,0,99,0.00,0.00,0.00
9214412,RI,01,RHODE ISLAND,1.019,1.033,0.892
9311202,SC,01,SOUTH CAROLINA,1.000,0.924,0.850
9403402,SD,02,SOUTH DAKOTA**,1.000,1.000,0.336
9510312,TN,35,TENNESSEE,1.000,0.909,0.537
9604412,TX,31,AUSTIN,1.002,1.058,0.886
9704412,TX,20,BEAUMONT,1.000,0.910,0.929
9804412,TX,09,BRAZORIA,1.008,0.991,0.780