Billing code 44100: Bowel biopsyMedicare rate & RVUs in Washington
Percutaneous needle sampling of bowel tissue is reported when a physician obtains a diagnostic specimen without excising a bowel segment.
CMS doesn’t publish an office rate for 44100 in Washington.
Medicare allowed amount for participating (non-QP) physicians, before deductible, coinsurance and claim adjustments. Not a patient’s bill or a hospital charge.
On this page 9 sections
What 44100 covers
Code 44100 represents tissue sampling of bowel with a needle passed percutaneously through the abdominal wall. A physician uses it when a bowel target requires needle biopsy for diagnosis and the service is not an endoscopic mucosal biopsy or removal of an intestinal segment. It is a narrowly defined surgical procedure, typically performed by a procedural physician in a hospital or procedure setting; the specimen is sent for pathology.
Report it for the needle biopsy itself, with the procedure note identifying the target, percutaneous route, sampling technique, and tissue obtained. Do not substitute this code for colonoscopic biopsy or an excisional bowel procedure; those describe different access or extent. CMS assigns a 0-day global period, so same-day preoperative and postoperative care is included. When other procedures occur in the same session, the highest-valued procedure is paid in full and remaining procedures are subject to the standard 50% multiple-procedure reduction. Modifier 50 is inappropriate. Assistant-at-surgery payment is barred, 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.
Where 44100 pays more and less in Washington
| Payment locality | Office | Facility |
|---|---|---|
| Rest Of Washington | Unavailable | $91.70 |
| Seattle (King Cnty) | Unavailable | $97.83 |
How the 44100 rate is calculated
Each of 44100’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 · 44100
RVUs × geographic indexes × conversion factor
Swap in your local Medicare rate.
Work 1.96Practice expense 0.57Malpractice 0.21
All indexes start at 1.000 (the national rate). Enter a ZIP or drag a slider.
Payment rules and modifiers for 44100
The CMS indicators that decide how 44100 is paid alongside other services.
CMS payment indicators · 44100
Bowel biopsy
| Rule | CMS value | What it means |
|---|---|---|
| Global period | 000 | Same-day global: pre- and post-op care on the day of the procedure is included. |
| Multiple procedures | 2 | Standard reduction: highest-valued procedure at 100%, others at 50%. |
| Bilateral (modifier 50) | 0 | The 150% bilateral adjustment doesn’t apply. |
| Assistant at surgery (80/81/82/AS) | 1 | Not paid (statutory restriction). |
| Co-surgeons (62) | 0 | Not permitted. |
| Team surgery (66) | 0 | Not permitted. |
| Professional/technical | 0 | Physician service: no professional/technical split. |
What modifiers do to the payment
Modifier 51 · payment effect
With and without the modifier
44100 without 51 · national facility
$91.52
Bowel biopsy
44100-51 · Second procedure: 50%
$45.76
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%).
44100 compared with similar codes
Compare codes
44100 vs 45380 vs 44110 vs 44120: national Medicare rates
Swap in your local Medicare rate.
How to choose
- 45380Colonoscopy with biopsy
- Use 44100 for percutaneous needle sampling of bowel. Use 45380 when the biopsy is taken through a colonoscope during colonoscopy.
- 44110Intestinal excision
- 44100 obtains tissue by needle. 44110 describes excision of an intestinal lesion, a more extensive removal rather than needle sampling.
- 44120Small-bowel resection
- 44120 describes resection of small bowel. Choose it when a bowel segment is removed, not when tissue is sampled percutaneously with a needle.
44100 billing questions
How does 44100 differ from a colonoscopic biopsy?
44100 describes needle sampling through the abdominal wall. A biopsy taken through a colonoscope is reported with the applicable endoscopic biopsy code, such as 45380 for colonoscopy.
Does 44100 include the pathology examination?
The code represents obtaining the bowel tissue, not its histologic examination. The pathology service may be reported separately at the level supported by the specimen and examination.
What documentation supports reporting 44100?
Document the bowel target, percutaneous needle approach, sampling performed, and tissue obtained. The record should distinguish needle sampling from endoscopic biopsy or surgical excision.
Is same-day postoperative care included?
Yes. The CMS global period is 0 days, and same-day preoperative and postoperative care is included.
How are other procedures in the same session paid?
The highest-valued procedure is paid in full; other procedures in that session are subject to the standard multiple-procedure reduction, with payment at 50%.
Can modifier 50 or an assistant surgeon be reported?
Modifier 50 is inappropriate for this code. CMS does not pay an assistant at surgery, and co-surgeon and team-surgery billing are not permitted.
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
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