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See a sample rate comparisonCPT 44386 Fee Schedule
Last Verified: October 2026
Healthcare providers use this code to document and receive reimbursement for visits that address moderate-level medical decision-making, often including multiple diagnoses or prescription management.
Small Bowel Exam With Scope, Exam Of A Pouch In The Small Intestine Using A Scope (Endoscope). The Procedure May Take A Sample Of Tissue For Testing (Biopsy).
| Key Fact | Detail |
|---|---|
| Service Type | Surgery Surgical Procedures on the Digestive System |
| Common Place of Service | 22 - On Campus Outpatient Hospital 24 - Ambulatory Surgical Center |
| Common Modifiers | 51 - Multiple procedures SG - Scene to Hospital ESRD facility |
| Complexity Level | Moderate |
| Medicare Fee Schedule | $347.70 national non-facility rate (2026) · View Medicare rates for 44386 |
| Medicaid Fee Schedule | $275.03 median of the 8 states in the free preview · View Medicaid rates for 44386 |
National average reimbursement for CPT 44386 by major payers:
$364.06
$418.96
$472.07
$181.04
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CPT 44386
5 of 25 sample ratesHigher to lower in this preview
Texas Health Surgery Center Rockwall, LLC
Texas Health Surgery Center Rockwall LLC
$2,392.00Published rateGlen Echo Surgery Center, LLC
Glen Echo Surgery Center LLC
$1,233.00Published rateBrainerd Lakes Surgery Center L L C
Brainerd Lakes Surgery Center, LLC
$867.00Published rateWestgreen Surgical Center LLC, Houston Orthopedic & Spine Surgery Center
$580.00Published rateToni Martin
Deaconess Hospital Inc
$235.58Published rate
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See a sample payer proposalCPT 44386 vs. Other Surgical Procedures on the Digestive System Codes
The CPT 44386 code is part of the Surgery services used for Surgical Procedures on the Digestive System. It represents a moderate-complexity encounter and is one of several codes that vary based on time spent, level of medical decision-making, and documentation requirements.
The CPT 44386 code involves more provider time and moderate medical decision-making, unlike lower-level codes that require less time and simpler assessments. It typically includes multiple diagnoses, medication management, or test interpretation, leading to higher reimbursement and more detailed documentation requirements.
| Code | Complexity | Description |
|---|---|---|
| 44369-CPT | Moderate | Small Bowel Endoscopy, Small Intestinal Endoscopy Enteroscopy Beyond Second Portion Of Duodenum Not Including Ileum With Ablation Of Tumor S Polyp S Or Other Lesion S Not Amenable To Removal By Hot Biopsy Forceps Bipolar Cautery Or Snare Technique |
| 44372-CPT | Moderate | Small Intestinal Endoscopy En, Small Intestinal Endoscopy Enteroscopy Beyond Secondportion Of Duodenum Not Including Ileum With Placement Of Percutaneous Jejunostomy Tube |
| 44385-CPT | Moderate | Endoscopic Evaluation Of Small, Endoscopic Evaluation Of Small Intestinal Pouch (Eg Kock Pouch Ileal Reservoir [S Or J]) Diagnostic Including Collection Of Specimen(S) By Brushing Or Washing When Performed (Separate Procedure) |
| 44386-CPT | Moderate | Small Bowel Exam With Scope, Exam Of A Pouch In The Small Intestine Using A Scope (Endoscope). The Procedure May Take A Sample Of Tissue For Testing (Biopsy). |
What is a fee schedule?
A fee schedule is a list of fixed prices that healthcare providers charge for specific services, including CPT 44386. These prices vary depending on payer type (Medicare, Medicaid, private insurance), geographic location, and provider contracts.
Understanding the 44386 fee schedule helps patients estimate costs and providers optimize billing for accurate reimbursements.
Factors that affect fee schedules
Medicare & Medicaid Rates
Government-set reimbursement amounts
Private Insurance Rates
Negotiated rates between providers and insurance companies
Geographic Location
Costs may be higher in urban areas.
Provider Type
Hospital providers may have different rates than private practice.
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