CPT 44386 Surgery - Digestive

How Much Does Endoscopy Bowel Pouch/biop Cost?

Also known as: Endoscopy bowel pouch/biop (CPT 44386)

Endoscopy Bowel Pouch/biop (CPT 44386) costs $81 at Medicare rates. Hospital outpatient rate: $950.

Cost Comparison by Payer

How much Endoscopy bowel pouch/biop costs across different settings and payers

Medicare
Facility rate
$81
Hospital Outpatient
OPPS rate
$950
Surgery Center
ASC rate
$510
Medicare (Facility)
$81
CMS PFS 2026 national rate
Medicare (Office/Clinic)
$348
Non-facility setting
Hospital Outpatient
$950
OPPS rate
Surgery Center (ASC)
$510
Ambulatory surgery center

Procedures Commonly Done Together

These procedures are frequently performed alongside Endoscopy bowel pouch/biop

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How to Reduce Your Cost for Endoscopy bowel pouch/biop

Practical tips that can save you hundreds or thousands of dollars

  • 1
    Ask about cash-pay discounts

    Many hospitals and clinics offer 20-40% discounts for self-pay patients. Always ask before scheduling.

  • 2
    Compare facility vs. office setting costs

    For this procedure, the office rate ($348) differs from the facility rate ($81). Ask if it can be done in an office setting.

  • 3
    Shop around — costs vary significantly

    Costs can vary 2-3x between providers in the same city. Get quotes from multiple facilities.

  • 4
    Check ambulatory surgery centers (ASCs)

    This procedure is available at ASCs for $510, compared to $950 at hospital outpatient departments. ASCs often offer lower costs with comparable quality.

How is the Price Calculated?

Medicare calculates procedure payments using Relative Value Units (RVUs). Each procedure has three components multiplied by a conversion factor ($33.40 in 2026) and adjusted by geographic cost indices.

1.46
Work RVU
0.79
Practice Expense RVU
0.18
Malpractice RVU
10.41
Total RVU

Payment = Total RVU (10.41) x CF ($33.40) = $348

Frequently Asked Questions

How much does Endoscopy bowel pouch/biop cost?

The Medicare facility rate for Endoscopy bowel pouch/biop is $81. In a hospital outpatient setting, the rate is $950. At an ambulatory surgery center, the rate is $510. Commercial insurance rates typically range from 150% to 250% of Medicare (varies by plan).

How much does Endoscopy bowel pouch/biop cost without insurance?

Without insurance, the cost of Endoscopy bowel pouch/biop can range from 150% of Medicare to 500% of Medicare depending on the facility. Many hospitals and clinics offer self-pay discounts of 20-40% off their chargemaster price. Always ask about cash pricing before your visit.

Does insurance cover Endoscopy bowel pouch/biop?

Most commercial health insurance plans and Medicare cover Endoscopy bowel pouch/biop when ordered by a physician for a medically necessary reason. Your out-of-pocket cost depends on your plan's deductible, copay/coinsurance structure, and whether you use an in-network provider. Check with your insurance company before scheduling to confirm coverage and get a cost estimate.

Why does the cost vary so much by location?

Medicare adjusts payments using Geographic Practice Cost Indices (GPCIs) that reflect local differences in physician work costs, practice expenses, and malpractice insurance. Manhattan, San Francisco, and other high-cost areas pay significantly more than rural regions. Commercial insurers follow similar geographic patterns.

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