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CPT code 44388: Colonoscopy, diagnostic, through stoma2026 Medicare rate & RVUs in Puerto Rico

Reports diagnostic examination of the colon using a scope passed through a stoma, when no separately coded therapeutic intervention defines the service.

CMS RVU26DEffective Oct 1, 2026One payment locality4K Medicare services in 2024

In Puerto Rico, Medicare pays $356.28 for 44388 in the office and $141.17 when it’s performed in a hospital or facility.

$356.28Office (non-facility)
$141.17Hospital or facility
+0.7%vs the national office rate ($353.72)

Check a contract rate as a % of Medicare · 44388 nationwide

Medicare allowed amount for participating (non-QP) physicians, before deductible, coinsurance and claim adjustments. Not a patient’s bill or a hospital charge.

We’ll open 44388 for the payment locality that covers the ZIP.

On this page 11 sections
  1. Rate in Puerto Rico
  2. What 44388 covers
  3. Compared with other areas
  4. Rate map
  5. How it’s calculated
  6. Payment rules
  7. Related codes
  8. Rate history
  9. Where it applies
  10. Billing questions
  11. Sources

What 44388 covers

A gastroenterologist or colorectal surgeon passes a colonoscope through a colostomy stoma to examine the colon. This approach is used when the patient’s anatomy or the clinical plan calls for examination through the stoma rather than through the anus. The service may be performed in an office or a facility. The report should identify the stoma access, the portion of colon examined, findings, and any sampling or treatment performed.

Select this diagnostic code when the examination is performed without a separately coded therapeutic intervention. If the endoscopist biopsies tissue, removes a foreign body or lesion, or treats bleeding, use the code describing that work instead. Medicare assigns a 0-day global period, so same-day preoperative and postoperative care is included. Modifier 53 is separately priced for a discontinued procedure. When multiple procedures are performed in one session, the highest-valued procedure is paid in full and the others are subject to the standard 50% reduction. Medicare does not pay assistant-at-surgery services for this code; co-surgeon and team-surgery services 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.

How Puerto Rico compares for 44388

Across 109 of 109 payment localities, the office rate for 44388 runs from $311.61 in Arkansas to $468.26 in San Benito County, CA. Puerto Rico pays $356.28. The RVUs are the same everywhere; the geographic indexes change the dollars.

44388 in Puerto Rico vs other payment areas
  1. Puerto Rico · this page$356.28
  2. Los Angeles, CA · California$398.77+$42.49
  3. Washington, DC area · District of Columbia$404.81+$48.53
  4. Miami, FL · Florida$384.97+$28.69
  5. Chicago, IL · Illinois$373.33+$17.05
  6. Manhattan, NY · New York$408.15+$51.87
  7. Alaska · Alaska$408.17+$51.89

Other areas in Puerto Rico first, then benchmark localities. Bars start at $0.

Every other payment area

44388 in every other Medicare payment locality
Payment localityOfficeFacility
AlabamaAlabama$316.33$130.17
ArkansasArkansas$311.61$128.85
ArizonaArizona$343.95$137.78
Bakersfield, CACalifornia$374.19$141.00
Chico, CACalifornia$373.01$139.82
El Centro, CACalifornia$373.08$139.89
Fresno, CACalifornia$373.01$139.82
Hanford, CACalifornia$373.01$139.82

44388 rates by state

Office rate range in each state. Select a state to see its payment localities.

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.

$311.61

$420.64

Color shows the midpoint of each state’s locality range.

View every state and territory as a table
44388 office rate range by state
State / territoryOffice rate rangeLocalities
AK$408.171
AL$316.331
AR$311.611
AZ$343.951
CA$373.01–$468.2629
CO$367.881
CT$377.731
DC$404.811
DE$349.761
FL$349.54–$384.973
GA$329.18–$360.762
GU$382.411
HI$382.411
IA$324.081
ID$326.381
IL$339.54–$373.334
IN$328.321
KS$322.781
KY$324.631
LA$324.22–$340.742
MA$365.68–$404.632
MD$356.50–$404.813
ME$328.42–$346.402
MI$333.60–$354.312
MN$351.371
MO$318.65–$341.673
MS$315.181
MT$353.691
NC$331.921
ND$345.581
NE$325.831
NH$362.321
NJ$381.72–$400.462
NM$335.591
NV$351.681
NY$337.07–$418.655
OH$331.941
OK$323.751
OR$348.64–$379.542
PA$332.34–$368.262
PR$356.281
RI$362.221
SC$332.551
SD$344.621
TN$324.491
TX$330.11–$366.928
UT$337.231
VA$345.41–$404.812
VI$356.281
VT$344.441
WA$364.92–$412.732
WI$333.681
WV$326.671
WY$350.151

See 44388 in every payment locality

How the 44388 rate is calculated

Each of 44388’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 · 44388

RVUs × geographic indexes × conversion factor

Office or facility?

Work2.65

2.65 RVUs× 1.000 GPCI

Practice expense7.53

7.53 RVUs× 1.000 GPCI

Malpractice0.41

0.41 RVUs× 1.000 GPCI

Adjusted RVUs

10.5900

Conversion factor

$33.4009

Medicare rate

$353.72

Every GPCI starts at 1.000, the national rate. Enter a ZIP or drag a slider.

The exact Puerto Rico inputs and CMS source lines

PPRRVU2026_Oct_nonQPP.csv

5,409

Code
44388
Physician work
2.65
Practice expense
7.53
Malpractice
0.41

GPCI2026.csv

91

Locality
Puerto Rico
Physician work
1.000
Practice expense
1.011
Malpractice
0.985
Office calculation for 44388 in Puerto Rico
ComponentRVULocality factorAdjusted
Physician work2.65× 1.0002.6500
Practice expense7.53× 1.0117.6128
Malpractice0.41× 0.9850.4038
Total RVUs10.6667
Conversion factor× 33.4009

Office rate, Puerto Rico$356.28

Office: (2.65 × 1 + 7.53 × 1.011 + 0.41 × 0.985) × $33.4009 = $356.28

Facility: (2.65 × 1 + 1.16 × 1.011 + 0.41 × 0.985) × $33.4009 = $141.17

Open 44388 in the RVU calculator

Payment rules and modifiers for 44388

The CMS indicators that decide how 44388 is paid alongside other services.

CMS payment indicators · 44388

Colonoscopy, diagnostic, through stoma

RuleCMS valueWhat it means
Global period000Same-day global: pre- and post-op care on the day of the procedure is included.
Multiple procedures2Standard reduction: highest-valued procedure at 100%, others at 50%.
Bilateral (modifier 50)0The 150% bilateral adjustment doesn’t apply.
Assistant at surgery (80/81/82/AS)1Not paid (statutory restriction).
Co-surgeons (62)0Not permitted.
Team surgery (66)0Not permitted.
Professional/technical0Physician service: no professional/technical split.

What modifiers do to the payment

Modifier 51 · payment effect

With and without the modifier

44388 without 51 · national office

$353.72

Colonoscopy, diagnostic, through stoma

44388-51 · Second procedure: 50%

$176.86

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%).

When to use modifier 51

Codes related to 44388

Related codes aren’t interchangeable: bill the code that matches the service performed.

Codes related to 44388
CodeHow it relatesOffice range, Puerto Rico
Used instead
44389Colonoscopy, through stoma, with biopsyUse for colonoscopy through a stoma when tissue biopsy is performed.$461.20
44390Stomal colonoscopy, foreign body removalDescribes removal of a foreign body during colonoscopy through a stoma.$452.49
44391Colonoscopy through stoma, control of bleedingDescribes endoscopic control of bleeding through a stoma.$707.59
44392Stoma colonoscopy, hot biopsy forceps removalDescribes lesion removal through a stoma using forceps or cautery.$435.19
44394Stomal colonoscopy, snare lesion removalDescribes lesion removal through a stoma using a snare.$487.08
44385Pouch endoscopy, without tissue biopsyUse the pouch endoscopy family when the scope examines a bowel pouch rather than the colon.$247.28

How 44388 has changed in Puerto Rico

44388 · Office / nonfacility

$356.28

Effective 2026-10-01

The base rate is $49.75 higher than on 2025-10-01, moving from $306.53 to $356.28 (16.2%).

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

    $306.53changed to$356.28

    • Conversion factor 32.3465 changed to 33.4009
    • Work RVU 2.72 changed to 2.65
    • Practice expense RVU 6.30 changed to 7.53
    • Malpractice RVU 0.42 changed to 0.41
    • Practice expense GPCI 1.007 changed to 1.011
    • Malpractice GPCI 0.982 changed to 0.985

    Held through RVU26B, RVU26C, RVU26D.

  2. January 1, 2025

    RVU25A

    $316.80changed to$306.53

    • Conversion factor 33.2875 changed to 32.3465
    • Practice expense RVU 6.35 changed to 6.30
    • Malpractice RVU 0.41 changed to 0.42

    Held through RVU25B, RVU25C, RVU25D.

  3. March 9, 2024

    RVU24AR

    $311.63changed to$316.80

    • Conversion factor 32.7442 changed to 33.2875

    Held through RVU24B, RVU24C, RVU24D.

  4. January 1, 2024

    RVU24A

    $323.09changed to$311.63

    • Conversion factor 33.8872 changed to 32.7442
    • Practice expense RVU 6.36 changed to 6.35
    • Practice expense GPCI 1.008 changed to 1.007
    • Malpractice GPCI 0.984 changed to 0.982

  5. October 1, 2023

    RVU23D

    $321.59changed to$323.09

    • Practice expense GPCI 1.000 changed to 1.008
    • Malpractice GPCI 1.000 changed to 0.984

  6. January 1, 2023

    RVU23A

    $334.17changed to$321.59

    • Conversion factor 34.6062 changed to 33.8872
    • Practice expense RVU 6.49 changed to 6.36
    • Malpractice RVU 0.40 changed to 0.41
    • Practice expense GPCI 1.008 changed to 1.000
    • Malpractice GPCI 0.986 changed to 1.000

    Held through RVU23B, RVU23C.

  7. January 1, 2022

    RVU22A

    $333.08changed to$334.17

    • Conversion factor 34.8931 changed to 34.6062
    • Practice expense RVU 6.39 changed to 6.49
    • Malpractice RVU 0.39 changed to 0.40

    Held through RVU22B, RVU22C, RVU22D.

  8. January 1, 2021

    RVU21A

    $315.05changed to$333.08

    • Conversion factor 36.0896 changed to 34.8931
    • Practice expense RVU 5.57 changed to 6.39
    • Malpractice RVU 0.40 changed to 0.39
    • Malpractice GPCI 0.988 changed to 0.986

    Held through RVU21B, RVU21C, RVU21D.

  9. January 1, 2020

    RVU20A

    $304.62changed to$315.05

    • Conversion factor 36.0391 changed to 36.0896
    • Practice expense RVU 5.27 changed to 5.57
    • Malpractice RVU 0.43 changed to 0.40
    • Practice expense GPCI 1.007 changed to 1.008
    • Malpractice GPCI 0.990 changed to 0.988

    Held through RVU20B, RVU20C, RVU20D.

  10. January 1, 2019

    RVU19A

    $298.12changed to$304.62

    • Conversion factor 35.9996 changed to 36.0391
    • Practice expense RVU 5.09 changed to 5.27
    • Malpractice RVU 0.44 changed to 0.43

    Held through RVU19B, RVU19C, RVU19D.

  11. January 1, 2018

    RVU18AR1

    $262.97changed to$298.12

    • Conversion factor 35.8887 changed to 35.9996
    • Practice expense RVU 5.06 changed to 5.09
    • Malpractice RVU 0.43 changed to 0.44
    • Practice expense GPCI 0.856 changed to 1.007
    • Malpractice GPCI 0.642 changed to 0.990

    Held through RVU18B, RVU18C, RVU18D.

  12. January 1, 2017

    RVU17A

    $276.33changed to$262.97

    • Conversion factor 35.8043 changed to 35.8887
    • Work RVU 2.82 changed to 2.72
    • Practice expense RVU 6.76 changed to 5.06
    • Malpractice RVU 0.45 changed to 0.43
    • Practice expense GPCI 0.705 changed to 0.856
    • Malpractice GPCI 0.293 changed to 0.642

    Held through RVU17B, RVU17C, RVU17D.

  13. January 1, 2016

    RVU16A

    $277.79changed to$276.33

    • Conversion factor 35.9335 changed to 35.8043
    • Practice expense RVU 6.77 changed to 6.76
    • Malpractice RVU 0.47 changed to 0.45

    Held through RVU16B, RVU16C, RVU16D.

  14. July 1, 2015

    RVU15C

    $276.40changed to$277.79

    • Conversion factor 35.7547 changed to 35.9335

    Held through RVU15D.

  15. January 1, 2015

    RVU15A

    $271.78changed to$276.40

    • Conversion factor 35.8228 changed to 35.7547
    • Practice expense RVU 6.72 changed to 6.77
    • Malpractice RVU 0.43 changed to 0.47
    • Practice expense GPCI 0.692 changed to 0.705
    • Malpractice GPCI 0.271 changed to 0.293

    Held through RVU15B.

  16. January 1, 2014

    RVU14A

    $277.15changed to$271.78

    • Conversion factor 34.0230 changed to 35.8228
    • Practice expense RVU 7.69 changed to 6.72
    • Malpractice RVU 0.45 changed to 0.43
    • Practice expense GPCI 0.678 changed to 0.692
    • Malpractice GPCI 0.249 changed to 0.271

    Held through RVU14B, RVU14C, RVU14D.

  17. January 1, 2013

    RVU13AR

    Earliest loaded release: $277.15

    Held through RVU13B, RVU13C, RVU13D.

Rates in every CMS release
Effective fromOfficeFacilityCMS release
2026-10-01$356.28$141.17RVU26D
2026-07-01$356.28$141.17RVU26C
2026-04-01$356.28$141.17RVU26B
2026-01-01$356.28$141.17RVU26A
2025-10-01$306.53$150.51RVU25D
2025-07-01$306.53$150.51RVU25C
2025-04-01$306.53$150.51RVU25B
2025-01-01$306.53$150.51RVU25A
2024-10-01$316.80$153.89RVU24D
2024-07-01$316.80$153.89RVU24C
2024-04-01$316.80$153.89RVU24B
2024-03-09$316.80$153.89RVU24AR
2024-01-01$311.63$151.38RVU24A
2023-10-01$323.09$156.06RVU23D
2023-07-01$321.59$155.88RVU23C
2023-04-01$321.59$155.88RVU23B
2023-01-01$321.59$155.88RVU23A
2022-10-01$334.17$158.71RVU22D
2022-07-01$334.17$158.71RVU22C
2022-04-01$334.17$158.71RVU22B
2022-01-01$334.17$158.71RVU22A
2021-10-01$333.08$159.33RVU21D
2021-07-01$333.08$159.33RVU21C
2021-04-01$333.08$159.33RVU21B
2021-01-01$333.08$159.33RVU21A
2020-10-01$315.05$163.36RVU20D
2020-07-01$315.05$163.36RVU20C
2020-04-01$315.05$163.36RVU20B
2020-01-01$315.05$163.36RVU20A
2019-10-01$304.62$164.54RVU19D
2019-07-01$304.62$164.54RVU19C
2019-04-01$304.62$164.54RVU19B
2019-01-01$304.62$164.54RVU19A
2018-10-01$298.12$165.80RVU18D
2018-07-01$298.12$165.80RVU18C
2018-04-01$298.12$165.80RVU18B
2018-01-01$298.12$165.80RVU18AR1
2017-10-01$262.97$151.76RVU17D
2017-07-01$262.97$151.76RVU17C
2017-04-01$262.97$151.76RVU17B
2017-01-01$262.97$151.76RVU17A
2016-10-01$276.33$142.79RVU16D
2016-07-01$276.33$142.79RVU16C
2016-04-01$276.33$142.79RVU16B
2016-01-01$276.33$142.79RVU16A
2015-10-01$277.79$144.53RVU15D
2015-07-01$277.79$144.53RVU15C
2015-04-01$276.40$143.81RVU15B
2015-01-01$276.40$143.81RVU15A
2014-10-01$271.78$142.87RVU14D
2014-07-01$271.78$142.87RVU14C
2014-04-01$271.78$142.87RVU14B
2014-01-01$271.78$142.87RVU14A
2013-10-01$277.15$139.20RVU13D
2013-07-01$277.15$139.20RVU13C
2013-04-01$277.15$139.20RVU13B
2013-01-01$277.15$139.20RVU13AR

Price 44388 for an earlier date of service

Where the Puerto Rico rate applies

Puerto Rico is a Medicare payment area, not a city. Our Census mapping connects it to 292 cities and communities in Puerto Rico. Some span more than one payment area; confirm with the service ZIP.

  • Aceitunas
  • Adjuntas
  • Aguada
  • Aguadilla
  • Aguas Buenas
  • Aguas Claras
  • Aguilita
  • Aibonito

Browse all communities in Puerto Rico

44388 billing questions

When should the diagnostic code be replaced by a therapeutic code?

Use a code for the intervention when the endoscopist biopsies tissue, removes a foreign body or lesion, or treats bleeding through the stoma. The diagnostic examination is not separately reported as the defining service for that therapeutic work.

How is this different from colonoscopy through the anus?

This code describes scope access through a stoma. A colonoscopy performed through the anus is coded from the applicable non-stoma colonoscopy family.

Does this code cover examination of an ileal pouch?

No. Pouch endoscopy is reported with the pouch-specific code family, such as 44385, rather than this colonoscopy-through-stoma code.

How should modifier 53 be handled?

CMS lists modifier 53 as separately priced for this code. It identifies a discontinued procedure; the record should explain why the examination was stopped.

What happens 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 multiple-procedure reduction. The code has a 0-day global period, which includes same-day preoperative and postoperative care.

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
RVUs for 44388PPRRVU2026_Oct_nonQPP.csv, line 5,409 (RVU26D)
Geographic factors for Puerto RicoGPCI2026.csv, line 91 (RVU26D)

Open CMS sourceHow we calculate rates

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