CPT code 44389: Colonoscopy, through stoma, with biopsy2026 Medicare rate & RVUs

Medicare pays $457.59 for 44389 nationally in the office and $153.64 in a hospital or facility. Local office rates run $402.32–$615.14.

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

What 44389 covers

Code 44389 describes endoscopic examination of the colon through an existing stoma, with tissue sampling during the procedure. A gastroenterologist or colorectal surgeon may use it to evaluate abnormal mucosa, a suspected neoplasm, or another finding in a patient with a colostomy. The access route is the stoma; a colonoscopy performed through the anus belongs to a different code family.

Report the service when the procedure note documents access through the stoma, the examination performed, and the biopsy site or sites. The code includes the colonoscopy and biopsy, whether one or multiple samples are taken; do not count biopsy sites as separate units. If the endoscopist removes a lesion or treats bleeding, select the code describing that intervention. This minor procedure has a 0-day global period, so same-day preoperative and postoperative care is included. CMS endoscopy-family pricing applies when related endoscopies are performed together. Modifier 50 is inappropriate for this single examination. Medicare does not pay an assistant at surgery, and co-surgeons and team surgery 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 44389 pays more and less

The same RVUs, adjusted for each area’s costs. Open a locality for its calculation, history and nearby areas.

109 of 109 payment localities

44389 rates by state

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

How the 44389 rate is calculated

Each of 44389’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.

Payment rules and modifiers for 44389

The CMS indicators that decide how 44389 is paid alongside other services.

What modifiers do to the payment

When to use modifier 51

44389 compared with similar codes

How to choose

44388ColonoscopyDiagnostic, through stoma

Use 44389 when tissue is sampled during colonoscopy through the stoma. Use 44388 for the stoma examination without biopsy.

45380Colonoscopy with biopsySingle or multiple forceps biopsies

Both include colonoscopy with biopsy, but 44389 is performed through a stoma and 45380 through the anus.

44392Stoma colonoscopyHot biopsy forceps removal

Code 44392 describes removal of a lesion through the stoma using hot biopsy forceps or bipolar cautery; 44389 describes biopsy sampling.

44394Stomal colonoscopySnare lesion removal

Code 44394 describes snare removal of a lesion through the stoma. Use 44389 when the service is biopsy rather than snare excision.

Codes related to 44389

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

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

Open CMS sourceHow we calculate rates