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

Reports examination of the colon through a stoma when the endoscopist takes one or more tissue samples during the procedure.

CMS RVU26DEffective Oct 1, 2026One payment locality2.5K Medicare services in 2024

In Houston, TX, Medicare pays $460.98 for 44389 in the office and $159.16 when it’s performed in a hospital or facility.

$460.98Office (non-facility)
$159.16Hospital or facility
+0.7%vs the national office rate ($457.59)

Check a contract rate as a % of Medicare · 44389 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 44389 for the payment locality that covers the ZIP.

On this page 11 sections
  1. Rate in Houston, TX
  2. What 44389 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 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.

How Houston, TX compares for 44389

Across 109 of 109 payment localities, the office rate for 44389 runs from $402.32 in Arkansas to $615.14 in San Benito County, CA. Houston, TX pays $460.98. The RVUs are the same everywhere; the geographic indexes change the dollars.

44389 in Houston, TX vs other payment areas
  1. Houston, TX · this page$460.98
  2. Austin, TX · Texas$476.34+$15.36
  3. Beaumont, TX · Texas$425.50−$35.48
  4. Brazoria, TX · Texas$452.32−$8.66
  5. Dallas, TX · Texas$455.19−$5.79
  6. Fort Worth, TX · Texas$451.91−$9.07
  7. Galveston, TX · Texas$453.66−$7.32

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

Every other payment area

44389 in every other Medicare payment locality
Payment localityOfficeFacility
Rest of TexasTexas$438.65$150.20
Los Angeles, CACalifornia$520.45$160.88
Washington, DC areaDistrict of Columbia$526.00$167.95
Miami, FLFlorida$492.21$175.80
Chicago, ILIllinois$477.31$171.84
Manhattan, NYNew York$527.76$174.58
AlaskaAlaska$523.19$199.48
AlabamaAlabama$408.54$142.59

44389 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.

$402.32

$550.71

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

View every state and territory as a table
44389 office rate range by state
State / territoryOffice rate rangeLocalities
AK$523.191
AL$408.541
AR$402.321
AZ$444.941
CA$486.28–$615.1429
CO$477.991
CT$489.011
DC$526.001
DE$452.581
FL$449.09–$492.213
GA$422.79–$466.112
GU$499.371
HI$499.371
IA$420.121
ID$422.871
IL$435.01–$477.944
IN$425.461
KS$417.751
KY$418.051
LA$417.24–$438.992
MA$474.79–$527.282
MD$461.63–$526.003
ME$424.86–$449.552
MI$429.21–$454.652
MN$458.221
MO$409.49–$441.013
MS$406.011
MT$457.571
NC$429.591
ND$449.661
NE$422.641
NH$470.111
NJ$494.65–$520.052
NM$431.561
NV$455.711
NY$436.32–$540.735
OH$427.591
OK$417.591
OR$452.24–$494.152
PA$428.48–$476.132
PR$461.201
RI$469.431
SC$429.291
SD$448.721
TN$419.921
TX$425.50–$476.348
UT$435.471
VA$447.78–$526.002
VI$461.201
VT$447.531
WA$474.02–$538.612
WI$433.811
WV$418.021
WY$454.121

See 44389 in every payment locality

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.

How the rate is built · 44389

RVUs × geographic indexes × conversion factor

Office or facility?

Work2.94

2.94 RVUs× 1.000 GPCI

Practice expense10.36

10.36 RVUs× 1.000 GPCI

Malpractice0.40

0.40 RVUs× 1.000 GPCI

Adjusted RVUs

13.7000

Conversion factor

$33.4009

Medicare rate

$457.59

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

The exact Houston, TX inputs and CMS source lines

PPRRVU2026_Oct_nonQPP.csv

5,411

Code
44389
Physician work
2.94
Practice expense
10.36
Malpractice
0.40

GPCI2026.csv

102

Locality
Houston, TX
Physician work
1.008
Practice expense
0.993
Malpractice
1.376
Office calculation for 44389 in Houston, TX
ComponentRVULocality factorAdjusted
Physician work2.94× 1.0082.9635
Practice expense10.36× 0.99310.2875
Malpractice0.40× 1.3760.5504
Total RVUs13.8014
Conversion factor× 33.4009

Office rate, Houston, TX$460.98

Office: (2.94 × 1.008 + 10.36 × 0.993 + 0.4 × 1.376) × $33.4009 = $460.98

Facility: (2.94 × 1.008 + 1.26 × 0.993 + 0.4 × 1.376) × $33.4009 = $159.16

Open 44389 in the RVU calculator

Payment rules and modifiers for 44389

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

CMS payment indicators · 44389

Colonoscopy, through stoma, with biopsy

RuleCMS valueWhat it means
Global period000Same-day global: pre- and post-op care on the day of the procedure is included.
Multiple procedures3Endoscopy family rules apply.
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

44389 without 51 · national office

$457.59

Colonoscopy, through stoma, with biopsy

44389-51 · Second procedure: 50%

$228.80

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 44389

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

Codes related to 44389
CodeHow it relatesOffice range, Houston, TX
Same family
44388Colonoscopy, diagnostic, through stomaStoma colonoscopy without the biopsy service described by 44389.$357.81
44391Colonoscopy through stoma, control of bleedingStoma colonoscopy for treatment of bleeding.$704.87
44392Stoma colonoscopy, hot biopsy forceps removalStoma colonoscopy with lesion removal by hot biopsy forceps or bipolar cautery.$438.45
44394Stomal colonoscopy, snare lesion removalStoma colonoscopy with lesion removal by snare technique.$488.75
Used instead
45380Colonoscopy with biopsy, single or multiple forceps biopsiesColonoscopy with biopsy through the anus rather than through a stoma.$483.72

How 44389 has changed in Houston, TX

44389 · Office / nonfacility

$460.98

Effective 2026-10-01

The base rate is $60.20 higher than on 2025-10-01, moving from $400.78 to $460.98 (15.0%).

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

    $400.78changed to$460.98

    • Conversion factor 32.3465 changed to 33.4009
    • Work RVU 3.02 changed to 2.94
    • Practice expense RVU 8.71 changed to 10.36
    • Malpractice RVU 0.42 changed to 0.40
    • Work GPCI 1.014 changed to 1.008
    • Practice expense GPCI 1.003 changed to 0.993
    • Malpractice GPCI 1.409 changed to 1.376

    Held through RVU26B, RVU26C, RVU26D.

  2. January 1, 2025

    RVU25A

    $418.18changed to$400.78

    • Conversion factor 33.2875 changed to 32.3465
    • Practice expense RVU 8.91 changed to 8.71
    • Malpractice RVU 0.40 changed to 0.42

    Held through RVU25B, RVU25C, RVU25D.

  3. March 9, 2024

    RVU24AR

    $411.35changed to$418.18

    • Conversion factor 32.7442 changed to 33.2875

    Held through RVU24B, RVU24C, RVU24D.

  4. January 1, 2024

    RVU24A

    $429.56changed to$411.35

    • Conversion factor 33.8872 changed to 32.7442
    • Practice expense RVU 8.97 changed to 8.91
    • Malpractice RVU 0.41 changed to 0.40
    • Work GPCI 1.023 changed to 1.014
    • Practice expense GPCI 1.016 changed to 1.003
    • Malpractice GPCI 1.154 changed to 1.409

  5. January 1, 2023

    RVU23A

    $448.32changed to$429.56

    • Conversion factor 34.6062 changed to 33.8872
    • Practice expense RVU 9.22 changed to 8.97
    • Malpractice RVU 0.39 changed to 0.41
    • Work GPCI 1.032 changed to 1.023
    • Practice expense GPCI 1.029 changed to 1.016
    • Malpractice GPCI 0.900 changed to 1.154

    Held through RVU23B, RVU23C, RVU23D.

  6. January 1, 2022

    RVU22A

    $448.50changed to$448.32

    • Conversion factor 34.8931 changed to 34.6062
    • Practice expense RVU 9.13 changed to 9.22
    • Malpractice RVU 0.38 changed to 0.39

    Held through RVU22B, RVU22C, RVU22D.

  7. January 1, 2021

    RVU21A

    $420.34changed to$448.50

    • Conversion factor 36.0896 changed to 34.8931
    • Practice expense RVU 8.03 changed to 9.13
    • Malpractice RVU 0.39 changed to 0.38
    • Work GPCI 1.026 changed to 1.032
    • Practice expense GPCI 1.020 changed to 1.029
    • Malpractice GPCI 0.918 changed to 0.900

    Held through RVU21B, RVU21C, RVU21D.

  8. January 1, 2020

    RVU20A

    $403.80changed to$420.34

    • Conversion factor 36.0391 changed to 36.0896
    • Practice expense RVU 7.63 changed to 8.03
    • Malpractice RVU 0.43 changed to 0.39
    • Work GPCI 1.020 changed to 1.026
    • Practice expense GPCI 1.012 changed to 1.020
    • Malpractice GPCI 0.936 changed to 0.918

    Held through RVU20B, RVU20C, RVU20D.

  9. January 1, 2019

    RVU19A

    $394.22changed to$403.80

    • Conversion factor 35.9996 changed to 36.0391
    • Practice expense RVU 7.37 changed to 7.63
    • Malpractice RVU 0.44 changed to 0.43

    Held through RVU19B, RVU19C, RVU19D.

  10. January 1, 2018

    RVU18AR1

    $389.84changed to$394.22

    • Conversion factor 35.8887 changed to 35.9996
    • Practice expense RVU 7.30 changed to 7.37
    • Practice expense GPCI 1.009 changed to 1.012
    • Malpractice GPCI 0.946 changed to 0.936

    Held through RVU18B, RVU18C, RVU18D.

  11. January 1, 2017

    RVU17A

    $455.91changed to$389.84

    • Conversion factor 35.8043 changed to 35.8887
    • Work RVU 3.12 changed to 3.02
    • Practice expense RVU 9.07 changed to 7.30
    • Malpractice RVU 0.45 changed to 0.44
    • Work GPCI 1.019 changed to 1.020
    • Practice expense GPCI 1.006 changed to 1.009
    • Malpractice GPCI 0.955 changed to 0.946

    Held through RVU17B, RVU17C, RVU17D.

  12. January 1, 2016

    RVU16A

    $407.98changed to$455.91

    • Conversion factor 35.9335 changed to 35.8043
    • Work RVU 3.13 changed to 3.12
    • Practice expense RVU 7.66 changed to 9.07
    • Malpractice RVU 0.48 changed to 0.45

    Held through RVU16B, RVU16C, RVU16D.

  13. July 1, 2015

    RVU15C

    $405.95changed to$407.98

    • Conversion factor 35.7547 changed to 35.9335

    Held through RVU15D.

  14. January 1, 2015

    RVU15A

    $403.21changed to$405.95

    • Conversion factor 35.8228 changed to 35.7547
    • Practice expense RVU 7.61 changed to 7.66
    • Malpractice RVU 0.47 changed to 0.48
    • Work GPCI 1.014 changed to 1.019
    • Practice expense GPCI 1.004 changed to 1.006
    • Malpractice GPCI 0.939 changed to 0.955

    Held through RVU15B.

  15. January 1, 2014

    RVU14A

    $421.48changed to$403.21

    • Conversion factor 34.0230 changed to 35.8228
    • Practice expense RVU 8.76 changed to 7.61
    • Malpractice RVU 0.49 changed to 0.47
    • Work GPCI 1.009 changed to 1.014
    • Practice expense GPCI 1.002 changed to 1.004
    • Malpractice GPCI 0.923 changed to 0.939

    Held through RVU14B, RVU14C, RVU14D.

  16. January 1, 2013

    RVU13AR

    Earliest loaded release: $421.48

    Held through RVU13B, RVU13C, RVU13D.

Rates in every CMS release
Effective fromOfficeFacilityCMS release
2026-10-01$460.98$159.16RVU26D
2026-07-01$460.98$159.16RVU26C
2026-04-01$460.98$159.16RVU26B
2026-01-01$460.98$159.16RVU26A
2025-10-01$400.78$172.05RVU25D
2025-07-01$400.78$172.05RVU25C
2025-04-01$400.78$172.05RVU25B
2025-01-01$400.78$172.05RVU25A
2024-10-01$418.18$175.79RVU24D
2024-07-01$418.18$175.79RVU24C
2024-04-01$418.18$175.79RVU24B
2024-03-09$418.18$175.79RVU24AR
2024-01-01$411.35$172.92RVU24A
2023-10-01$429.56$176.50RVU23D
2023-07-01$429.56$176.50RVU23C
2023-04-01$429.56$176.50RVU23B
2023-01-01$429.56$176.50RVU23A
2022-10-01$448.32$177.69RVU22D
2022-07-01$448.32$177.69RVU22C
2022-04-01$448.32$177.69RVU22B
2022-01-01$448.32$177.69RVU22A
2021-10-01$448.50$178.49RVU21D
2021-07-01$448.50$178.49RVU21C
2021-04-01$448.50$178.49RVU21B
2021-01-01$448.50$178.49RVU21A
2020-10-01$420.34$182.17RVU20D
2020-07-01$420.34$182.17RVU20C
2020-04-01$420.34$182.17RVU20B
2020-01-01$420.34$182.17RVU20A
2019-10-01$403.80$182.78RVU19D
2019-07-01$403.80$182.78RVU19C
2019-04-01$403.80$182.78RVU19B
2019-01-01$403.80$182.78RVU19A
2018-10-01$394.22$184.01RVU18D
2018-07-01$394.22$184.01RVU18C
2018-04-01$394.22$184.01RVU18B
2018-01-01$394.22$184.01RVU18AR1
2017-10-01$389.84$183.07RVU17D
2017-07-01$389.84$183.07RVU17C
2017-04-01$389.84$183.07RVU17B
2017-01-01$389.84$183.07RVU17A
2016-10-01$455.91$187.93RVU16D
2016-07-01$455.91$187.93RVU16C
2016-04-01$455.91$187.93RVU16B
2016-01-01$455.91$187.93RVU16A
2015-10-01$407.98$192.17RVU15D
2015-07-01$407.98$192.17RVU15C
2015-04-01$405.95$191.22RVU15B
2015-01-01$405.95$191.22RVU15A
2014-10-01$403.21$190.29RVU14D
2014-07-01$403.21$190.29RVU14C
2014-04-01$403.21$190.29RVU14B
2014-01-01$403.21$190.29RVU14A
2013-10-01$421.48$188.29RVU13D
2013-07-01$421.48$188.29RVU13C
2013-04-01$421.48$188.29RVU13B
2013-01-01$421.48$188.29RVU13AR

Price 44389 for an earlier date of service

Where the Houston, TX rate applies

Houston, TX is a Medicare payment area, not a city. Our Census mapping connects it to 46 cities and communities in Texas. Some span more than one payment area; confirm with the service ZIP.

Browse all communities in Texas

44389 billing questions

How does 44389 differ from 45380?

Code 44389 is for colonoscopy performed through a stoma. Code 45380 describes colonoscopy with biopsy through the usual anal route.

Do multiple biopsy sites create multiple units?

No. The code covers the examination with one or more biopsies; the number of sites or specimens does not create additional units.

Can the diagnostic stoma colonoscopy be billed separately?

The examination is included in 44389 when biopsy is performed during it. Do not separately report a diagnostic colonoscopy for that same examination.

Which code should be used if a lesion is removed?

Use the stoma-colonoscopy code that describes the removal technique, such as 44392 or 44394, rather than coding biopsy alone for the removal.

Can modifier 50 or an assistant-at-surgery claim be reported?

Modifier 50 is inappropriate for this single stoma examination. Medicare does not pay an assistant at surgery for 44389.

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 44389PPRRVU2026_Oct_nonQPP.csv, line 5,411 (RVU26D)
Geographic factors for Houston, TXGPCI2026.csv, line 102 (RVU26D)

Open CMS sourceHow we calculate rates

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