CPT code 44390: Stomal colonoscopy, foreign body removal2026 Medicare rate & RVUs in Missouri
Reports colonoscopy performed through a stoma to retrieve a foreign object from the colon using an endoscopic instrument.
Medicare pays $405.60–$434.22 for 44390 in the office in Missouri, from Rest of Missouri to Metropolitan St. Louis, MO. Which amount applies depends on the service address.
Medicare allowed amount for participating (non-QP) physicians, before deductible, coinsurance and claim adjustments. Not a patient’s bill or a hospital charge.
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What 44390 covers
A gastroenterologist or colorectal surgeon uses a colonoscope passed through a colostomy stoma to locate and retrieve a foreign object in the colon. The service is typically performed in an endoscopy suite or hospital procedure setting when the object can be reached and removed endoscopically. The operative report should identify the route through the stoma, the foreign object, its location, and the retrieval performed.
Choose this code for endoscopic foreign-body removal through a stoma, rather than a diagnostic examination alone or treatment directed at a polyp, bleeding site, or tissue sample. CMS assigns a 0-day global period, so same-day preoperative and postoperative care is included. When related endoscopies are performed together, endoscopy family pricing applies. Modifier 50 is inappropriate for this anatomy. Medicare does not pay for an assistant at surgery; 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 44390 pays more and less in Missouri
The same RVUs, adjusted for each area’s costs. Open a locality for its calculation, history and nearby areas.
3 payment localities
$405.60 to $434.22
| Payment locality | Office | Facility |
|---|---|---|
| Metropolitan Kansas City, MO | $429.80 | $182.34 |
| Metropolitan St. Louis, MO | $434.22 | $183.33 |
| Rest of Missouri | $405.60 | $178.44 |
How the 44390 rate is calculated
Each of 44390’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 · 44390
RVUs × geographic indexes × conversion factor
Work3.65
3.65 RVUs× 1.000 GPCI
Practice expense9.39
9.39 RVUs× 1.000 GPCI
Malpractice0.41
0.41 RVUs× 1.000 GPCI
Adjusted RVUs
13.4500
Conversion factor
$33.4009
Medicare rate
$449.24
Every GPCI starts at 1.000, the national rate. Enter a ZIP or drag a slider.
Payment rules and modifiers for 44390
The CMS indicators that decide how 44390 is paid alongside other services.
CMS payment indicators · 44390
Stomal colonoscopy, foreign body removal
| Rule | CMS value | What it means |
|---|---|---|
| Global period | 000 | Same-day global: pre- and post-op care on the day of the procedure is included. |
| Multiple procedures | 3 | Endoscopy family rules apply. |
| Bilateral (modifier 50) | 0 | The 150% bilateral adjustment doesn’t apply. |
| Assistant at surgery (80/81/82/AS) | 1 | Not paid (statutory restriction). |
| Co-surgeons (62) | 0 | Not permitted. |
| Team surgery (66) | 0 | Not permitted. |
| Professional/technical | 0 | Physician service: no professional/technical split. |
What modifiers do to the payment
Modifier 51 · payment effect
With and without the modifier
44390 without 51 · national office
$449.24
Stomal colonoscopy, foreign body removal
44390-51 · Second procedure: 50%
$224.62
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%).
44390 compared with similar codes
Compare codes · National
5 codes, side by side
How to choose
- 45379ColonoscopyForeign body removal
- Use 44390 when the colonoscope passes through a stoma; use 45379 for foreign-body removal by the usual anal route.
- 44388ColonoscopyDiagnostic, through stoma
- Code 44388 describes colonoscopy through a stoma without the foreign-body removal service. Choose 44390 when endoscopic retrieval is performed.
- 44391Colonoscopy through stomaControl of bleeding
- Code 44391 is for endoscopic control of bleeding through a stoma. Code 44390 is for retrieval of a foreign object.
- 44394Stomal colonoscopySnare lesion removal
- Code 44394 describes snare removal of a polyp through a stoma; 44390 identifies foreign-body removal.
44390 billing questions
How does this differ from code 45379?
Code 44390 describes foreign-body removal by colonoscopy through a stoma. Code 45379 is the corresponding foreign-body removal service through the usual anal route.
Can this code be used for a diagnostic examination through the stoma?
No. Use 44390 when the colonoscopy through the stoma includes endoscopic foreign-body removal. A diagnostic examination without that treatment is represented by a different code.
Is removal of a polyp or control of bleeding included?
This code is for foreign-body removal, not polypectomy or treatment of a bleeding site. Report the code matching the therapeutic service actually performed.
How should same-day related endoscopies be handled?
When related endoscopies are performed together, CMS endoscopy family pricing applies. The operative documentation should support each service and its distinct purpose.
Can modifier 50 or an assistant-at-surgery claim be reported?
Modifier 50 is inappropriate for this stoma-based service. Medicare does not pay an assistant at surgery for this code.
What documentation supports reporting 44390?
Document that the colonoscope entered through the stoma, the foreign object and its location, and the endoscopic retrieval 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
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