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CPT code 44390: Stomal colonoscopy, foreign body removal2026 Medicare rate & RVUs in Puerto Rico

Reports colonoscopy performed through a stoma to retrieve a foreign object from the colon using an endoscopic instrument.

CMS RVU26DEffective Oct 1, 2026One payment locality25 Medicare services in 2024

In Puerto Rico, Medicare pays $452.49 for 44390 in the office and $186.05 when it’s performed in a hospital or facility.

$452.49Office (non-facility)
$186.05Hospital or facility
+0.7%vs the national office rate ($449.24)

Check a contract rate as a % of Medicare · 44390 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 44390 for the payment locality that covers the ZIP.

On this page 11 sections
  1. Rate in Puerto Rico
  2. What 44390 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 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.

How Puerto Rico compares for 44390

Across 109 of 109 payment localities, the office rate for 44390 runs from $398.38 in Arkansas to $594.92 in San Benito County, CA. Puerto Rico pays $452.49. The RVUs are the same everywhere; the geographic indexes change the dollars.

44390 in Puerto Rico vs other payment areas
  1. Puerto Rico · this page$452.49
  2. Los Angeles, CA · California$507.03+$54.54
  3. Washington, DC area · District of Columbia$513.20+$60.71
  4. Miami, FL · Florida$483.04+$30.55
  5. Chicago, IL · Illinois$469.40+$16.91
  6. Manhattan, NY · New York$515.88+$63.39
  7. Alaska · Alaska$524.44+$71.95

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

Every other payment area

44390 in every other Medicare payment locality
Payment localityOfficeFacility
AlabamaAlabama$404.09$173.50
ArkansasArkansas$398.38$172.00
ArizonaArizona$437.55$182.18
Bakersfield, CACalifornia$476.31$187.48
Chico, CACalifornia$475.07$186.24
El Centro, CACalifornia$475.14$186.31
Fresno, CACalifornia$475.07$186.24
Hanford, CACalifornia$475.07$186.24

44390 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.

$398.38

$535.00

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

View every state and territory as a table
44390 office rate range by state
State / territoryOffice rate rangeLocalities
AK$524.441
AL$404.091
AR$398.381
AZ$437.551
CA$475.07–$594.9229
CO$467.781
CT$478.711
DC$513.201
DE$444.701
FL$442.33–$483.043
GA$418.00–$457.382
GU$486.441
HI$486.441
IA$414.331
ID$416.931
IL$429.67–$469.404
IN$419.311
KS$412.341
KY$413.261
LA$412.60–$432.602
MA$465.04–$513.582
MD$453.10–$513.203
ME$418.97–$441.372
MI$423.72–$447.662
MN$448.701
MO$405.60–$434.223
MS$402.071
MT$449.211
NC$423.281
ND$441.111
NE$416.571
NH$460.391
NJ$484.30–$508.042
NM$425.961
NV$447.271
NY$429.49–$528.065
OH$422.071
OK$412.631
OR$443.92–$482.502
PA$422.77–$466.942
PR$452.491
RI$460.431
SC$423.351
SD$440.151
TN$414.361
TX$420.04–$466.128
UT$429.031
VA$439.88–$513.202
VI$452.491
VT$439.341
WA$464.18–$524.032
WI$426.591
WV$414.061
WY$445.681

See 44390 in every payment locality

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

Office or facility?

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.

The exact Puerto Rico inputs and CMS source lines

PPRRVU2026_Oct_nonQPP.csv

5,412

Code
44390
Physician work
3.65
Practice expense
9.39
Malpractice
0.41

GPCI2026.csv

91

Locality
Puerto Rico
Physician work
1.000
Practice expense
1.011
Malpractice
0.985
Office calculation for 44390 in Puerto Rico
ComponentRVULocality factorAdjusted
Physician work3.65× 1.0003.6500
Practice expense9.39× 1.0119.4933
Malpractice0.41× 0.9850.4038
Total RVUs13.5471
Conversion factor× 33.4009

Office rate, Puerto Rico$452.49

Office: (3.65 × 1 + 9.39 × 1.011 + 0.41 × 0.985) × $33.4009 = $452.49

Facility: (3.65 × 1 + 1.5 × 1.011 + 0.41 × 0.985) × $33.4009 = $186.05

Open 44390 in the RVU calculator

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

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

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%).

When to use modifier 51

Codes related to 44390

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

Codes related to 44390
CodeHow it relatesOffice range, Puerto Rico
Same family
44388Colonoscopy, diagnostic, through stomaColonoscopy through a stoma without the foreign-body removal service.$356.28
44389Colonoscopy, through stoma, with biopsyStomal colonoscopy with biopsy, rather than foreign-body removal.$461.20
44391Colonoscopy through stoma, control of bleedingStomal colonoscopy directed at controlling bleeding.$707.59
44392Stoma colonoscopy, hot biopsy forceps removalStomal colonoscopy with polyp removal by a method other than snare.$435.19
44394Stomal colonoscopy, snare lesion removalStomal colonoscopy with snare removal of a polyp.$487.08
Used instead
45379Colonoscopy, foreign body removalForeign-body removal by colonoscopy through the usual anal route.$482.62

How 44390 has changed in Puerto Rico

44390 · Office / nonfacility

$452.49

Effective 2026-10-01

The base rate is $62.52 higher than on 2025-10-01, moving from $389.97 to $452.49 (16.0%).

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

    $389.97changed to$452.49

    • Conversion factor 32.3465 changed to 33.4009
    • Work RVU 3.74 changed to 3.65
    • Practice expense RVU 7.80 changed to 9.39
    • Malpractice RVU 0.47 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

    $405.03changed to$389.97

    • Conversion factor 33.2875 changed to 32.3465
    • Practice expense RVU 7.94 changed to 7.80
    • Malpractice RVU 0.44 changed to 0.47

    Held through RVU25B, RVU25C, RVU25D.

  3. March 9, 2024

    RVU24AR

    $398.42changed to$405.03

    • Conversion factor 32.7442 changed to 33.2875

    Held through RVU24B, RVU24C, RVU24D.

  4. January 1, 2024

    RVU24A

    $413.31changed to$398.42

    • Conversion factor 33.8872 changed to 32.7442
    • Practice expense RVU 7.96 changed to 7.94
    • Practice expense GPCI 1.008 changed to 1.007
    • Malpractice GPCI 0.984 changed to 0.982

  5. October 1, 2023

    RVU23D

    $411.39changed to$413.31

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

  6. January 1, 2023

    RVU23A

    $427.72changed to$411.39

    • Conversion factor 34.6062 changed to 33.8872
    • Practice expense RVU 8.16 changed to 7.96
    • Malpractice RVU 0.40 changed to 0.44
    • 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

    $427.74changed to$427.72

    • Conversion factor 34.8931 changed to 34.6062
    • Practice expense RVU 8.05 changed to 8.16
    • Malpractice RVU 0.41 changed to 0.40

    Held through RVU22B, RVU22C, RVU22D.

  8. January 1, 2021

    RVU21A

    $406.80changed to$427.74

    • Conversion factor 36.0896 changed to 34.8931
    • Practice expense RVU 7.08 changed to 8.05
    • Malpractice RVU 0.40 changed to 0.41
    • Malpractice GPCI 0.988 changed to 0.986

    Held through RVU21B, RVU21C, RVU21D.

  9. January 1, 2020

    RVU20A

    $396.52changed to$406.80

    • Conversion factor 36.0391 changed to 36.0896
    • Practice expense RVU 6.74 changed to 7.08
    • Malpractice RVU 0.48 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

    $388.46changed to$396.52

    • Conversion factor 35.9996 changed to 36.0391
    • Practice expense RVU 6.52 changed to 6.74
    • Malpractice RVU 0.49 changed to 0.48

    Held through RVU19B, RVU19C, RVU19D.

  11. January 1, 2018

    RVU18AR1

    $342.82changed to$388.46

    • Conversion factor 35.8887 changed to 35.9996
    • Practice expense RVU 6.43 changed to 6.52
    • Malpractice RVU 0.48 changed to 0.49
    • 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

    $351.74changed to$342.82

    • Conversion factor 35.8043 changed to 35.8887
    • Work RVU 3.84 changed to 3.74
    • Practice expense RVU 8.28 changed to 6.43
    • Malpractice RVU 0.50 changed to 0.48
    • 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

    $367.00changed to$351.74

    • Conversion factor 35.9335 changed to 35.8043
    • Work RVU 3.82 changed to 3.84
    • Practice expense RVU 8.84 changed to 8.28
    • Malpractice RVU 0.55 changed to 0.50

    Held through RVU16B, RVU16C, RVU16D.

  14. July 1, 2015

    RVU15C

    $365.18changed to$367.00

    • Conversion factor 35.7547 changed to 35.9335

    Held through RVU15D.

  15. January 1, 2015

    RVU15A

    $358.74changed to$365.18

    • Conversion factor 35.8228 changed to 35.7547
    • Practice expense RVU 8.74 changed to 8.84
    • Malpractice RVU 0.54 changed to 0.55
    • 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

    $370.23changed to$358.74

    • Conversion factor 34.0230 changed to 35.8228
    • Practice expense RVU 10.21 changed to 8.74
    • Malpractice RVU 0.56 changed to 0.54
    • 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: $370.23

    Held through RVU13B, RVU13C, RVU13D.

Rates in every CMS release
Effective fromOfficeFacilityCMS release
2026-10-01$452.49$186.05RVU26D
2026-07-01$452.49$186.05RVU26C
2026-04-01$452.49$186.05RVU26B
2026-01-01$452.49$186.05RVU26A
2025-10-01$389.97$202.03RVU25D
2025-07-01$389.97$202.03RVU25C
2025-04-01$389.97$202.03RVU25B
2025-01-01$389.97$202.03RVU25A
2024-10-01$405.03$206.59RVU24D
2024-07-01$405.03$206.59RVU24C
2024-04-01$405.03$206.59RVU24B
2024-03-09$405.03$206.59RVU24AR
2024-01-01$398.42$203.22RVU24A
2023-10-01$413.31$209.38RVU23D
2023-07-01$411.39$209.08RVU23C
2023-04-01$411.39$209.08RVU23B
2023-01-01$411.39$209.08RVU23A
2022-10-01$427.72$212.49RVU22D
2022-07-01$427.72$212.49RVU22C
2022-04-01$427.72$212.49RVU22B
2022-01-01$427.72$212.49RVU22A
2021-10-01$427.74$213.90RVU21D
2021-07-01$427.74$213.90RVU21C
2021-04-01$427.74$213.90RVU21B
2021-01-01$427.74$213.90RVU21A
2020-10-01$406.80$219.45RVU20D
2020-07-01$406.80$219.45RVU20C
2020-04-01$406.80$219.45RVU20B
2020-01-01$406.80$219.45RVU20A
2019-10-01$396.52$222.68RVU19D
2019-07-01$396.52$222.68RVU19C
2019-04-01$396.52$222.68RVU19B
2019-01-01$396.52$222.68RVU19A
2018-10-01$388.46$223.88RVU18D
2018-07-01$388.46$223.88RVU18C
2018-04-01$388.46$223.88RVU18B
2018-01-01$388.46$223.88RVU18AR1
2017-10-01$342.82$206.11RVU17D
2017-07-01$342.82$206.11RVU17C
2017-04-01$342.82$206.11RVU17B
2017-01-01$342.82$206.11RVU17A
2016-10-01$351.74$193.22RVU16D
2016-07-01$351.74$193.22RVU16C
2016-04-01$351.74$193.22RVU16B
2016-01-01$351.74$193.22RVU16A
2015-10-01$367.00$195.75RVU15D
2015-07-01$367.00$195.75RVU15C
2015-04-01$365.18$194.78RVU15B
2015-01-01$365.18$194.78RVU15A
2014-10-01$358.74$193.65RVU14D
2014-07-01$358.74$193.65RVU14C
2014-04-01$358.74$193.65RVU14B
2014-01-01$358.74$193.65RVU14A
2013-10-01$370.23$190.07RVU13D
2013-07-01$370.23$190.07RVU13C
2013-04-01$370.23$190.07RVU13B
2013-01-01$370.23$190.07RVU13AR

Price 44390 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

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

Show the CMS file lines behind this rate
RVUs for 44390PPRRVU2026_Oct_nonQPP.csv, line 5,412 (RVU26D)
Geographic factors for Puerto RicoGPCI2026.csv, line 91 (RVU26D)

Open CMS sourceHow we calculate rates

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