CPT code 44391: Colonoscopy through stoma, control of bleeding2026 Medicare rate & RVUs in Montana
Reports colonoscopy performed through a stoma to locate and treat a bleeding site using an endoscopic hemostasis method.
In Montana, Medicare pays $701.72 for 44391 in the office and $203.05 when it’s performed in a hospital or facility.
Check a contract rate as a % of Medicare · 44391 nationwide
Medicare allowed amount for participating (non-QP) physicians, before deductible, coinsurance and claim adjustments. Not a patient’s bill or a hospital charge.
On this page 11 sections
What 44391 covers
A gastroenterologist or surgeon advances a colonoscope through a colostomy or other stoma to examine the colon and control active bleeding. The service includes endoscopic hemostasis, such as treatment of a bleeding lesion identified during the examination. It is typically performed in a hospital or ambulatory endoscopy facility when a patient with a stoma has gastrointestinal bleeding requiring endoscopic treatment.
Report this code when the colonoscopy reaches the colon through the stoma and bleeding is treated; documentation should identify the route, the bleeding site or source when found, and the hemostasis performed. It is not the code for a routine examination through a stoma or for treatment of a polyp instead of bleeding. 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. CMS 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 Montana compares for 44391
Across 109 of 109 payment localities, the office rate for 44391 runs from $616.34 in Arkansas to $953.13 in San Benito County, CA. Montana pays $701.72. The RVUs are the same everywhere; the geographic indexes change the dollars.
- Montana · this page$701.72
- Los Angeles, CA · California$802.96+$101.24
- Washington, DC area · District of Columbia$808.99+$107.27
- Miami, FL · Florida$748.38+$46.66
- Chicago, IL · Illinois$725.78+$24.06
- Manhattan, NY · New York$808.93+$107.21
- Alaska · Alaska$797.71+$95.99
Other areas in Montana first, then benchmark localities. Bars start at $0.
Every other payment area
| Payment locality | Office | Facility |
|---|---|---|
| AlabamaAlabama | $625.97 | $189.63 |
| ArkansasArkansas | $616.34 | $187.98 |
| ArizonaArizona | $682.39 | $199.17 |
| Bakersfield, CACalifornia | $751.14 | $204.59 |
| Chico, CACalifornia | $749.72 | $203.17 |
| El Centro, CACalifornia | $749.80 | $203.25 |
| Fresno, CACalifornia | $749.72 | $203.17 |
| Hanford, CACalifornia | $749.72 | $203.17 |
| Madera, CACalifornia | $749.72 | $203.17 |
| Merced, CACalifornia | $749.72 | $203.17 |
| Modesto, CACalifornia | $749.72 | $203.17 |
| Napa, CACalifornia | $877.96 | $220.70 |
| Oxnard, CACalifornia | $800.02 | $210.58 |
| Redding, CACalifornia | $749.72 | $203.17 |
| Rest of CaliforniaCalifornia | $749.72 | $203.17 |
| Riverside, CACalifornia | $754.83 | $208.29 |
| Sacramento, CACalifornia | $789.24 | $209.28 |
| Salinas, CACalifornia | $786.36 | $208.40 |
| San Diego, CACalifornia | $806.74 | $210.32 |
| Marin County, CACalifornia | $932.25 | $229.11 |
| San Francisco, CACalifornia | $931.71 | $228.58 |
| San Benito County, CACalifornia | $953.13 | $234.04 |
| Santa Clara County, CACalifornia | $950.94 | $231.85 |
| San Luis Obispo, CACalifornia | $773.45 | $205.46 |
| Santa Cruz, CACalifornia | $815.92 | $210.03 |
| Santa Maria, CACalifornia | $789.82 | $208.37 |
| Santa Rosa, CACalifornia | $824.30 | $211.93 |
| Stockton, CACalifornia | $749.72 | $203.17 |
| Vallejo, CACalifornia | $877.19 | $219.93 |
| Visalia, CACalifornia | $749.72 | $203.17 |
| Yuba City, CACalifornia | $749.72 | $203.17 |
| ColoradoColorado | $735.24 | $204.65 |
| ConnecticutConnecticut | $750.22 | $213.15 |
| DelawareDelaware | $694.22 | $201.53 |
| Fort Lauderdale, FLFlorida | $721.61 | $216.45 |
| Rest of FloridaFlorida | $685.37 | $208.64 |
| Atlanta, GAGeorgia | $714.14 | $207.49 |
| Rest of GeorgiaGeorgia | $645.17 | $200.36 |
| Hawaii, Guam, HIHawaii | $770.74 | $203.74 |
| IowaIowa | $645.39 | $189.10 |
| IdahoIdaho | $649.34 | $190.56 |
| East St. Louis, ILIllinois | $673.53 | $214.75 |
| Rest of IllinoisIllinois | $662.59 | $207.30 |
| Suburban Chicago, ILIllinois | $729.71 | $217.57 |
| IndianaIndiana | $653.40 | $191.13 |
| KansasKansas | $641.00 | $190.19 |
| KentuckyKentucky | $639.17 | $195.85 |
| New Orleans, LALouisiana | $671.33 | $202.08 |
| Rest of LouisianaLouisiana | $637.64 | $196.31 |
| Metropolitan Boston, MAMassachusetts | $812.58 | $217.16 |
| Rest of MassachusettsMassachusetts | $729.96 | $204.85 |
| Baltimore area, MDMaryland | $747.90 | $212.82 |
| Rest of MarylandMaryland | $708.43 | $203.77 |
| Rest of MaineMaine | $651.68 | $192.89 |
| Southern Maine, MEMaine | $690.99 | $196.81 |
| Detroit, MIMichigan | $693.21 | $211.99 |
| Rest of MichiganMichigan | $655.77 | $200.48 |
| MinnesotaMinnesota | $706.70 | $193.57 |
| Metropolitan Kansas City, MOMissouri | $667.73 | $199.48 |
| Metropolitan St. Louis, MOMissouri | $675.30 | $200.56 |
| Rest of MissouriMissouri | $625.20 | $195.34 |
| MississippiMississippi | $620.96 | $191.60 |
| North CarolinaNorth Carolina | $659.12 | $193.85 |
| North DakotaNorth Dakota | $692.43 | $193.75 |
| NebraskaNebraska | $649.50 | $189.22 |
| New HampshireNew Hampshire | $722.41 | $203.29 |
| Northern New JerseyNew Jersey | $799.56 | $221.10 |
| Rest of New JerseyNew Jersey | $759.41 | $214.86 |
| New MexicoNew Mexico | $659.11 | $201.82 |
| NevadaNevada | $699.68 | $200.51 |
| NYC suburbs and Long Island, NYNew York | $828.09 | $235.16 |
| Poughkeepsie and northern NYC suburbs, NYNew York | $763.51 | $217.46 |
| Queens, NYNew York | $817.71 | $228.28 |
| Rest of New YorkNew York | $669.50 | $195.76 |
| OhioOhio | $653.87 | $198.58 |
| OklahomaOklahoma | $639.21 | $193.89 |
| Portland, OROregon | $761.13 | $207.10 |
| Rest of OregonOregon | $694.88 | $198.20 |
| Metropolitan Philadelphia, PAPennsylvania | $729.82 | $210.70 |
| Rest of PennsylvaniaPennsylvania | $655.64 | $197.86 |
| Puerto RicoPuerto Rico | $707.59 | $203.43 |
| Rhode IslandRhode Island | $720.82 | $205.69 |
| South CarolinaSouth Carolina | $657.46 | $196.69 |
| South DakotaSouth Dakota | $691.33 | $192.65 |
| TennesseeTennessee | $644.27 | $190.98 |
| Austin, TXTexas | $732.24 | $204.64 |
| Beaumont, TXTexas | $650.98 | $197.18 |
| Brazoria, TXTexas | $694.41 | $200.22 |
| Dallas, TXTexas | $698.53 | $201.84 |
| Fort Worth, TXTexas | $693.21 | $201.52 |
| Galveston, TXTexas | $696.26 | $201.08 |
| Houston, TXTexas | $704.87 | $209.68 |
| Rest of TexasTexas | $672.09 | $198.85 |
| UtahUtah | $667.04 | $198.29 |
| VirginiaVirginia | $687.76 | $197.56 |
| Virgin Islands, VIUnited States Virgin Islands | $707.59 | $203.43 |
| VermontVermont | $688.48 | $194.79 |
| Rest of WashingtonWashington | $728.99 | $203.89 |
| King County, WAWashington | $830.85 | $218.97 |
| WisconsinWisconsin | $667.71 | $189.98 |
| West VirginiaWest Virginia | $636.24 | $202.89 |
| WyomingWyoming | $697.67 | $199.00 |
44391 rates by state
Office rate range in each state. Select a state to see its payment localities.
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.
$616.34
$851.43
Color shows the midpoint of each state’s locality range.
View every state and territory as a table
| State / territory | Office rate range | Localities |
|---|---|---|
| AK | $797.71 | 1 |
| AL | $625.97 | 1 |
| AR | $616.34 | 1 |
| AZ | $682.39 | 1 |
| CA | $749.72–$953.13 | 29 |
| CO | $735.24 | 1 |
| CT | $750.22 | 1 |
| DC | $808.99 | 1 |
| DE | $694.22 | 1 |
| FL | $685.37–$748.38 | 3 |
| GA | $645.17–$714.14 | 2 |
| GU | $770.74 | 1 |
| HI | $770.74 | 1 |
| IA | $645.39 | 1 |
| ID | $649.34 | 1 |
| IL | $662.59–$729.71 | 4 |
| IN | $653.40 | 1 |
| KS | $641.00 | 1 |
| KY | $639.17 | 1 |
| LA | $637.64–$671.33 | 2 |
| MA | $729.96–$812.58 | 2 |
| MD | $708.43–$808.99 | 3 |
| ME | $651.68–$690.99 | 2 |
| MI | $655.77–$693.21 | 2 |
| MN | $706.70 | 1 |
| MO | $625.20–$675.30 | 3 |
| MS | $620.96 | 1 |
| MT | $701.72 | 1 |
| NC | $659.12 | 1 |
| ND | $692.43 | 1 |
| NE | $649.50 | 1 |
| NH | $722.41 | 1 |
| NJ | $759.41–$799.56 | 2 |
| NM | $659.11 | 1 |
| NV | $699.68 | 1 |
| NY | $669.50–$828.09 | 5 |
| OH | $653.87 | 1 |
| OK | $639.21 | 1 |
| OR | $694.88–$761.13 | 2 |
| PA | $655.64–$729.82 | 2 |
| PR | $707.59 | 1 |
| RI | $720.82 | 1 |
| SC | $657.46 | 1 |
| SD | $691.33 | 1 |
| TN | $644.27 | 1 |
| TX | $650.98–$732.24 | 8 |
| UT | $667.04 | 1 |
| VA | $687.76–$808.99 | 2 |
| VI | $707.59 | 1 |
| VT | $688.48 | 1 |
| WA | $728.99–$830.85 | 2 |
| WI | $667.71 | 1 |
| WV | $636.24 | 1 |
| WY | $697.67 | 1 |
How the 44391 rate is calculated
Each of 44391’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 · 44391
RVUs × geographic indexes × conversion factor
Work4.02
4.02 RVUs× 1.000 GPCI
Practice expense16.52
16.52 RVUs× 1.000 GPCI
Malpractice0.47
0.47 RVUs× 1.000 GPCI
Adjusted RVUs
21.0100
Conversion factor
$33.4009
Medicare rate
$701.75
Every GPCI starts at 1.000, the national rate. Enter a ZIP or drag a slider.
The exact Montana inputs and CMS source lines
PPRRVU2026_Oct_nonQPP.csv
5,413
- Code
- 44391
- Physician work
- 4.02
- Practice expense
- 16.52
- Malpractice
- 0.47
GPCI2026.csv
71
- Locality
- Montana
- Physician work
- 1.000
- Practice expense
- 1.000
- Malpractice
- 0.998
| Component | RVU | Locality factor | Adjusted |
|---|---|---|---|
| Physician work | 4.02 | × 1.000 | 4.0200 |
| Practice expense | 16.52 | × 1.000 | 16.5200 |
| Malpractice | 0.47 | × 0.998 | 0.4691 |
| Total RVUs | 21.0091 | ||
| Conversion factor | × 33.4009 | ||
Office rate, Montana$701.72
Office: (4.02 × 1 + 16.52 × 1 + 0.47 × 0.998) × $33.4009 = $701.72
Facility: (4.02 × 1 + 1.59 × 1 + 0.47 × 0.998) × $33.4009 = $203.05
Payment rules and modifiers for 44391
The CMS indicators that decide how 44391 is paid alongside other services.
CMS payment indicators · 44391
Colonoscopy through stoma, control of bleeding
| 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
44391 without 51 · national office
$701.75
Colonoscopy through stoma, control of bleeding
44391-51 · Second procedure: 50%
$350.88
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%).
How 44391 has changed in Montana
44391 · Office / nonfacility
$701.72
Effective 2026-10-01
The base rate is $102.06 higher than on 2025-10-01, moving from $599.66 to $701.72 (17.0%).
It is unchanged from the immediately preceding available release, effective 2026-07-01.
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
January 1, 2026
RVU26A
$599.66changed to$701.72
- Conversion factor 32.3465 changed to 33.4009
- Work RVU 4.12 changed to 4.02
- Practice expense RVU 13.92 changed to 16.52
- Malpractice RVU 0.51 changed to 0.47
- Malpractice GPCI 0.978 changed to 0.998
Held through RVU26B, RVU26C, RVU26D.
January 1, 2025
RVU25A
$634.75changed to$599.66
- Conversion factor 33.2875 changed to 32.3465
- Practice expense RVU 14.45 changed to 13.92
Held through RVU25B, RVU25C, RVU25D.
March 9, 2024
RVU24AR
$624.39changed to$634.75
- Conversion factor 32.7442 changed to 33.2875
Held through RVU24B, RVU24C, RVU24D.
January 1, 2024
RVU24A
$652.63changed to$624.39
- Conversion factor 33.8872 changed to 32.7442
- Practice expense RVU 14.64 changed to 14.45
January 1, 2023
RVU23A
$683.77changed to$652.63
- Conversion factor 34.6062 changed to 33.8872
- Practice expense RVU 15.15 changed to 14.64
- Malpractice RVU 0.50 changed to 0.51
- Malpractice GPCI 0.977 changed to 0.978
Held through RVU23B, RVU23C, RVU23D.
January 1, 2022
RVU22A
$713.54changed to$683.77
- Conversion factor 34.8931 changed to 34.6062
- Practice expense RVU 15.88 changed to 15.15
- Malpractice RVU 0.46 changed to 0.50
Held through RVU22B, RVU22C, RVU22D.
January 1, 2021
RVU21A
$700.49changed to$713.54
- Conversion factor 36.0896 changed to 34.8931
- Practice expense RVU 14.69 changed to 15.88
- Malpractice GPCI 1.304 changed to 0.977
Held through RVU21B, RVU21C, RVU21D.
January 1, 2020
RVU20A
$707.74changed to$700.49
- Conversion factor 36.0391 changed to 36.0896
- Practice expense RVU 14.67 changed to 14.69
- Malpractice RVU 0.52 changed to 0.46
- Malpractice GPCI 1.631 changed to 1.304
Held through RVU20B, RVU20C, RVU20D.
January 1, 2019
RVU19A
$724.24changed to$707.74
- Conversion factor 35.9996 changed to 36.0391
- Practice expense RVU 15.15 changed to 14.67
Held through RVU19B, RVU19C, RVU19D.
January 1, 2018
RVU18AR1
$714.04changed to$724.24
- Conversion factor 35.8887 changed to 35.9996
- Practice expense RVU 14.99 changed to 15.15
- Malpractice RVU 0.55 changed to 0.52
- Malpractice GPCI 1.429 changed to 1.631
Held through RVU18B, RVU18C, RVU18D.
January 1, 2017
RVU17A
$784.07changed to$714.04
- Conversion factor 35.8043 changed to 35.8887
- Work RVU 4.22 changed to 4.12
- Practice expense RVU 16.98 changed to 14.99
- Malpractice RVU 0.57 changed to 0.55
- Malpractice GPCI 1.226 changed to 1.429
Held through RVU17B, RVU17C, RVU17D.
January 1, 2016
RVU16A
$515.45changed to$784.07
- Conversion factor 35.9335 changed to 35.8043
- Work RVU 4.31 changed to 4.22
- Practice expense RVU 9.25 changed to 16.98
- Malpractice RVU 0.64 changed to 0.57
Held through RVU16B, RVU16C, RVU16D.
July 1, 2015
RVU15C
$512.89changed to$515.45
- Conversion factor 35.7547 changed to 35.9335
Held through RVU15D.
January 1, 2015
RVU15A
$508.05changed to$512.89
- Conversion factor 35.8228 changed to 35.7547
- Practice expense RVU 9.15 changed to 9.25
- Malpractice RVU 0.62 changed to 0.64
- Malpractice GPCI 1.165 changed to 1.226
Held through RVU15B.
January 1, 2014
RVU14A
$531.34changed to$508.05
- Conversion factor 34.0230 changed to 35.8228
- Practice expense RVU 10.59 changed to 9.15
- Malpractice RVU 0.65 changed to 0.62
- Malpractice GPCI 1.103 changed to 1.165
Held through RVU14B, RVU14C, RVU14D.
January 1, 2013
RVU13AR
Earliest loaded release: $531.34
Held through RVU13B, RVU13C, RVU13D.
| Effective from | Office | Facility | CMS release |
|---|---|---|---|
| 2026-10-01 | $701.72 | $203.05 | RVU26D |
| 2026-07-01 | $701.72 | $203.05 | RVU26C |
| 2026-04-01 | $701.72 | $203.05 | RVU26B |
| 2026-01-01 | $701.72 | $203.05 | RVU26A |
| 2025-10-01 | $599.66 | $219.59 | RVU25D |
| 2025-07-01 | $599.66 | $219.59 | RVU25C |
| 2025-04-01 | $599.66 | $219.59 | RVU25B |
| 2025-01-01 | $599.66 | $219.59 | RVU25A |
| 2024-10-01 | $634.75 | $225.98 | RVU24D |
| 2024-07-01 | $634.75 | $225.98 | RVU24C |
| 2024-04-01 | $634.75 | $225.98 | RVU24B |
| 2024-03-09 | $634.75 | $225.98 | RVU24AR |
| 2024-01-01 | $624.39 | $222.29 | RVU24A |
| 2023-10-01 | $652.63 | $229.04 | RVU23D |
| 2023-07-01 | $652.63 | $229.04 | RVU23C |
| 2023-04-01 | $652.63 | $229.04 | RVU23B |
| 2023-01-01 | $652.63 | $229.04 | RVU23A |
| 2022-10-01 | $683.77 | $233.19 | RVU22D |
| 2022-07-01 | $683.77 | $233.19 | RVU22C |
| 2022-04-01 | $683.77 | $233.19 | RVU22B |
| 2022-01-01 | $683.77 | $233.19 | RVU22A |
| 2021-10-01 | $713.54 | $233.41 | RVU21D |
| 2021-07-01 | $713.54 | $233.41 | RVU21C |
| 2021-04-01 | $713.54 | $233.41 | RVU21B |
| 2021-01-01 | $713.54 | $233.41 | RVU21A |
| 2020-10-01 | $700.49 | $245.04 | RVU20D |
| 2020-07-01 | $700.49 | $245.04 | RVU20C |
| 2020-04-01 | $700.49 | $245.04 | RVU20B |
| 2020-01-01 | $700.49 | $245.04 | RVU20A |
| 2019-10-01 | $707.74 | $254.01 | RVU19D |
| 2019-07-01 | $707.74 | $254.01 | RVU19C |
| 2019-04-01 | $707.74 | $254.01 | RVU19B |
| 2019-01-01 | $707.74 | $254.01 | RVU19A |
| 2018-10-01 | $724.24 | $254.81 | RVU18D |
| 2018-07-01 | $724.24 | $254.81 | RVU18C |
| 2018-04-01 | $724.24 | $254.81 | RVU18B |
| 2018-01-01 | $724.24 | $254.81 | RVU18AR1 |
| 2017-10-01 | $714.04 | $251.43 | RVU17D |
| 2017-07-01 | $714.04 | $251.43 | RVU17C |
| 2017-04-01 | $714.04 | $251.43 | RVU17B |
| 2017-01-01 | $714.04 | $251.43 | RVU17A |
| 2016-10-01 | $784.07 | $252.74 | RVU16D |
| 2016-07-01 | $784.07 | $252.74 | RVU16C |
| 2016-04-01 | $784.07 | $252.74 | RVU16B |
| 2016-01-01 | $784.07 | $252.74 | RVU16A |
| 2015-10-01 | $515.45 | $263.92 | RVU15D |
| 2015-07-01 | $515.45 | $263.92 | RVU15C |
| 2015-04-01 | $512.89 | $262.61 | RVU15B |
| 2015-01-01 | $512.89 | $262.61 | RVU15A |
| 2014-10-01 | $508.05 | $260.87 | RVU14D |
| 2014-07-01 | $508.05 | $260.87 | RVU14C |
| 2014-04-01 | $508.05 | $260.87 | RVU14B |
| 2014-01-01 | $508.05 | $260.87 | RVU14A |
| 2013-10-01 | $531.34 | $258.13 | RVU13D |
| 2013-07-01 | $531.34 | $258.13 | RVU13C |
| 2013-04-01 | $531.34 | $258.13 | RVU13B |
| 2013-01-01 | $531.34 | $258.13 | RVU13AR |
Where the Montana rate applies
Montana is a Medicare payment area, not a city. Our Census mapping connects it to 497 cities and communities in Montana. Some span more than one payment area; confirm with the service ZIP.
- Absarokee
- Acton
- Alberton
- Alder
- Alzada
- Amsterdam
- Anaconda-Deer Lodge County
- Antelope
44391 billing questions
How is this different from colonoscopy through a stoma without a therapeutic intervention?
Use 44391 when the endoscopist controls bleeding during the examination. A diagnostic examination through a stoma without bleeding control is represented by 44388.
Can a diagnostic colonoscopy through the stoma be reported separately?
The examination used to locate and treat the bleeding is part of the therapeutic service. When related endoscopies are performed together, CMS endoscopy family pricing applies.
Can modifier 50 be added for bilateral treatment?
No. CMS identifies bilateral adjustment as inappropriate for this code because of its descriptor or anatomy.
Can an assistant surgeon or co-surgeon be reported?
CMS does not pay an assistant at surgery for this code. Co-surgeons and team surgery are not permitted.
What documentation supports reporting 44391?
Document that the colonoscope entered through the stoma, the bleeding site or source when identified, and the method used to control bleeding.
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
Fee sheets · Coming soon
Put 44391 and the rest of your codes on one sheet
Your codes at your locality, with payer contracts beside Medicare.
Join the waitlist