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CPT code 44391: Colonoscopy through stoma, control of bleeding2026 Medicare rate & RVUs in Nevada

Reports colonoscopy performed through a stoma to locate and treat a bleeding site using an endoscopic hemostasis method.

CMS RVU26DEffective Oct 1, 2026One payment locality160 Medicare services in 2024

In Nevada, Medicare pays $699.68 for 44391 in the office and $200.51 when it’s performed in a hospital or facility.

$699.68Office (non-facility)
$200.51Hospital or facility
−0.3%vs the national office rate ($701.75)

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.

We’ll open 44391 for the payment locality that covers the ZIP.

On this page 11 sections
  1. Rate in Nevada
  2. What 44391 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 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 Nevada 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. Nevada pays $699.68. The RVUs are the same everywhere; the geographic indexes change the dollars.

44391 in Nevada vs other payment areas
  1. Nevada · this page$699.68
  2. Los Angeles, CA · California$802.96+$103.28
  3. Washington, DC area · District of Columbia$808.99+$109.31
  4. Miami, FL · Florida$748.38+$48.70
  5. Chicago, IL · Illinois$725.78+$26.10
  6. Manhattan, NY · New York$808.93+$109.25
  7. Alaska · Alaska$797.71+$98.03

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

Every other payment area

44391 in every other Medicare payment locality
Payment localityOfficeFacility
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

44391 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.

$616.34

$851.43

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

View every state and territory as a table
44391 office rate range by state
State / territoryOffice rate rangeLocalities
AK$797.711
AL$625.971
AR$616.341
AZ$682.391
CA$749.72–$953.1329
CO$735.241
CT$750.221
DC$808.991
DE$694.221
FL$685.37–$748.383
GA$645.17–$714.142
GU$770.741
HI$770.741
IA$645.391
ID$649.341
IL$662.59–$729.714
IN$653.401
KS$641.001
KY$639.171
LA$637.64–$671.332
MA$729.96–$812.582
MD$708.43–$808.993
ME$651.68–$690.992
MI$655.77–$693.212
MN$706.701
MO$625.20–$675.303
MS$620.961
MT$701.721
NC$659.121
ND$692.431
NE$649.501
NH$722.411
NJ$759.41–$799.562
NM$659.111
NV$699.681
NY$669.50–$828.095
OH$653.871
OK$639.211
OR$694.88–$761.132
PA$655.64–$729.822
PR$707.591
RI$720.821
SC$657.461
SD$691.331
TN$644.271
TX$650.98–$732.248
UT$667.041
VA$687.76–$808.992
VI$707.591
VT$688.481
WA$728.99–$830.852
WI$667.711
WV$636.241
WY$697.671

See 44391 in every payment locality

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

Office or facility?

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 Nevada 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

73

Locality
Nevada
Physician work
1.000
Practice expense
1.001
Malpractice
0.833
Office calculation for 44391 in Nevada
ComponentRVULocality factorAdjusted
Physician work4.02× 1.0004.0200
Practice expense16.52× 1.00116.5365
Malpractice0.47× 0.8330.3915
Total RVUs20.9480
Conversion factor× 33.4009

Office rate, Nevada$699.68

Office: (4.02 × 1 + 16.52 × 1.001 + 0.47 × 0.833) × $33.4009 = $699.68

Facility: (4.02 × 1 + 1.59 × 1.001 + 0.47 × 0.833) × $33.4009 = $200.51

Open 44391 in the RVU calculator

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

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

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%).

When to use modifier 51

Codes related to 44391

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

Codes related to 44391
CodeHow it relatesOffice range, Nevada
Same family
44388Colonoscopy, diagnostic, through stomaColonoscopy through a stoma for examination without a therapeutic intervention.$351.68
44389Colonoscopy, through stoma, with biopsyColonoscopy through a stoma with biopsy rather than bleeding control.$455.71
44390Stomal colonoscopy, foreign body removalColonoscopy through a stoma to remove a foreign body.$447.27
44392Stoma colonoscopy, hot biopsy forceps removalColonoscopy through a stoma with lesion removal by specified non-snare methods.$429.21
44394Stomal colonoscopy, snare lesion removalColonoscopy through a stoma with snare removal of a lesion.$481.14
Used instead
45382Colonoscopy, control of bleedingBleeding control by colonoscopy when the colon is approached other than through a stoma.$727.92

How 44391 has changed in Nevada

44391 · Office / nonfacility

$699.68

Effective 2026-10-01

The base rate is $102.23 higher than on 2025-10-01, moving from $597.45 to $699.68 (17.1%).

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

    $597.45changed to$699.68

    • 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
    • Practice expense GPCI 1.000 changed to 1.001
    • Malpractice GPCI 0.844 changed to 0.833

    Held through RVU26B, RVU26C, RVU26D.

  2. January 1, 2025

    RVU25A

    $632.48changed to$597.45

    • Conversion factor 33.2875 changed to 32.3465
    • Practice expense RVU 14.45 changed to 13.92

    Held through RVU25B, RVU25C, RVU25D.

  3. March 9, 2024

    RVU24AR

    $622.15changed to$632.48

    • Conversion factor 32.7442 changed to 33.2875

    Held through RVU24B, RVU24C, RVU24D.

  4. January 1, 2024

    RVU24A

    $654.70changed to$622.15

    • Conversion factor 33.8872 changed to 32.7442
    • Practice expense RVU 14.64 changed to 14.45
    • Malpractice GPCI 1.098 changed to 0.844

  5. January 1, 2023

    RVU23A

    $690.95changed to$654.70

    • 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
    • Work GPCI 1.005 changed to 1.000
    • Malpractice GPCI 1.351 changed to 1.098

    Held through RVU23B, RVU23C, RVU23D.

  6. January 1, 2022

    RVU22A

    $720.27changed to$690.95

    • 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.

  7. January 1, 2021

    RVU21A

    $698.20changed to$720.27

    • Conversion factor 36.0896 changed to 34.8931
    • Practice expense RVU 14.69 changed to 15.88
    • Work GPCI 1.004 changed to 1.005
    • Malpractice GPCI 1.130 changed to 1.351

    Held through RVU21B, RVU21C, RVU21D.

  8. January 1, 2020

    RVU20A

    $703.49changed to$698.20

    • 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
    • Work GPCI 1.002 changed to 1.004
    • Practice expense GPCI 1.017 changed to 1.000
    • Malpractice GPCI 0.909 changed to 1.130

    Held through RVU20B, RVU20C, RVU20D.

  9. January 1, 2019

    RVU19A

    $720.30changed to$703.49

    • Conversion factor 35.9996 changed to 36.0391
    • Practice expense RVU 15.15 changed to 14.67

    Held through RVU19B, RVU19C, RVU19D.

  10. January 1, 2018

    RVU18AR1

    $723.39changed to$720.30

    • 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
    • Work GPCI 1.004 changed to 1.002
    • Practice expense GPCI 1.034 changed to 1.017
    • Malpractice GPCI 0.946 changed to 0.909

    Held through RVU18B, RVU18C, RVU18D.

  11. January 1, 2017

    RVU17A

    $810.85changed to$723.39

    • 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
    • Work GPCI 1.005 changed to 1.004
    • Practice expense GPCI 1.051 changed to 1.034
    • Malpractice GPCI 0.982 changed to 0.946

    Held through RVU17B, RVU17C, RVU17D.

  12. January 1, 2016

    RVU16A

    $527.57changed to$810.85

    • 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.

  13. July 1, 2015

    RVU15C

    $524.94changed to$527.57

    • Conversion factor 35.7547 changed to 35.9335

    Held through RVU15D.

  14. January 1, 2015

    RVU15A

    $524.94changed to$524.94

    • 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
    • Work GPCI 1.001 changed to 1.005
    • Practice expense GPCI 1.055 changed to 1.051
    • Malpractice GPCI 1.107 changed to 0.982

    Held through RVU15B.

  15. January 1, 2014

    RVU14A

    $555.09changed to$524.94

    • 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
    • Work GPCI 1.000 changed to 1.001
    • Practice expense GPCI 1.058 changed to 1.055
    • Malpractice GPCI 1.232 changed to 1.107

    Held through RVU14B, RVU14C, RVU14D.

  16. October 1, 2013

    RVU13D

    No ratechanged to$555.09

  17. January 1, 2013

    RVU13AR

    Earliest loaded release: No rate

    Held through RVU13B, RVU13C.

Rates in every CMS release
Effective fromOfficeFacilityCMS release
2026-10-01$699.68$200.51RVU26D
2026-07-01$699.68$200.51RVU26C
2026-04-01$699.68$200.51RVU26B
2026-01-01$699.68$200.51RVU26A
2025-10-01$597.45$217.38RVU25D
2025-07-01$597.45$217.38RVU25C
2025-04-01$597.45$217.38RVU25B
2025-01-01$597.45$217.38RVU25A
2024-10-01$632.48$223.71RVU24D
2024-07-01$632.48$223.71RVU24C
2024-04-01$632.48$223.71RVU24B
2024-03-09$632.48$223.71RVU24AR
2024-01-01$622.15$220.06RVU24A
2023-10-01$654.70$231.11RVU23D
2023-07-01$654.70$231.11RVU23C
2023-04-01$654.70$231.11RVU23B
2023-01-01$654.70$231.11RVU23A
2022-10-01$690.95$240.38RVU22D
2022-07-01$690.95$240.38RVU22C
2022-04-01$690.95$240.38RVU22B
2022-01-01$690.95$240.38RVU22A
2021-10-01$720.27$240.14RVU21D
2021-07-01$720.27$240.14RVU21C
2021-04-01$720.27$240.14RVU21B
2021-01-01$720.27$240.14RVU21A
2020-10-01$698.20$242.75RVU20D
2020-07-01$698.20$242.75RVU20C
2020-04-01$698.20$242.75RVU20B
2020-01-01$698.20$242.75RVU20A
2019-10-01$703.49$242.05RVU19D
2019-07-01$703.49$242.05RVU19C
2019-04-01$703.49$242.05RVU19B
2019-01-01$703.49$242.05RVU19A
2018-10-01$720.30$242.88RVU18D
2018-07-01$720.30$242.88RVU18C
2018-04-01$720.30$242.88RVU18B
2018-01-01$720.30$242.88RVU18AR1
2017-10-01$723.39$245.05RVU17D
2017-07-01$723.39$245.05RVU17C
2017-04-01$723.39$245.05RVU17B
2017-01-01$723.39$245.05RVU17A
2016-10-01$810.85$252.42RVU16D
2016-07-01$810.85$252.42RVU16C
2016-04-01$810.85$252.42RVU16B
2016-01-01$810.85$252.42RVU16A
2015-10-01$527.57$263.20RVU15D
2015-07-01$527.57$263.20RVU15C
2015-04-01$524.94$261.90RVU15B
2015-01-01$524.94$261.90RVU15A
2014-10-01$524.94$264.17RVU14D
2014-07-01$524.94$264.17RVU14C
2014-04-01$524.94$264.17RVU14B
2014-01-01$524.94$264.17RVU14A
2013-10-01$555.09$266.04RVU13D
2013-07-01Rate data unavailableRate data unavailableRVU13C
2013-04-01Rate data unavailableRate data unavailableRVU13B
2013-01-01Rate data unavailableRate data unavailableRVU13AR

Price 44391 for an earlier date of service

Where the Nevada rate applies

Nevada is a Medicare payment area, not a city. Our Census mapping connects it to 138 cities and communities in Nevada. Some span more than one payment area; confirm with the service ZIP.

  • Alamo
  • Amargosa Valley
  • Austin
  • Baker
  • Battle Mountain
  • Beatty
  • Beaverdam
  • Bennett Springs

Browse all communities in Nevada

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
RVUs for 44391PPRRVU2026_Oct_nonQPP.csv, line 5,413 (RVU26D)
Geographic factors for NevadaGPCI2026.csv, line 73 (RVU26D)

Open CMS sourceHow we calculate rates

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