CPT code 44392: Stoma colonoscopy, hot biopsy forceps removal2026 Medicare rate & RVUs in Maryland
Reports therapeutic colonoscopy performed through a stoma when a lesion is removed using hot biopsy forceps.
Medicare pays $435.31–$493.61 for 44392 in the office in Maryland, from Rest of Maryland to Washington, DC area. 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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On this page 9 sections
What 44392 covers
A gastroenterologist or colorectal surgeon performs this therapeutic examination by passing a colonoscope through a colostomy or other bowel stoma to inspect the colon and remove a lesion with hot biopsy forceps. It is used when the stoma is the route of access and forceps removal is the technique documented; a snare removal or biopsy-only procedure is coded differently. These procedures are commonly performed in a hospital outpatient endoscopy unit or ambulatory surgery setting.
The report should identify the stoma route, the lesion treated, and removal with hot biopsy forceps. This is a minor procedure with 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 and procedure. Medicare does not pay an assistant at surgery, and co-surgeons and team surgery are not permitted for this code.
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 44392 pays more and less in Maryland
The same RVUs, adjusted for each area’s costs. Open a locality for its calculation, history and nearby areas.
3 payment localities
$435.31 to $493.61
| Payment locality | Office | Facility |
|---|---|---|
| Baltimore area, MD | $460.44 | $189.50 |
| Rest of Maryland | $435.31 | $179.77 |
| Washington, DC area | $493.61 | $196.15 |
How the 44392 rate is calculated
Each of 44392’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 · 44392
RVUs × geographic indexes × conversion factor
Work3.44
3.44 RVUs× 1.000 GPCI
Practice expense8.91
8.91 RVUs× 1.000 GPCI
Malpractice0.59
0.59 RVUs× 1.000 GPCI
Adjusted RVUs
12.9400
Conversion factor
$33.4009
Medicare rate
$432.21
Every GPCI starts at 1.000, the national rate. Enter a ZIP or drag a slider.
Payment rules and modifiers for 44392
The CMS indicators that decide how 44392 is paid alongside other services.
CMS payment indicators · 44392
Stoma colonoscopy, hot biopsy forceps 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
44392 without 51 · national office
$432.21
Stoma colonoscopy, hot biopsy forceps removal
44392-51 · Second procedure: 50%
$216.11
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%).
44392 compared with similar codes
Compare codes · National
4 codes, side by side
How to choose
- 44389ColonoscopyThrough stoma, with biopsy
- Both use a colonoscope passed through a stoma, but 44389 represents biopsy; this code is for lesion removal with hot biopsy forceps.
- 44394Stomal colonoscopySnare lesion removal
- Both represent therapeutic colonoscopy through a stoma. Select this code for hot biopsy forceps removal and 44394 for snare removal.
- 45384Colonoscopy polyp removalHot biopsy or bipolar cautery
- The removal technique is similar, but 45384 is used when the colonoscope is not passed through a stoma.
44392 billing questions
When should this code be chosen over 44394?
Use this code when the lesion is removed through the stoma with hot biopsy forceps. Code 44394 describes removal using a snare.
How does this differ from 44389?
This code is for forceps removal of a lesion through the stoma. Code 44389 represents colonoscopy through a stoma with biopsy rather than this therapeutic removal technique.
Can modifier 50 be appended?
No. Modifier 50 is inappropriate because the anatomy and procedure do not represent a bilateral service.
Can an assistant or co-surgeon be reported?
Medicare does not pay an assistant at surgery for this code. Co-surgeons and team surgery are not permitted.
What same-day care is included?
The 0-day global period includes same-day preoperative and postoperative care. When related endoscopies are performed together, endoscopy family pricing applies.
What should the procedure note establish?
Document that the colonoscope passed through a stoma, identify the lesion treated, and specify removal with hot biopsy forceps.
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
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