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CPT code 44394: Stomal colonoscopy, snare lesion removal2026 Medicare rate & RVUs in Puerto Rico

Report this service when a colonoscope is passed through a stoma and a colonic lesion is removed using a snare during the examination.

CMS RVU26DEffective Oct 1, 2026One payment locality2.5K Medicare services in 2024

In Puerto Rico, Medicare pays $487.08 for 44394 in the office and $200.05 when it’s performed in a hospital or facility.

$487.08Office (non-facility)
$200.05Hospital or facility
+0.7%vs the national office rate ($483.65)

Check a contract rate as a % of Medicare · 44394 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 44394 for the payment locality that covers the ZIP.

On this page 11 sections
  1. Rate in Puerto Rico
  2. What 44394 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 44394 covers

A gastroenterologist or colorectal surgeon advances a colonoscope through a colonic stoma to examine the colon and remove a tumor, polyp, or other lesion with a snare. This may occur during an outpatient endoscopy or a hospital-based procedure for a patient with a colostomy. The approach through the stoma and the snare removal distinguish this service from routine inspection, forceps removal, and colonoscopy performed through the anus.

Select the code from the access route and documented removal technique; the report should identify the stoma approach and the lesion treatment performed. This minor procedure has a 0-day global period, so same-day preoperative and postoperative care is included. When related endoscopies are performed together, CMS endoscopy family pricing applies. Modifier 50 is inappropriate because the descriptor and anatomy do not support bilateral adjustment. CMS does not pay an assistant at surgery for this service; 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 44394

Across 109 of 109 payment localities, the office rate for 44394 runs from $428.10 in Arkansas to $638.40 in San Benito County, CA. Puerto Rico pays $487.08. The RVUs are the same everywhere; the geographic indexes change the dollars.

44394 in Puerto Rico vs other payment areas
  1. Puerto Rico · this page$487.08
  2. Los Angeles, CA · California$544.67+$57.59
  3. Washington, DC area · District of Columbia$552.35+$65.27
  4. Miami, FL · Florida$523.44+$36.36
  5. Chicago, IL · Illinois$508.30+$21.22
  6. Manhattan, NY · New York$556.35+$69.27
  7. Alaska · Alaska$563.43+$76.35

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

Every other payment area

44394 in every other Medicare payment locality
Payment localityOfficeFacility
AlabamaAlabama$434.33$185.91
ArkansasArkansas$428.10$184.22
ArizonaArizona$470.80$195.69
Bakersfield, CACalifornia$511.67$200.51
Chico, CACalifornia$510.17$199.00
El Centro, CACalifornia$510.25$199.09
Fresno, CACalifornia$510.17$199.00
Hanford, CACalifornia$510.17$199.00

44394 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.

$428.10

$574.29

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

View every state and territory as a table
44394 office rate range by state
State / territoryOffice rate rangeLocalities
AK$563.431
AL$434.331
AR$428.101
AZ$470.801
CA$510.17–$638.4029
CO$502.951
CT$515.671
DC$552.351
DE$478.561
FL$477.46–$523.443
GA$450.70–$492.832
GU$522.421
HI$522.421
IA$444.871
ID$447.841
IL$464.06–$508.304
IN$450.411
KS$443.001
KY$444.971
LA$444.36–$466.182
MA$500.06–$552.212
MD$487.59–$552.353
ME$450.38–$474.342
MI$456.67–$483.592
MN$481.381
MO$436.92–$467.583
MS$432.591
MT$483.611
NC$455.031
ND$473.531
NE$447.231
NH$495.261
NJ$521.40–$546.732
NM$459.241
NV$481.141
NY$461.82–$570.025
OH$454.611
OK$443.961
OR$477.24–$518.612
PA$455.21–$503.042
PR$487.081
RI$495.371
SC$455.601
SD$472.331
TN$445.241
TX$452.25–$501.428
UT$461.791
VA$472.94–$552.352
VI$487.081
VT$471.881
WA$499.05–$563.212
WI$457.771
WV$447.061
WY$479.221

See 44394 in every payment locality

How the 44394 rate is calculated

Each of 44394’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 · 44394

RVUs × geographic indexes × conversion factor

Office or facility?

Work3.93

3.93 RVUs× 1.000 GPCI

Practice expense10.04

10.04 RVUs× 1.000 GPCI

Malpractice0.51

0.51 RVUs× 1.000 GPCI

Adjusted RVUs

14.4800

Conversion factor

$33.4009

Medicare rate

$483.65

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

5,415

Code
44394
Physician work
3.93
Practice expense
10.04
Malpractice
0.51

GPCI2026.csv

91

Locality
Puerto Rico
Physician work
1.000
Practice expense
1.011
Malpractice
0.985
Office calculation for 44394 in Puerto Rico
ComponentRVULocality factorAdjusted
Physician work3.93× 1.0003.9300
Practice expense10.04× 1.01110.1504
Malpractice0.51× 0.9850.5023
Total RVUs14.5828
Conversion factor× 33.4009

Office rate, Puerto Rico$487.08

Office: (3.93 × 1 + 10.04 × 1.011 + 0.51 × 0.985) × $33.4009 = $487.08

Facility: (3.93 × 1 + 1.54 × 1.011 + 0.51 × 0.985) × $33.4009 = $200.05

Open 44394 in the RVU calculator

Payment rules and modifiers for 44394

The CMS indicators that decide how 44394 is paid alongside other services.

CMS payment indicators · 44394

Stomal colonoscopy, snare lesion 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

44394 without 51 · national office

$483.65

Stomal colonoscopy, snare lesion removal

44394-51 · Second procedure: 50%

$241.83

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 44394

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

Codes related to 44394
CodeHow it relatesOffice range, Puerto Rico
Same family
44388Colonoscopy, diagnostic, through stomaColonoscopy through a stoma for examination without the snare lesion-removal service.$356.28
44389Colonoscopy, through stoma, with biopsyColonoscopy through a stoma with tissue sampling by biopsy.$461.20
44391Colonoscopy through stoma, control of bleedingStomal colonoscopy to treat bleeding rather than remove a lesion by snare.$707.59
Used instead
44392Stoma colonoscopy, hot biopsy forceps removalStomal colonoscopy lesion removal using hot biopsy forceps or bipolar cautery rather than a snare.$435.19
45385Snare polypectomy, during colonoscopySnare removal during colonoscopy through the anus rather than through a stoma.$503.43

How 44394 has changed in Puerto Rico

44394 · Office / nonfacility

$487.08

Effective 2026-10-01

The base rate is $65.96 higher than on 2025-10-01, moving from $421.12 to $487.08 (15.7%).

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

    $421.12changed to$487.08

    • Conversion factor 32.3465 changed to 33.4009
    • Work RVU 4.03 changed to 3.93
    • Practice expense RVU 8.40 changed to 10.04
    • Malpractice RVU 0.54 changed to 0.51
    • 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

    $438.74changed to$421.12

    • Conversion factor 33.2875 changed to 32.3465
    • Practice expense RVU 8.56 changed to 8.40

    Held through RVU25B, RVU25C, RVU25D.

  3. March 9, 2024

    RVU24AR

    $431.58changed to$438.74

    • Conversion factor 32.7442 changed to 33.2875

    Held through RVU24B, RVU24C, RVU24D.

  4. January 1, 2024

    RVU24A

    $448.33changed to$431.58

    • Conversion factor 33.8872 changed to 32.7442
    • Practice expense RVU 8.60 changed to 8.56
    • Practice expense GPCI 1.008 changed to 1.007
    • Malpractice GPCI 0.984 changed to 0.982

  5. October 1, 2023

    RVU23D

    $446.29changed to$448.33

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

  6. January 1, 2023

    RVU23A

    $465.56changed to$446.29

    • Conversion factor 34.6062 changed to 33.8872
    • Practice expense RVU 8.82 changed to 8.60
    • 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

    $464.18changed to$465.56

    • Conversion factor 34.8931 changed to 34.6062
    • Practice expense RVU 8.72 changed to 8.82
    • Malpractice RVU 0.49 changed to 0.54

    Held through RVU22B, RVU22C, RVU22D.

  8. January 1, 2021

    RVU21A

    $439.01changed to$464.18

    • Conversion factor 36.0896 changed to 34.8931
    • Practice expense RVU 7.57 changed to 8.72
    • Malpractice RVU 0.51 changed to 0.49
    • Malpractice GPCI 0.988 changed to 0.986

    Held through RVU21B, RVU21C, RVU21D.

  9. January 1, 2020

    RVU20A

    $426.50changed to$439.01

    • Conversion factor 36.0391 changed to 36.0896
    • Practice expense RVU 7.18 changed to 7.57
    • Malpractice RVU 0.58 changed to 0.51
    • 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

    $416.97changed to$426.50

    • Conversion factor 35.9996 changed to 36.0391
    • Practice expense RVU 6.93 changed to 7.18

    Held through RVU19B, RVU19C, RVU19D.

  11. January 1, 2018

    RVU18AR1

    $369.35changed to$416.97

    • Conversion factor 35.8887 changed to 35.9996
    • Practice expense RVU 6.88 changed to 6.93
    • 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

    $372.26changed to$369.35

    • Conversion factor 35.8043 changed to 35.8887
    • Work RVU 4.13 changed to 4.03
    • Practice expense RVU 8.64 changed to 6.88
    • Malpractice RVU 0.60 changed to 0.58
    • 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

    $395.10changed to$372.26

    • Conversion factor 35.9335 changed to 35.8043
    • Work RVU 4.42 changed to 4.13
    • Practice expense RVU 9.04 changed to 8.64
    • Malpractice RVU 0.69 changed to 0.60

    Held through RVU16B, RVU16C, RVU16D.

  14. July 1, 2015

    RVU15C

    $393.14changed to$395.10

    • Conversion factor 35.7547 changed to 35.9335

    Held through RVU15D.

  15. January 1, 2015

    RVU15A

    $387.35changed to$393.14

    • Conversion factor 35.8228 changed to 35.7547
    • Practice expense RVU 8.98 changed to 9.04
    • Malpractice RVU 0.66 changed to 0.69
    • 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

    $394.52changed to$387.35

    • Conversion factor 34.0230 changed to 35.8228
    • Practice expense RVU 10.33 changed to 8.98
    • Malpractice RVU 0.69 changed to 0.66
    • 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: $394.52

    Held through RVU13B, RVU13C, RVU13D.

Rates in every CMS release
Effective fromOfficeFacilityCMS release
2026-10-01$487.08$200.05RVU26D
2026-07-01$487.08$200.05RVU26C
2026-04-01$487.08$200.05RVU26B
2026-01-01$487.08$200.05RVU26A
2025-10-01$421.12$215.91RVU25D
2025-07-01$421.12$215.91RVU25C
2025-04-01$421.12$215.91RVU25B
2025-01-01$421.12$215.91RVU25A
2024-10-01$438.74$221.52RVU24D
2024-07-01$438.74$221.52RVU24C
2024-04-01$438.74$221.52RVU24B
2024-03-09$438.74$221.52RVU24AR
2024-01-01$431.58$217.91RVU24A
2023-10-01$448.33$224.60RVU23D
2023-07-01$446.29$224.33RVU23C
2023-04-01$446.29$224.33RVU23B
2023-01-01$446.29$224.33RVU23A
2022-10-01$465.56$229.40RVU22D
2022-07-01$465.56$229.40RVU22C
2022-04-01$465.56$229.40RVU22B
2022-01-01$465.56$229.40RVU22A
2021-10-01$464.18$228.88RVU21D
2021-07-01$464.18$228.88RVU21C
2021-04-01$464.18$228.88RVU21B
2021-01-01$464.18$228.88RVU21A
2020-10-01$439.01$235.65RVU20D
2020-07-01$439.01$235.65RVU20C
2020-04-01$439.01$235.65RVU20B
2020-01-01$439.01$235.65RVU20A
2019-10-01$426.50$238.15RVU19D
2019-07-01$426.50$238.15RVU19C
2019-04-01$426.50$238.15RVU19B
2019-01-01$426.50$238.15RVU19A
2018-10-01$416.97$239.34RVU18D
2018-07-01$416.97$239.34RVU18C
2018-04-01$416.97$239.34RVU18B
2018-01-01$416.97$239.34RVU18AR1
2017-10-01$369.35$220.05RVU17D
2017-07-01$369.35$220.05RVU17C
2017-04-01$369.35$220.05RVU17B
2017-01-01$369.35$220.05RVU17A
2016-10-01$372.26$206.16RVU16D
2016-07-01$372.26$206.16RVU16C
2016-04-01$372.26$206.16RVU16B
2016-01-01$372.26$206.16RVU16A
2015-10-01$395.10$222.84RVU15D
2015-07-01$395.10$222.84RVU15C
2015-04-01$393.14$221.73RVU15B
2015-01-01$393.14$221.73RVU15A
2014-10-01$387.35$220.77RVU14D
2014-07-01$387.35$220.77RVU14C
2014-04-01$387.35$220.77RVU14B
2014-01-01$387.35$220.77RVU14A
2013-10-01$394.52$214.82RVU13D
2013-07-01$394.52$214.82RVU13C
2013-04-01$394.52$214.82RVU13B
2013-01-01$394.52$214.82RVU13AR

Price 44394 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

44394 billing questions

How does this differ from 44392?

Both describe lesion removal during colonoscopy through a stoma. Use 44394 for snare removal; 44392 is for removal by hot biopsy forceps or bipolar cautery.

When is 44389 more appropriate?

Use 44389 when tissue is sampled by biopsy during colonoscopy through a stoma rather than removed by snare.

Can the diagnostic examination be billed separately?

The code describes snare removal during the examination, not a separate diagnostic-only procedure. When related endoscopies are performed together, CMS endoscopy family pricing applies.

Should modifier 50 be reported?

No. The descriptor and anatomy make bilateral adjustment and modifier 50 inappropriate.

Can an assistant or co-surgeon be paid?

CMS does not pay an assistant at surgery for this service. Co-surgeons and team surgery are not permitted.

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 44394PPRRVU2026_Oct_nonQPP.csv, line 5,415 (RVU26D)
Geographic factors for Puerto RicoGPCI2026.csv, line 91 (RVU26D)

Open CMS sourceHow we calculate rates

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