Billing code 44392: Stoma colonoscopyMedicare rate & RVUs
Reports therapeutic colonoscopy performed through a stoma when a lesion is removed using hot biopsy forceps.
Medicare pays $432.21 for 44392 nationally in the office and $179.70 in a hospital or facility. Local office rates run $380.69–$567.24.
Medicare rate · 44392
Stoma colonoscopy
- Work RVUs
- 3.44
- Total RVUs
- 12.94
- Global days
- 000
National rate · 2026
$432.21
Office setting, before claim adjustments.
See every locality for 44392 →Billed by an NP, PA or therapist? →
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 10 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
The same RVUs, adjusted for each area’s costs. Open a locality for its calculation, history and nearby areas.
109 payment localities
$380.69 to $567.24
109 of 109 payment localities
| Payment locality | Office | Facility |
|---|---|---|
| Alabama | $386.45 | $165.51 |
| Alaska* | $500.15 | $231.23 |
| Arizona | $420.14 | $175.46 |
| Arkansas | $380.69 | $163.78 |
| Atlanta | $441.27 | $184.72 |
| Austin | $447.45 | $180.30 |
| Bakersfield | $455.26 | $178.50 |
| Baltimore/Surr. Cntys | $460.44 | $189.50 |
| Beaumont | $404.02 | $174.24 |
| Brazoria | $426.11 | $175.87 |
| Chicago | $460.02 | $206.25 |
| Chico | $453.59 | $176.84 |
| Colorado | $448.32 | $179.65 |
| Connecticut | $461.56 | $189.61 |
| Dallas | $429.25 | $177.75 |
| Dc + Md/Va Suburbs | $493.61 | $196.15 |
| Delaware | $427.22 | $177.74 |
| Detroit | $435.31 | $191.64 |
| East St. Louis | $428.38 | $196.07 |
| El Centro | $453.69 | $176.93 |
| Fort Lauderdale | $452.00 | $196.21 |
| Fort Worth | $426.53 | $177.56 |
| Fresno | $453.59 | $176.84 |
| Galveston | $427.65 | $176.91 |
| Hanford-Corcoran | $453.59 | $176.84 |
| Hawaii, Guam | $464.68 | $177.58 |
| Houston | $438.45 | $187.71 |
| Idaho | $398.01 | $165.70 |
| Indiana | $400.35 | $166.28 |
| Iowa | $395.03 | $163.98 |
| Kansas | $393.86 | $165.59 |
| Kentucky | $397.50 | $173.02 |
| Los Angeles-Long Beach-Anaheim (Los Angeles/Orange Cnty) | $484.76 | $186.04 |
| Madera | $453.59 | $176.84 |
| Manhattan | $499.32 | $205.90 |
| Merced | $453.59 | $176.84 |
| Metropolitan Boston | $492.49 | $190.99 |
| Metropolitan Kansas City | $413.60 | $176.49 |
| Metropolitan Philadelphia | $450.28 | $187.42 |
| Metropolitan St. Louis | $417.96 | $177.57 |
| Miami | $474.54 | $211.68 |
| Minnesota | $426.96 | $167.13 |
| Mississippi | $385.70 | $168.29 |
| Modesto | $453.59 | $176.84 |
| Montana** | $432.17 | $179.66 |
| Napa | $524.39 | $191.58 |
| Nebraska | $397.03 | $163.97 |
| Nevada** | $429.21 | $176.45 |
| New Hampshire | $441.95 | $179.08 |
| New Mexico | $411.47 | $179.92 |
| New Orleans | $417.33 | $179.72 |
| North Carolina | $405.15 | $169.56 |
| North Dakota** | $420.50 | $167.99 |
| Northern Nj | $488.40 | $195.49 |
| Nyc Suburbs/Long Island | $512.70 | $212.46 |
| Ohio | $406.47 | $175.93 |
| Oklahoma | $395.97 | $170.48 |
| Oxnard-Thousand Oaks-Ventura | $482.16 | $183.69 |
| Portland | $462.03 | $181.50 |
| Poughkpsie/N Nyc Suburbs | $469.79 | $193.29 |
| Puerto Rico | $435.19 | $179.90 |
| Queens | $502.44 | $203.97 |
| Redding | $453.59 | $176.84 |
| Rest Of California | $453.59 | $176.84 |
| Rest Of Florida | $429.03 | $187.63 |
| Rest Of Georgia | $403.85 | $178.61 |
| Rest Of Illinois | $417.41 | $186.87 |
| Rest Of Louisiana | $397.16 | $173.68 |
| Rest Of Maine | $400.95 | $168.64 |
| Rest Of Maryland | $435.31 | $179.77 |
| Rest Of Massachusetts | $445.82 | $179.92 |
| Rest Of Michigan | $408.86 | $178.32 |
| Rest Of Missouri | $390.63 | $172.96 |
| Rest Of New Jersey | $466.09 | $190.35 |
| Rest Of New York | $411.47 | $171.59 |
| Rest Of Oregon | $425.16 | $173.66 |
| Rest Of Pennsylvania | $406.72 | $174.92 |
| Rest Of Texas | $415.12 | $175.49 |
| Rest Of Washington | $444.76 | $178.87 |
| Rhode Island | $442.08 | $181.24 |
| Riverside-San Bernardino-Ontario | $459.95 | $183.20 |
| Sacramento-Roseville-Folsom | $475.71 | $182.04 |
| Salinas | $473.94 | $181.28 |
| San Diego-Chula Vista-Carlsbad | $484.96 | $182.96 |
| San Francisco-Oakland-Berkeley (Marin Cnty) | $554.48 | $198.44 |
| San Francisco-Oakland-Berkeley (San Francisco/San Mateo/Alameda/Contra Costa Cnty) | $553.81 | $197.77 |
| San Jose-Sunnyvale-Santa Clara (San Benito Cnty) | $567.24 | $203.12 |
| San Jose-Sunnyvale-Santa Clara (Santa Clara Cnty) | $564.50 | $200.38 |
| San Luis Obispo-Paso Robles | $466.38 | $178.77 |
| Santa Cruz-Watsonville | $489.46 | $182.66 |
| Santa Maria-Santa Barbara | $475.68 | $181.26 |
| Santa Rosa-Petaluma | $494.36 | $184.28 |
| Seattle (King Cnty) | $501.90 | $192.07 |
| South Carolina | $406.63 | $173.31 |
| South Dakota** | $419.12 | $166.61 |
| Southern Maine | $422.26 | $172.02 |
| Stockton | $453.59 | $176.84 |
| Suburban Chicago | $456.26 | $196.93 |
| Tennessee | $396.00 | $166.47 |
| Utah | $412.34 | $174.98 |
| Vallejo | $523.42 | $190.61 |
| Vermont | $419.50 | $169.51 |
| Virgin Islands | $435.19 | $179.90 |
| Virginia | $421.35 | $173.14 |
| Visalia | $453.59 | $176.84 |
| West Virginia | $401.72 | $182.28 |
| Wisconsin | $406.07 | $164.17 |
| Wyoming** | $427.08 | $174.57 |
| Yuba City | $453.59 | $176.84 |
44392 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.
$380.69
$510.41
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 | $500.15 | 1 |
| AL | $386.45 | 1 |
| AR | $380.69 | 1 |
| AZ | $420.14 | 1 |
| CA | $453.59–$567.24 | 29 |
| CO | $448.32 | 1 |
| CT | $461.56 | 1 |
| DC | $493.61 | 1 |
| DE | $427.22 | 1 |
| FL | $429.03–$474.54 | 3 |
| GA | $403.85–$441.27 | 2 |
| GU | $464.68 | 1 |
| HI | $464.68 | 1 |
| IA | $395.03 | 1 |
| ID | $398.01 | 1 |
| IL | $417.41–$460.02 | 4 |
| IN | $400.35 | 1 |
| KS | $393.86 | 1 |
| KY | $397.50 | 1 |
| LA | $397.16–$417.33 | 2 |
| MA | $445.82–$492.49 | 2 |
| MD | $435.31–$493.61 | 3 |
| ME | $400.95–$422.26 | 2 |
| MI | $408.86–$435.31 | 2 |
| MN | $426.96 | 1 |
| MO | $390.63–$417.96 | 3 |
| MS | $385.70 | 1 |
| MT | $432.17 | 1 |
| NC | $405.15 | 1 |
| ND | $420.50 | 1 |
| NE | $397.03 | 1 |
| NH | $441.95 | 1 |
| NJ | $466.09–$488.40 | 2 |
| NM | $411.47 | 1 |
| NV | $429.21 | 1 |
| NY | $411.47–$512.70 | 5 |
| OH | $406.47 | 1 |
| OK | $395.97 | 1 |
| OR | $425.16–$462.03 | 2 |
| PA | $406.72–$450.28 | 2 |
| PR | $435.19 | 1 |
| RI | $442.08 | 1 |
| SC | $406.63 | 1 |
| SD | $419.12 | 1 |
| TN | $396.00 | 1 |
| TX | $404.02–$447.45 | 8 |
| UT | $412.34 | 1 |
| VA | $421.35–$493.61 | 2 |
| VI | $435.19 | 1 |
| VT | $419.50 | 1 |
| WA | $444.76–$501.90 | 2 |
| WI | $406.07 | 1 |
| WV | $401.72 | 1 |
| WY | $427.08 | 1 |
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
| 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
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
- 44389Colonoscopy
- Both use a colonoscope passed through a stoma, but 44389 represents biopsy; this code is for lesion removal with hot biopsy forceps.
- 44394Stomal colonoscopy
- Both represent therapeutic colonoscopy through a stoma. Select this code for hot biopsy forceps removal and 44394 for snare removal.
- 45384Colonoscopy polyp removal
- 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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