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Billing code 44403: ColonoscopyMedicare rate & RVUs

Reports colonoscopy with endoscopic resection of a colorectal lesion when the therapeutic work goes beyond routine biopsy or standard snare removal.

CMS RVU26DEffective Oct 1, 2026109 payment localities97 Medicare services in 2024

Medicare pays $265.87 for 44403 nationally in a facility.

Medicare rate · 44403

Colonoscopy

Work RVUs
5.36
Total RVUs
7.96
Global days
000

National rate · 2026

$265.87

Facility setting, before claim adjustments.

See every locality for 44403 →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
  1. Medicare rate
  2. What 44403 covers
  3. By payment locality
  4. Rate map
  5. How it’s calculated
  6. Payment rules
  7. Similar codes
  8. Related codes
  9. Billing questions
  10. Sources

What 44403 covers

During this therapeutic colonoscopy, the endoscopist identifies and removes a colorectal lesion by an endoscopic resection technique. It is used for lesions selected for resection rather than simple tissue sampling or routine polypectomy. Gastroenterologists and other qualified endoscopists typically perform the service in a hospital outpatient department or ambulatory surgery center, with the patient receiving endoscopic sedation or anesthesia as appropriate.

Report the code when the operative note supports the resection performed, including the lesion’s location and the technique used; do not choose it solely because tissue was removed. Distinguish it from biopsy and standard snare removal based on the documented service. 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. Medicare does not pay an assistant at surgery for this service, and co-surgeon and team-surgery reporting 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.

Where 44403 pays more and less

The same RVUs, adjusted for each area’s costs. Open a locality for its calculation, history and nearby areas.

109 of 109 payment localities

44403 office and facility rates by payment locality
Payment localityOfficeFacility
AlabamaUnavailable$248.93
Alaska*Unavailable$350.90
ArizonaUnavailable$260.95
ArkansasUnavailable$246.85
AtlantaUnavailable$271.44
AustinUnavailable$267.88
BakersfieldUnavailable$268.01
Baltimore/Surr. CntysUnavailable$278.31
BeaumontUnavailable$258.43
BrazoriaUnavailable$262.36

44403 rates by state

Office rate range in each state. Select a state to see its payment localities.

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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.

View every state and territory as a table
44403 office rate range by state
State / territoryOffice rate rangeLocalities
AKNo published base rate1
ALNo published base rate1
ARNo published base rate1
AZNo published base rate1
CANo published base rate29
CONo published base rate1
CTNo published base rate1
DCNo published base rate1
DENo published base rate1
FLNo published base rate3
GANo published base rate2
GUNo published base rate1
HINo published base rate1
IANo published base rate1
IDNo published base rate1
ILNo published base rate4
INNo published base rate1
KSNo published base rate1
KYNo published base rate1
LANo published base rate2
MANo published base rate2
MDNo published base rate3
MENo published base rate2
MINo published base rate2
MNNo published base rate1
MONo published base rate3
MSNo published base rate1
MTNo published base rate1
NCNo published base rate1
NDNo published base rate1
NENo published base rate1
NHNo published base rate1
NJNo published base rate2
NMNo published base rate1
NVNo published base rate1
NYNo published base rate5
OHNo published base rate1
OKNo published base rate1
ORNo published base rate2
PANo published base rate2
PRNo published base rate1
RINo published base rate1
SCNo published base rate1
SDNo published base rate1
TNNo published base rate1
TXNo published base rate8
UTNo published base rate1
VANo published base rate2
VINo published base rate1
VTNo published base rate1
WANo published base rate2
WINo published base rate1
WVNo published base rate1
WYNo published base rate1

How the 44403 rate is calculated

Each of 44403’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 · 44403

RVUs × geographic indexes × conversion factor

Work5.36

5.36 RVUs× 1.000 GPCI

Practice expense2.01

2.01 RVUs× 1.000 GPCI

Malpractice0.59

0.59 RVUs× 1.000 GPCI

Adjusted RVUs

7.9600

Conversion factor

$33.4009

Medicare rate

$265.87

Every GPCI starts at 1.000, the national rate. Enter a ZIP or drag a slider.

Payment rules and modifiers for 44403

The CMS indicators that decide how 44403 is paid alongside other services.

CMS payment indicators · 44403

Colonoscopy

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

44403 without 51 · national facility

$265.87

Colonoscopy

44403-51 · Second procedure: 50%

$132.94

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

44403 compared with similar codes

Compare codes · National

5 codes, side by side

  • 44403

    Colonoscopy5.36 wRVU

    Not priced

  • 45385

    Snare polypectomy4.46 wRVU

    $500.01

  • 45380

    Colonoscopy with biopsy3.47 wRVU

    $479.97

  • 44401

    Colonoscopy ablation4.23 wRVU

    $2,581.22

  • 44404

    Colonoscopy2.94 wRVU

    $465.61

How to choose

45385Snare polypectomy
45385 describes standard snare removal of a lesion. Use 44403 when the documented work is an endoscopic resection rather than routine snare polypectomy.
45380Colonoscopy with biopsy
45380 is for colonoscopic biopsy or tissue sampling. It does not describe removal of a lesion by endoscopic resection.
44401Colonoscopy ablation
44401 is for ablation of a lesion, while 44403 is for endoscopic resection. Follow the intervention documented in the procedure note.
44404Colonoscopy
44404 describes colonoscopy with injection. Injection alone does not represent the lesion resection reported with 44403.

Codes related to 44403

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

Codes related to 44403
CodeHow it relatesNational office range
Used instead
45385Snare polypectomyStandard colonoscopic snare removal, rather than the advanced resection service.$444.65–$656.13
45380Colonoscopy with biopsyColonoscopy with biopsy when tissue sampling, not lesion resection, is performed.$423.81–$640.93
45390ColonoscopyColonoscopy with endoscopic mucosal resection; select according to the documented resection service.No office rate
44401Colonoscopy ablationColonoscopy with lesion ablation rather than endoscopic resection.$2,231.79–$3,660.99

44403 billing questions

How is this different from standard snare polypectomy?

Use this code when the documented work is endoscopic lesion resection rather than routine snare removal. Standard snare polypectomy is represented by 45385 when that is the service performed.

Can biopsy be reported separately when tissue is removed?

The resection itself includes removal of tissue for examination. The record should support a distinct diagnostic biopsy service before separately reporting one.

What documentation supports this code?

Document the lesion’s location and the resection technique, along with the procedure performed and findings. The note should distinguish the resection from simple biopsy or routine polypectomy.

How are related endoscopies priced when performed together?

CMS applies endoscopy family pricing when related endoscopies are performed together. The same-day resection and related endoscopic work should be documented clearly.

Can modifier 50 or an assistant-at-surgery claim be used?

No. Modifier 50 is inappropriate for this code, and Medicare does not pay an assistant at surgery for the service.

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 44403PPRRVU2026_Oct_nonQPP.csv, line 5,418 (RVU26D)

Open CMS sourceHow we calculate rates

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