Billing code 44404: ColonoscopyMedicare rate & RVUs
Reports colonoscopy with a substance injected into the colonic submucosa, such as tattoo ink used to mark a lesion for later localization.
Medicare pays $465.61 for 44404 nationally in the office and $152.98 in a hospital or facility. Local office rates run $409.32–$627.00.
Medicare rate · 44404
Colonoscopy
Swap in your local Medicare rate.
- Work RVUs
- 2.94
- Total RVUs
- 13.94
- Global days
- 000
National rate · 2026
$465.61
Office setting, before claim adjustments.
See every locality for 44404 → · 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 44404 covers
During this flexible colonoscopy, the endoscopist directs one or more injections into the submucosal layer of the colon. A common purpose is tattooing a lesion, such as a polyp or suspected tumor, so it can be located during later endoscopy or surgery. Gastroenterologists and other clinicians trained in colonoscopy perform the service, typically in a hospital outpatient department or ambulatory surgery center.
Select this code when the colonoscopy includes directed submucosal injection, rather than choosing a code for a different endoscopic intervention such as resection or dilation. The procedure report should identify the site and purpose of the injection and the substance used when documented. This minor procedure has 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-surgery 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.
Where 44404 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
$409.32 to $627.00
109 of 109 payment localities
| Payment locality | Office | Facility |
|---|---|---|
| Alabama | $415.66 | $142.10 |
| Alaska* | $531.89 | $198.94 |
| Arizona | $452.75 | $149.81 |
| Arkansas | $409.32 | $140.77 |
| Atlanta | $474.19 | $156.56 |
| Austin | $484.87 | $154.11 |
| Bakersfield | $496.40 | $153.76 |
| Baltimore/Surr. Cntys | $496.14 | $160.68 |
| Beaumont | $432.79 | $148.29 |
| Brazoria | $460.34 | $150.52 |
| Chicago | $484.94 | $170.74 |
| Chico | $495.25 | $152.61 |
| Colorado | $486.61 | $153.97 |
| Connecticut | $497.60 | $160.89 |
| Dallas | $463.23 | $151.84 |
| Dc + Md/Va Suburbs | $535.46 | $167.18 |
| Delaware | $460.53 | $151.65 |
| Detroit | $462.14 | $160.45 |
| East St. Louis | $450.47 | $162.84 |
| El Centro | $495.32 | $152.67 |
| Fort Lauderdale | $480.74 | $164.04 |
| Fort Worth | $459.85 | $151.59 |
| Fresno | $495.25 | $152.61 |
| Galveston | $461.67 | $151.23 |
| Hanford-Corcoran | $495.25 | $152.61 |
| Hawaii, Guam | $508.67 | $153.21 |
| Houston | $468.81 | $158.37 |
| Idaho | $430.39 | $142.77 |
| Indiana | $433.04 | $143.23 |
| Iowa | $427.63 | $141.57 |
| Kansas | $425.13 | $142.51 |
| Kentucky | $425.16 | $147.23 |
| Los Angeles-Long Beach-Anaheim (Los Angeles/Orange Cnty) | $530.11 | $160.27 |
| Madera | $495.25 | $152.61 |
| Manhattan | $536.94 | $173.66 |
| Merced | $495.25 | $152.61 |
| Metropolitan Boston | $536.95 | $163.67 |
| Metropolitan Kansas City | $443.69 | $150.13 |
| Metropolitan Philadelphia | $484.42 | $158.97 |
| Metropolitan St. Louis | $448.62 | $151.00 |
| Miami | $500.06 | $174.61 |
| Minnesota | $466.72 | $145.02 |
| Mississippi | $412.95 | $143.77 |
| Modesto | $495.25 | $152.61 |
| Montana** | $465.58 | $152.95 |
| Napa | $578.08 | $166.03 |
| Nebraska | $430.22 | $141.66 |
| Nevada** | $463.79 | $150.84 |
| New Hampshire | $478.51 | $153.06 |
| New Mexico | $438.81 | $152.13 |
| New Orleans | $446.47 | $152.28 |
| North Carolina | $437.16 | $145.48 |
| North Dakota** | $457.87 | $145.24 |
| Northern Nj | $529.38 | $166.73 |
| Nyc Suburbs/Long Island | $550.04 | $178.32 |
| Ohio | $434.88 | $149.45 |
| Oklahoma | $424.78 | $145.60 |
| Oxnard-Thousand Oaks-Ventura | $527.94 | $158.41 |
| Portland | $503.18 | $155.85 |
| Poughkpsie/N Nyc Suburbs | $506.43 | $164.10 |
| Puerto Rico | $469.31 | $153.24 |
| Queens | $542.15 | $172.62 |
| Redding | $495.25 | $152.61 |
| Rest Of California | $495.25 | $152.61 |
| Rest Of Florida | $456.57 | $157.69 |
| Rest Of Georgia | $429.84 | $150.97 |
| Rest Of Illinois | $442.11 | $156.68 |
| Rest Of Louisiana | $424.31 | $147.63 |
| Rest Of Maine | $432.33 | $144.71 |
| Rest Of Maryland | $469.77 | $153.39 |
| Rest Of Massachusetts | $483.32 | $154.12 |
| Rest Of Michigan | $436.46 | $151.02 |
| Rest Of Missouri | $416.36 | $146.88 |
| Rest Of New Jersey | $503.40 | $162.01 |
| Rest Of New York | $444.02 | $147.02 |
| Rest Of Oregon | $460.32 | $148.94 |
| Rest Of Pennsylvania | $435.83 | $148.84 |
| Rest Of Texas | $446.27 | $149.58 |
| Rest Of Washington | $482.55 | $153.35 |
| Rhode Island | $477.76 | $154.81 |
| Riverside-San Bernardino-Ontario | $499.48 | $156.84 |
| Sacramento-Roseville-Folsom | $520.86 | $157.27 |
| Salinas | $518.96 | $156.61 |
| San Diego-Chula Vista-Carlsbad | $532.05 | $158.14 |
| San Francisco-Oakland-Berkeley (Marin Cnty) | $613.19 | $172.38 |
| San Francisco-Oakland-Berkeley (San Francisco/San Mateo/Alameda/Contra Costa Cnty) | $612.74 | $171.93 |
| San Jose-Sunnyvale-Santa Clara (San Benito Cnty) | $627.00 | $176.19 |
| San Jose-Sunnyvale-Santa Clara (Santa Clara Cnty) | $625.19 | $174.38 |
| San Luis Obispo-Paso Robles | $510.49 | $154.40 |
| Santa Cruz-Watsonville | $537.82 | $157.97 |
| Santa Maria-Santa Barbara | $521.14 | $156.61 |
| Santa Rosa-Petaluma | $543.31 | $159.40 |
| Seattle (King Cnty) | $548.58 | $164.98 |
| South Carolina | $436.72 | $147.85 |
| South Dakota** | $456.96 | $144.33 |
| Southern Maine | $457.61 | $147.79 |
| Stockton | $495.25 | $152.61 |
| Suburban Chicago | $485.92 | $164.85 |
| Tennessee | $427.33 | $143.15 |
| Utah | $443.02 | $149.14 |
| Vallejo | $577.44 | $165.39 |
| Vermont | $455.63 | $146.12 |
| Virgin Islands | $469.31 | $153.24 |
| Virginia | $455.75 | $148.44 |
| Visalia | $495.25 | $152.61 |
| West Virginia | $424.80 | $153.12 |
| Wisconsin | $441.71 | $142.21 |
| Wyoming** | $462.22 | $149.59 |
| Yuba City | $495.25 | $152.61 |
44404 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.
$409.32
$561.13
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 | $531.89 | 1 |
| AL | $415.66 | 1 |
| AR | $409.32 | 1 |
| AZ | $452.75 | 1 |
| CA | $495.25–$627.00 | 29 |
| CO | $486.61 | 1 |
| CT | $497.60 | 1 |
| DC | $535.46 | 1 |
| DE | $460.53 | 1 |
| FL | $456.57–$500.06 | 3 |
| GA | $429.84–$474.19 | 2 |
| GU | $508.67 | 1 |
| HI | $508.67 | 1 |
| IA | $427.63 | 1 |
| ID | $430.39 | 1 |
| IL | $442.11–$485.92 | 4 |
| IN | $433.04 | 1 |
| KS | $425.13 | 1 |
| KY | $425.16 | 1 |
| LA | $424.31–$446.47 | 2 |
| MA | $483.32–$536.95 | 2 |
| MD | $469.77–$535.46 | 3 |
| ME | $432.33–$457.61 | 2 |
| MI | $436.46–$462.14 | 2 |
| MN | $466.72 | 1 |
| MO | $416.36–$448.62 | 3 |
| MS | $412.95 | 1 |
| MT | $465.58 | 1 |
| NC | $437.16 | 1 |
| ND | $457.87 | 1 |
| NE | $430.22 | 1 |
| NH | $478.51 | 1 |
| NJ | $503.40–$529.38 | 2 |
| NM | $438.81 | 1 |
| NV | $463.79 | 1 |
| NY | $444.02–$550.04 | 5 |
| OH | $434.88 | 1 |
| OK | $424.78 | 1 |
| OR | $460.32–$503.18 | 2 |
| PA | $435.83–$484.42 | 2 |
| PR | $469.31 | 1 |
| RI | $477.76 | 1 |
| SC | $436.72 | 1 |
| SD | $456.96 | 1 |
| TN | $427.33 | 1 |
| TX | $432.79–$484.87 | 8 |
| UT | $443.02 | 1 |
| VA | $455.75–$535.46 | 2 |
| VI | $469.31 | 1 |
| VT | $455.63 | 1 |
| WA | $482.55–$548.58 | 2 |
| WI | $441.71 | 1 |
| WV | $424.80 | 1 |
| WY | $462.22 | 1 |
How the 44404 rate is calculated
Each of 44404’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 · 44404
RVUs × geographic indexes × conversion factor
Swap in your local Medicare rate.
Work 2.94Practice expense 10.61Malpractice 0.39
All indexes start at 1.000 (the national rate). Enter a ZIP or drag a slider.
Payment rules and modifiers for 44404
The CMS indicators that decide how 44404 is paid alongside other services.
CMS payment indicators · 44404
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
44404 without 51 · national office
$465.61
Colonoscopy
44404-51 · Second procedure: 50%
$232.81
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%).
44404 compared with similar codes
Compare codes
44404 vs 44403 vs 44401 vs 44405: national Medicare rates
Swap in your local Medicare rate.
How to choose
- 44403Colonoscopy
- Use 44404 when the colonoscopy includes directed submucosal injection, such as lesion marking. Use 44403 when the service includes endoscopic tissue resection.
- 44401Colonoscopy ablation
- 44404 describes submucosal injection; 44401 describes ablation of a lesion.
- 44405Colonoscopy
- 44404 describes injection into the submucosa, while 44405 describes dilation during colonoscopy.
44404 billing questions
When should this code be chosen instead of the colonoscopy resection code?
Choose this code for directed injection into the colonic submucosa, such as tattooing a lesion. Use the resection code when the service includes endoscopic removal of tissue.
Can injection and another endoscopic service be reported at the same encounter?
The code describes the injection service. When related endoscopies are performed together, CMS endoscopy family pricing applies; the procedure documentation should show which services were performed.
Should modifier 50 be appended for injections on both sides of the colon?
No. The CMS bilateral adjustment does not apply to this code, and modifier 50 is inappropriate.
Is same-day care included in the payment?
Yes. The 0-day global period includes same-day preoperative and postoperative care.
Can an assistant, co-surgeon, or surgical team be paid for this procedure?
Medicare 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
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