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Billing code 44406: ColonoscopyMedicare rate & RVUs

Reports colonoscopy with endoscopic ultrasound to assess colorectal wall layers or nearby structures during evaluation of a lesion or abnormality.

CMS RVU26DEffective Oct 1, 2026109 payment localities

Medicare pays $202.08 for 44406 nationally in a facility.

Medicare rate · 44406

Colonoscopy

Work RVUs
4
Total RVUs
6.05
Global days
000

National rate · 2026

$202.08

Facility setting, before claim adjustments.

See every locality for 44406 →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 44406 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 44406 covers

This service combines colonoscopic visualization with ultrasound imaging from the endoscope to assess the bowel wall or structures near the colon and rectum. Gastroenterologists typically perform it in an endoscopy unit or hospital procedure room when standard visual examination alone does not provide the needed information, such as when evaluating a subepithelial abnormality or suspected involvement of adjacent tissue. The ultrasound examination is the defining service; ordinary colonoscopy without ultrasound is not a substitute.

Report the code when the endoscopic ultrasound examination is performed and documented, including the area evaluated and relevant findings. It 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 for this service. Medicare does not pay an assistant at surgery, and 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.

Where 44406 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

44406 office and facility rates by payment locality
Payment localityOfficeFacility
AlabamaUnavailable$188.98
Alaska*Unavailable$265.77
ArizonaUnavailable$198.29
ArkansasUnavailable$187.37
AtlantaUnavailable$206.29
AustinUnavailable$203.79
BakersfieldUnavailable$204.03
Baltimore/Surr. CntysUnavailable$211.62
BeaumontUnavailable$196.19
BrazoriaUnavailable$199.43

44406 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
44406 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 44406 rate is calculated

Each of 44406’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 · 44406

RVUs × geographic indexes × conversion factor

Work4.00

4.00 RVUs× 1.000 GPCI

Practice expense1.61

1.61 RVUs× 1.000 GPCI

Malpractice0.44

0.44 RVUs× 1.000 GPCI

Adjusted RVUs

6.0500

Conversion factor

$33.4009

Medicare rate

$202.08

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

Payment rules and modifiers for 44406

The CMS indicators that decide how 44406 is paid alongside other services.

CMS payment indicators · 44406

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

44406 without 51 · national facility

$202.08

Colonoscopy

44406-51 · Second procedure: 50%

$101.04

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

44406 compared with similar codes

Compare codes · National

4 codes, side by side

  • 44406

    Colonoscopy4 wRVU

    Not priced

  • 44407

    Colonoscopy with sampling4.84 wRVU

    Not priced

  • 44403

    Colonoscopy5.36 wRVU

    Not priced

  • 44405

    Colonoscopy3.15 wRVU

    $614.58

How to choose

44407Colonoscopy with sampling
Choose the ultrasound service when imaging is performed; the needle aspiration or biopsy service is distinguished by sampling. Confirm which service was actually performed and documented.
44403Colonoscopy
This code describes ultrasound examination, while 44403 concerns endoscopic resection. An abnormality visualized on ultrasound does not by itself establish that resection was performed.
44405Colonoscopy
Use 44405 for the colonoscopy service involving dilation. Ultrasound examination is the distinguishing service for 44406.

Codes related to 44406

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

Codes related to 44406
CodeHow it relatesNational office range
Same family
44407Colonoscopy with samplingRelated colonoscopy service involving needle aspiration or biopsy.No office rate
44403ColonoscopyColonoscopy with resection rather than ultrasound examination.No office rate
44404ColonoscopyColonoscopy with injection rather than ultrasound examination.$409.32–$627.00
44405ColonoscopyColonoscopy with dilation rather than ultrasound examination.$538.62–$840.39
44401Colonoscopy ablationColonoscopy with ablation rather than ultrasound examination.$2,231.79–$3,660.99

44406 billing questions

Can a related endoscopy be reported on the same date?

When related endoscopies are performed together, CMS endoscopy family pricing applies. Document the distinct services performed.

Is modifier 50 appropriate if both sides of the colon are examined?

No. CMS identifies bilateral adjustment as inappropriate for this code.

Does the code include same-day care?

Yes. Its 0-day global period includes same-day preoperative and postoperative care.

Can an assistant surgeon or co-surgeon be reported?

Medicare does not pay an assistant at surgery for this service, and 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 44406PPRRVU2026_Oct_nonQPP.csv, line 5,421 (RVU26D)

Open CMS sourceHow we calculate rates

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