FeeBase
Log inGet started
Menu

Billing code 44408: Colon decompressionMedicare rate & RVUs

Reports endoscopic decompression performed through a colostomy or other stoma, commonly to relieve colonic volvulus or megacolon, with a decompression tube included when placed.

CMS RVU26DEffective Oct 1, 2026109 payment localities24 Medicare services in 2024

Medicare pays $203.75 for 44408 nationally in a facility.

Medicare rate · 44408

Colon decompression

Swap in your local Medicare rate.

Work RVUs
4.04
Total RVUs
6.10
Global days
000

National rate · 2026

$203.75

Facility setting, before claim adjustments.

See every locality for 44408 → · 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 44408 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 44408 covers

This service uses a flexible colonoscope passed through a stoma to relieve colonic distention or obstruction, such as in volvulus or megacolon. The endoscopist may place a decompression tube as part of the procedure. It is typically performed by a gastroenterologist or surgeon in a facility setting when endoscopic access through the stoma is indicated.

Report the code when the documented service is therapeutic decompression through the stoma, rather than inspection alone or a different intervention such as dilation or tissue sampling. The record should support the indication, route through the stoma, decompressive work, and tube placement if performed. CMS assigns a 0-day global period, so same-day preoperative and postoperative care is included. When related endoscopies occur together, endoscopy-family pricing applies. Modifier 50 is inappropriate; an assistant at surgery is not paid, 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 44408 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

44408 office and facility rates by payment locality
Payment localityOfficeFacility
AlabamaUnavailable$190.60
Alaska*Unavailable$268.13
ArizonaUnavailable$199.95
ArkansasUnavailable$188.99
AtlantaUnavailable$207.97
AustinUnavailable$205.48
BakersfieldUnavailable$205.76
Baltimore/Surr. CntysUnavailable$213.34
BeaumontUnavailable$197.83
BrazoriaUnavailable$201.10

44408 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.

View every state and territory as a table
44408 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 44408 rate is calculated

Each of 44408’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 · 44408

RVUs × geographic indexes × conversion factor

Swap in your local Medicare rate.

Work 4.04Practice expense 1.62Malpractice 0.44

6.1000 adjusted RVUs×$33.4009 conversion factor=$203.75

All indexes start at 1.000 (the national rate). Enter a ZIP or drag a slider.

Payment rules and modifiers for 44408

The CMS indicators that decide how 44408 is paid alongside other services.

CMS payment indicators · 44408

Colon decompression

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

44408 without 51 · national facility

$203.75

Colon decompression

44408-51 · Second procedure: 50%

$101.88

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

44408 compared with similar codes

Compare codes

44408 vs 45393 vs 44405 vs 44407 vs 44388: national Medicare rates

Swap in your local Medicare rate.

  • 44408
    Colon decompression · 4.04 wRVU
    —
  • 45393
    Colonic decompression · 4.56 wRVU
    —
  • 44405
    Colonoscopy · 3.15 wRVU
    $614.58
  • 44407
    Colonoscopy with sampling · 4.84 wRVU
    —
  • 44388
    Colonoscopy · 2.65 wRVU
    $353.72

How to choose

45393Colonic decompression
Both describe colonoscopic decompression, but 44408 is performed through a stoma; 45393 is performed through the anus.
44405Colonoscopy
44405 is for dilation through the stoma. Choose 44408 when the procedure's purpose is colonic decompression.
44407Colonoscopy with sampling
44407 covers needle aspiration or biopsy through the stoma. It does not describe decompression.
44388Colonoscopy
44388 describes diagnostic colonoscopy through a stoma. Use 44408 when therapeutic decompression is performed.

Codes related to 44408

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

Codes related to 44408
CodeHow it relatesNational office range
Same family
44401Colonoscopy ablationRelated through-stoma colonoscopy code for ablation rather than decompression.$2,231.79–$3,660.99
44402ColonoscopyRelated through-stoma colonoscopy code for stent placement.No office rate
44403ColonoscopyRelated through-stoma colonoscopy code for resection.No office rate
44404ColonoscopyRelated through-stoma colonoscopy code for injection.$409.32–$627.00
44405ColonoscopyRelated through-stoma colonoscopy code for dilation.$538.62–$840.39
44407Colonoscopy with samplingRelated through-stoma colonoscopy code for needle aspiration or biopsy.No office rate
Used instead
45393Colonic decompressionDecompression by colonoscopy through the anus rather than through a stoma.No office rate

44408 billing questions

How does this differ from 45393?

44408 describes decompression performed through a stoma. Use 45393 for the comparable decompression procedure performed through the anus.

Is placement of a decompression tube separately reported?

Tube placement, when performed as part of the decompression, is included in this service.

Can modifier 50 be appended?

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

Can a diagnostic colonoscopy through the stoma be billed separately?

The inspection associated with the decompression is part of the therapeutic service. Do not separately report a diagnostic examination for the same session and service.

What documentation supports reporting 44408?

Document the clinical reason for decompression, that the scope was passed through the stoma, the decompressive maneuver, and whether a tube was placed.

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 44408PPRRVU2026_Oct_nonQPP.csv, line 5,423 (RVU26D)

Open CMS sourceHow we calculate rates

Did this answer your question about what 44408 pays?

Tell us what you were actually trying to work out. We’ll answer you directly, or build the page that does.

Fee sheets

Put 44408 and the rest of your codes on one sheet

Build a fee sheet from your own code list at your locality, put your payer contracts beside Medicare, and see what changed each quarter.

Build my fee sheetOr price your code list free →