$316.33
Use 44389 when tissue is sampled during colonoscopy through the stoma. Use 44388 for the stoma examination without biopsy.
On this page
CMS RVU26D · Effective 2026-10-01
44389 Colonoscopy Medicare reimbursement rates in Alabama
Reports examination of the colon through a stoma when the endoscopist takes one or more tissue samples during the procedure. Compare 44389 office and facility rates across CMS payment localities in Alabama.
Amounts below use the non-QP conversion factor for participating physicians. These are base physician payments before claim-level adjustments, not patient costs or total hospital charges.
What does Medicare pay for 44389 in Alabama?
Alabama has 1 payment locality in this comparison. Use the service location to choose the applicable amount. These are the supported base rates for the payment area shown below, using the same CMS release.
Office / nonfacility
$408.54
1 of 1 localities have a supported rate.
Payment area: Alabama
One mapped payment locality.
Facility setting
$142.59
1 of 1 localities have a supported rate.
Payment area: Alabama
One mapped payment locality.
These are locality ranges, not averages or address-specific quotes. A facility-setting amount covers the physician service; it does not include a hospital’s separate bill. Choose a locality below to inspect its calculation, compare other payment areas, or price a percentage of Medicare.
Endoscopy
About 44389: Colonoscopy through stoma with biopsy
Reports examination of the colon through a stoma when the endoscopist takes one or more tissue samples during the procedure.
Code 44389 describes endoscopic examination of the colon through an existing stoma, with tissue sampling during the procedure. A gastroenterologist or colorectal surgeon may use it to evaluate abnormal mucosa, a suspected neoplasm, or another finding in a patient with a colostomy. The access route is the stoma; a colonoscopy performed through the anus belongs to a different code family.
Report the service when the procedure note documents access through the stoma, the examination performed, and the biopsy site or sites. The code includes the colonoscopy and biopsy, whether one or multiple samples are taken; do not count biopsy sites as separate units. If the endoscopist removes a lesion or treats bleeding, select the code describing that intervention. This minor procedure has a 0-day global period, so same-day preoperative and postoperative care is included. CMS endoscopy-family pricing applies when related endoscopies are performed together. Modifier 50 is inappropriate for this single examination. Medicare does not pay an assistant at surgery, and co-surgeons and team surgery are not permitted.
CMS billing rules for 44389
- Global period
- Minor procedure with a 0-day global period: same-day preoperative and postoperative care is included.
- Multiple procedures
- Endoscopy family pricing applies when related endoscopies are performed together.
- Bilateral procedures
- Bilateral adjustment does not apply; the descriptor or anatomy makes modifier 50 inappropriate.
- Assistant at surgery
- Statutory restriction: assistant at surgery is not paid.
- Co-surgeons
- Co-surgeons not permitted.
- Team surgery
- Team surgery not permitted.
Where the value comes from
- Work RVU2.94 · 21%
- Practice expense (office) RVU10.36 · 76%
- Malpractice RVU0.40 · 3%
2.5K
Medicare services in 2024 · #2291 by national volume
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.
44389 compared with similar codes
Office rates for Alabama, from the same CMS release.
$430.13
Both include colonoscopy with biopsy, but 44389 is performed through a stoma and 45380 through the anus.
$386.45
Code 44392 describes removal of a lesion through the stoma using hot biopsy forceps or bipolar cautery; 44389 describes biopsy sampling.
$434.33
Code 44394 describes snare removal of a lesion through the stoma. Use 44389 when the service is biopsy rather than snare excision.
Compare 44389 by payment locality
Find the payment area for your service address, then open its rate page for calculation inputs, release history and the percentage-of-Medicare tool. A city may cross payment-area boundaries; the ZIP lookup above helps resolve the location.
1 of 1 payment localities
Alabama →
Office / nonfacility
$408.54
Facility
$142.59
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How this local rate is calculated
Each RVU component is multiplied by its own geographic practice cost index (GPCI). The three adjusted components are added, then multiplied by the conversion factor. These are the inputs used for 44389 in Alabama.
PPRRVU2026_Oct_nonQPP.csv
5,411
- Code
- 44389
- Physician work
- 2.94
- Practice expense
- 10.36
- Malpractice
- 0.40
GPCI2026.csv
4
- Locality
- Alabama
- Physician work
- 1.000
- Practice expense
- 0.875
- Malpractice
- 0.566
| Component | RVU | Locality factor | Adjusted |
|---|---|---|---|
| Physician work | 2.94 | × 1.000 | 2.9400 |
| Practice expense | 10.36 | × 0.875 | 9.0650 |
| Malpractice | 0.40 | × 0.566 | 0.2264 |
| Total RVUs | 12.2314 | ||
| Conversion factor | × 33.4009 | ||
Office / nonfacility rate, Alabama$408.54
Explore RVUs, geographic factors and the full formula
Office / nonfacility
| Component | RVU | Local GPCI |
|---|---|---|
| Work | 2.94 | 1 |
| Practice expense | 10.36 | 0.875 |
| Malpractice | 0.4 | 0.566 |
(2.94 × 1 + 10.36 × 0.875 + 0.4 × 0.566) × $33.4009 = $408.54
Facility
| Component | RVU | Local GPCI |
|---|---|---|
| Work | 2.94 | 1 |
| Practice expense | 1.26 | 0.875 |
| Malpractice | 0.4 | 0.566 |
(2.94 × 1 + 1.26 × 0.875 + 0.4 × 0.566) × $33.4009 = $142.59
The office and facility calculations use their respective practice-expense RVUs. The facility amount here is the physician fee, not a separate hospital or facility bill.
44389 billing questions
How does 44389 differ from 45380?
Code 44389 is for colonoscopy performed through a stoma. Code 45380 describes colonoscopy with biopsy through the usual anal route.
Do multiple biopsy sites create multiple units?
No. The code covers the examination with one or more biopsies; the number of sites or specimens does not create additional units.
Can the diagnostic stoma colonoscopy be billed separately?
The examination is included in 44389 when biopsy is performed during it. Do not separately report a diagnostic colonoscopy for that same examination.
Which code should be used if a lesion is removed?
Use the stoma-colonoscopy code that describes the removal technique, such as 44392 or 44394, rather than coding biopsy alone for the removal.
Can modifier 50 or an assistant-at-surgery claim be reported?
Modifier 50 is inappropriate for this single stoma examination. Medicare does not pay an assistant at surgery for 44389.
Where these rates come from
FeeBase calculates base physician payments from CMS work, practice-expense, and malpractice RVUs, adjusted by each locality’s geographic indices and the applicable conversion factor. Unavailable or separately priced services are labeled rather than assigned a made-up amount.
Source: RVU26D. Effective 2026-10-01 through the day before 2027-01-01.
5,40844386,,Endoscopy bowel pouch/biop,A,,1.46,8.77,,0.79,,0.18,10.41,2.43,0,000,0.00,0.00,0.00,2,0,1,0,0,9,,33.4009,09,0,99,0.00,0.00,0.00
5,40944388,,Colonoscopy thru stoma spx,A,,2.65,7.53,,1.16,,0.41,10.59,4.22,0,000,0.00,0.00,0.00,2,0,1,0,0,9,,33.4009,09,0,99,0.00,0.00,0.00
5,41044388,53,Colonoscopy thru stoma spx,A,,1.33,3.76,,0.58,,0.21,5.30,2.12,0,000,0.00,0.00,0.00,2,0,1,0,0,9,,33.4009,09,0,99,0.00,0.00,0.00
5,41144389,,Colonoscopy with biopsy,A,,2.94,10.36,,1.26,,0.40,13.70,4.60,0,000,0.00,0.00,0.00,3,0,1,0,0,9,44388,33.4009,09,0,99,0.00,0.00,0.00
5,41244390,,Colonoscopy for foreign body,A,,3.65,9.39,,1.50,,0.41,13.45,5.56,0,000,0.00,0.00,0.00,3,0,1,0,0,9,44388,33.4009,09,0,99,0.00,0.00,0.00
5,41344391,,Colonoscopy for bleeding,A,,4.02,16.52,,1.59,,0.47,21.01,6.08,0,000,0.00,0.00,0.00,3,0,1,0,0,9,44388,33.4009,09,0,99,0.00,0.00,0.00
5,41444392,,Colonoscopy & polypectomy,A,,3.44,8.91,,1.35,,0.59,12.94,5.38,0,000,0.00,0.00,0.00,3,0,1,0,0,9,44388,33.4009,09,0,99,0.00,0.00,0.00
1ADDENDUM E. FINAL CY 2026 GEOGRAPHIC PRACTICE COST INDICES (GPCIs) BY STATE AND MEDICARE LOCALITY,,,,,,
2,,,,,,
3Medicare Administrative Contractor (MAC),State,Locality Number,Locality Name,2026 PW GPCI (with 1.0 Floor)***,2026 PE GPCI,2026 MP GPCI
410112,AL,00,ALABAMA,1.000,0.875,0.566
502102,AK,01,ALASKA*,1.500,1.065,0.551
603102,AZ,00,ARIZONA,1.000,0.969,0.856
707102,AR,13,ARKANSAS,1.000,0.859,0.515