$487.20
45385 describes standard snare removal of a lesion. Use 44403 when the documented work is an endoscopic resection rather than routine snare polypectomy.
On this page
CMS RVU26D · Effective 2026-10-01
44403 Colonoscopy Medicare reimbursement rates in Arizona
Reports colonoscopy with endoscopic resection of a colorectal lesion when the therapeutic work goes beyond routine biopsy or standard snare removal. Compare 44403 office and facility rates across CMS payment localities in Arizona.
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 44403 in Arizona?
Arizona 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
No supported rate
Facility setting
$260.95
1 of 1 localities have a supported rate.
Payment area: Arizona
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.
Gastroenterology
About 44403: Colonoscopy with advanced lesion resection
Reports colonoscopy with endoscopic resection of a colorectal lesion when the therapeutic work goes beyond routine biopsy or standard snare removal.
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.
CMS billing rules for 44403
- 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 RVU5.36 · 67%
- Practice expense (office) RVU2.01 · 25%
- Malpractice RVU0.59 · 7%
97
Medicare services in 2024 · #4909 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.
44403 compared with similar codes
Office rates for Arizona, from the same CMS release.
$467.10
45380 is for colonoscopic biopsy or tissue sampling. It does not describe removal of a lesion by endoscopic resection.
$2,503.81
44401 is for ablation of a lesion, while 44403 is for endoscopic resection. Follow the intervention documented in the procedure note.
$452.75
44404 describes colonoscopy with injection. Injection alone does not represent the lesion resection reported with 44403.
Compare 44403 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
Arizona →
Office / nonfacility
Unavailable
Facility
$260.95
Need rates for a whole code list?
Fee-sheet and API access are in early access. Tell us which codes and locations your team needs.
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 44403 in Arizona.
PPRRVU2026_Oct_nonQPP.csv
5,418
- Code
- 44403
- Physician work
- 5.36
- Practice expense
- 2.01
- Malpractice
- 0.59
GPCI2026.csv
6
- Locality
- Arizona
- Physician work
- 1.000
- Practice expense
- 0.969
- Malpractice
- 0.856
| Component | RVU | Locality factor | Adjusted |
|---|---|---|---|
| Physician work | 5.36 | × 1.000 | 5.3600 |
| Practice expense | 2.01 | × 0.969 | 1.9477 |
| Malpractice | 0.59 | × 0.856 | 0.5050 |
| Total RVUs | 7.8127 | ||
| Conversion factor | × 33.4009 | ||
Facility rate, Arizona$260.95
Explore RVUs, geographic factors and the full formula
Facility
| Component | RVU | Local GPCI |
|---|---|---|
| Work | 5.36 | 1 |
| Practice expense | 2.01 | 0.969 |
| Malpractice | 0.59 | 0.856 |
(5.36 × 1 + 2.01 × 0.969 + 0.59 × 0.856) × $33.4009 = $260.95
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.
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 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.
5,41544394,,Colonoscopy w/snare,A,,3.93,10.04,,1.54,,0.51,14.48,5.98,0,000,0.00,0.00,0.00,3,0,1,0,0,9,44388,33.4009,09,0,99,0.00,0.00,0.00
5,41644401,,Colonoscopy with ablation,A,,4.23,72.58,,1.68,,0.47,77.28,6.38,0,000,0.00,0.00,0.00,3,0,1,0,0,9,44388,33.4009,09,0,99,0.00,0.00,0.00
5,41744402,,Colonoscopy w/stent plcmt,A,,4.58,1.78,NA,1.78,,0.50,6.86,6.86,0,000,0.00,0.00,0.00,3,0,1,0,0,9,44388,33.4009,09,0,99,0.00,0.00,0.00
5,41844403,,Colonoscopy w/resection,A,,5.36,2.01,NA,2.01,,0.59,7.96,7.96,0,000,0.00,0.00,0.00,3,0,1,0,0,9,44388,33.4009,09,0,99,0.00,0.00,0.00
5,41944404,,Colonoscopy w/injection,A,,2.94,10.61,,1.25,,0.39,13.94,4.58,0,000,0.00,0.00,0.00,3,0,1,0,0,9,44388,33.4009,09,0,99,0.00,0.00,0.00
5,42044405,,Colonoscopy w/dilation,A,,3.15,14.89,,1.36,,0.36,18.40,4.87,0,000,0.00,0.00,0.00,3,0,1,0,0,9,44388,33.4009,09,0,99,0.00,0.00,0.00
5,42144406,,Colonoscopy w/ultrasound,A,,4.00,1.61,NA,1.61,,0.44,6.05,6.05,0,000,0.00,0.00,0.00,3,0,1,0,0,9,44388,33.4009,09,0,99,0.00,0.00,0.00
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
801112,CA,54,BAKERSFIELD,1.019,1.096,0.609
901112,CA,55,CHICO,1.017,1.096,0.536