Billing code 44390: Stomal colonoscopyMedicare rate & RVUs in Delaware

Reports colonoscopy performed through a stoma to retrieve a foreign object from the colon using an endoscopic instrument.

CMS RVU26DEffective Oct 1, 20261 payment locality25 Medicare services in 2024

Medicare pays $444.70 for 44390 in the office in Delaware (Delaware). Which amount applies depends on the service address.

$444.70Office (non-facility)
$184.33Hospital or facility

Medicare allowed amount for participating (non-QP) physicians, before deductible, coinsurance and claim adjustments. Not a patient’s bill or a hospital charge.

We’ll open 44390 for the payment locality that covers the ZIP.

On this page 9 sections
  1. Rate in Delaware
  2. What 44390 covers
  3. By payment locality
  4. How it’s calculated
  5. Payment rules
  6. Similar codes
  7. Related codes
  8. Billing questions
  9. Sources

What 44390 covers

A gastroenterologist or colorectal surgeon uses a colonoscope passed through a colostomy stoma to locate and retrieve a foreign object in the colon. The service is typically performed in an endoscopy suite or hospital procedure setting when the object can be reached and removed endoscopically. The operative report should identify the route through the stoma, the foreign object, its location, and the retrieval performed.

Choose this code for endoscopic foreign-body removal through a stoma, rather than a diagnostic examination alone or treatment directed at a polyp, bleeding site, or tissue sample. 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 for this anatomy. Medicare does not pay for an assistant at surgery; 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.

44390 in Delaware

44390 office and facility rates by payment locality
Payment localityOfficeFacility
Delaware$444.70$184.33

How the 44390 rate is calculated

Each of 44390’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 · 44390

RVUs × geographic indexes × conversion factor

Swap in your local Medicare rate.

Work 3.65Practice expense 9.39Malpractice 0.41

13.4500 adjusted RVUs×$33.4009 conversion factor=$449.24

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

Payment rules and modifiers for 44390

The CMS indicators that decide how 44390 is paid alongside other services.

CMS payment indicators · 44390

Stomal 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

44390 without 51 · national office

$449.24

Stomal colonoscopy

44390-51 · Second procedure: 50%

$224.62

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

44390 compared with similar codes

Compare codes

44390 vs 45379 vs 44388 vs 44391 vs 44394: national Medicare rates

Swap in your local Medicare rate.

  • 44390
    Stomal colonoscopy · 3.65 wRVU
    $449.24
  • 45379
    Colonoscopy · 4.17 wRVU
    $479.30+$30.06
  • 44388
    Colonoscopy · 2.65 wRVU
    $353.72−$95.52
  • 44391
    Colonoscopy through stoma · 4.02 wRVU
    $701.75+$252.51
  • 44394
    Stomal colonoscopy · 3.93 wRVU
    $483.65+$34.41

How to choose

45379Colonoscopy
Use 44390 when the colonoscope passes through a stoma; use 45379 for foreign-body removal by the usual anal route.
44388Colonoscopy
Code 44388 describes colonoscopy through a stoma without the foreign-body removal service. Choose 44390 when endoscopic retrieval is performed.
44391Colonoscopy through stoma
Code 44391 is for endoscopic control of bleeding through a stoma. Code 44390 is for retrieval of a foreign object.
44394Stomal colonoscopy
Code 44394 describes snare removal of a polyp through a stoma; 44390 identifies foreign-body removal.

44390 billing questions

How does this differ from code 45379?

Code 44390 describes foreign-body removal by colonoscopy through a stoma. Code 45379 is the corresponding foreign-body removal service through the usual anal route.

Can this code be used for a diagnostic examination through the stoma?

No. Use 44390 when the colonoscopy through the stoma includes endoscopic foreign-body removal. A diagnostic examination without that treatment is represented by a different code.

Is removal of a polyp or control of bleeding included?

This code is for foreign-body removal, not polypectomy or treatment of a bleeding site. Report the code matching the therapeutic service actually performed.

How should same-day related endoscopies be handled?

When related endoscopies are performed together, CMS endoscopy family pricing applies. The operative documentation should support each service and its distinct purpose.

Can modifier 50 or an assistant-at-surgery claim be reported?

Modifier 50 is inappropriate for this stoma-based service. Medicare does not pay an assistant at surgery for this code.

What documentation supports reporting 44390?

Document that the colonoscope entered through the stoma, the foreign object and its location, and the endoscopic retrieval performed.

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 44390PPRRVU2026_Oct_nonQPP.csv, line 5,412 (RVU26D)
Geographic factors for DelawareGPCI2026.csv, line 40 (RVU26D)

Open CMS sourceHow we calculate rates

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