Billing code 44403: ColonoscopyMedicare rate & RVUs in Guam
Reports colonoscopy with endoscopic resection of a colorectal lesion when the therapeutic work goes beyond routine biopsy or standard snare removal.
CMS doesn’t publish an office rate for 44403 in Guam.
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 9 sections
What 44403 covers
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.
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 in Hawaii, Guam
| Payment locality | Office | Facility |
|---|---|---|
| Hawaii, Guam | Unavailable | $266.77 |
How the 44403 rate is calculated
Each of 44403’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 · 44403
RVUs × geographic indexes × conversion factor
Swap in your local Medicare rate.
Work 5.36Practice expense 2.01Malpractice 0.59
All indexes start at 1.000 (the national rate). Enter a ZIP or drag a slider.
Payment rules and modifiers for 44403
The CMS indicators that decide how 44403 is paid alongside other services.
CMS payment indicators · 44403
Colonoscopy
| Rule | CMS value | What it means |
|---|---|---|
| Global period | 000 | Same-day global: pre- and post-op care on the day of the procedure is included. |
| Multiple procedures | 3 | Endoscopy family rules apply. |
| Bilateral (modifier 50) | 0 | The 150% bilateral adjustment doesn’t apply. |
| Assistant at surgery (80/81/82/AS) | 1 | Not paid (statutory restriction). |
| Co-surgeons (62) | 0 | Not permitted. |
| Team surgery (66) | 0 | Not permitted. |
| Professional/technical | 0 | Physician service: no professional/technical split. |
What modifiers do to the payment
Modifier 51 · payment effect
With and without the modifier
44403 without 51 · national facility
$265.87
Colonoscopy
44403-51 · Second procedure: 50%
$132.94
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%).
44403 compared with similar codes
Compare codes
44403 vs 45385 vs 45380 vs 44401 vs 44404: national Medicare rates
Swap in your local Medicare rate.
How to choose
- 45385Snare polypectomy
- 45385 describes standard snare removal of a lesion. Use 44403 when the documented work is an endoscopic resection rather than routine snare polypectomy.
- 45380Colonoscopy with biopsy
- 45380 is for colonoscopic biopsy or tissue sampling. It does not describe removal of a lesion by endoscopic resection.
- 44401Colonoscopy ablation
- 44401 is for ablation of a lesion, while 44403 is for endoscopic resection. Follow the intervention documented in the procedure note.
- 44404Colonoscopy
- 44404 describes colonoscopy with injection. Injection alone does not represent the lesion resection reported with 44403.
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 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
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