No office rate
Choose the ultrasound service when imaging is performed; the needle aspiration or biopsy service is distinguished by sampling. Confirm which service was actually performed and documented.
On this page
CMS RVU26D · Effective 2026-10-01
44406 Colonoscopy Medicare reimbursement rates in Indiana
Reports colonoscopy with endoscopic ultrasound to assess colorectal wall layers or nearby structures during evaluation of a lesion or abnormality. Compare 44406 office and facility rates across CMS payment localities in Indiana.
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 44406 in Indiana?
Indiana 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
$190.60
1 of 1 localities have a supported rate.
Payment area: Indiana
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.
Gastrointestinal endoscopy
About 44406: Colonoscopy with endoscopic ultrasound
Reports colonoscopy with endoscopic ultrasound to assess colorectal wall layers or nearby structures during evaluation of a lesion or abnormality.
This service combines colonoscopic visualization with ultrasound imaging from the endoscope to assess the bowel wall or structures near the colon and rectum. Gastroenterologists typically perform it in an endoscopy unit or hospital procedure room when standard visual examination alone does not provide the needed information, such as when evaluating a subepithelial abnormality or suspected involvement of adjacent tissue. The ultrasound examination is the defining service; ordinary colonoscopy without ultrasound is not a substitute.
Report the code when the endoscopic ultrasound examination is performed and documented, including the area evaluated and relevant findings. It has a 0-day global period, so same-day preoperative and postoperative care is included. When related endoscopies are performed together, CMS endoscopy family pricing applies. Modifier 50 is inappropriate for this service. Medicare does not pay an assistant at surgery, and co-surgeons and team surgery are not permitted.
CMS billing rules for 44406
- 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 RVU4.00 · 66%
- Practice expense (office) RVU1.61 · 27%
- Malpractice RVU0.44 · 7%
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.
44406 compared with similar codes
Office rates for Indiana, from the same CMS release.
No office rate
This code describes ultrasound examination, while 44403 concerns endoscopic resection. An abnormality visualized on ultrasound does not by itself establish that resection was performed.
$572.09
Use 44405 for the colonoscopy service involving dilation. Ultrasound examination is the distinguishing service for 44406.
Compare 44406 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
Indiana →
Office / nonfacility
Unavailable
Facility
$190.60
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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 44406 in Indiana.
PPRRVU2026_Oct_nonQPP.csv
5,421
- Code
- 44406
- Physician work
- 4.00
- Practice expense
- 1.61
- Malpractice
- 0.44
GPCI2026.csv
52
- Locality
- Indiana
- Physician work
- 1.000
- Practice expense
- 0.927
- Malpractice
- 0.486
| Component | RVU | Locality factor | Adjusted |
|---|---|---|---|
| Physician work | 4.00 | × 1.000 | 4.0000 |
| Practice expense | 1.61 | × 0.927 | 1.4925 |
| Malpractice | 0.44 | × 0.486 | 0.2138 |
| Total RVUs | 5.7063 | ||
| Conversion factor | × 33.4009 | ||
Facility rate, Indiana$190.60
Explore RVUs, geographic factors and the full formula
Facility
| Component | RVU | Local GPCI |
|---|---|---|
| Work | 4 | 1 |
| Practice expense | 1.61 | 0.927 |
| Malpractice | 0.44 | 0.486 |
(4 × 1 + 1.61 × 0.927 + 0.44 × 0.486) × $33.4009 = $190.60
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.
44406 billing questions
Can a related endoscopy be reported on the same date?
When related endoscopies are performed together, CMS endoscopy family pricing applies. Document the distinct services performed.
Is modifier 50 appropriate if both sides of the colon are examined?
No. CMS identifies bilateral adjustment as inappropriate for this code.
Does the code include same-day care?
Yes. Its 0-day global period includes same-day preoperative and postoperative care.
Can an assistant surgeon or co-surgeon be reported?
Medicare does not pay an assistant at surgery for this service, and co-surgeons and team surgery are not permitted.
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.
5,41844403,,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
5,42244407,,Colonoscopy w/ndl aspir/bx,A,,4.84,1.85,NA,1.85,,0.53,7.22,7.22,0,000,0.00,0.00,0.00,3,0,1,0,0,9,44388,33.4009,09,0,99,0.00,0.00,0.00
5,42344408,,Colonoscopy w/decompression,A,,4.04,1.62,NA,1.62,,0.44,6.10,6.10,0,000,0.00,0.00,0.00,3,0,1,0,0,9,44388,33.4009,09,0,99,0.00,0.00,0.00
5,42444500,,Intro gastrointestinal tube,A,,0.38,0.07,NA,0.07,,0.04,0.49,0.49,0,000,0.00,0.00,0.00,0,0,0,0,0,9,,33.4009,09,0,99,0.00,0.00,0.00
4906102,IL,12,EAST ST. LOUIS,1.000,0.920,2.014
5006102,IL,15,SUBURBAN CHICAGO,1.007,1.027,1.772
5106102,IL,99,REST OF ILLINOIS,1.000,0.913,1.563
5208102,IN,00,INDIANA,1.000,0.927,0.486
5305102,IA,00,IOWA,1.000,0.915,0.397
5405202,KS,00,KANSAS,1.000,0.904,0.504
5515102,KY,00,KENTUCKY,1.000,0.889,0.915