No office rate
Both describe colonoscopic decompression, but 44408 is performed through a stoma; 45393 is performed through the anus.
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CMS RVU26D · Effective 2026-10-01
44408 Colon decompression Medicare reimbursement rates in Iowa
Reports endoscopic decompression performed through a colostomy or other stoma, commonly to relieve colonic volvulus or megacolon, with a decompression tube included when placed. Compare 44408 office and facility rates across CMS payment localities in Iowa.
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 44408 in Iowa?
Iowa 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
$190.28
1 of 1 localities have a supported rate.
Payment area: Iowa
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 44408: Colonoscopy through stoma with decompression
Reports endoscopic decompression performed through a colostomy or other stoma, commonly to relieve colonic volvulus or megacolon, with a decompression tube included when placed.
This service uses a flexible colonoscope passed through a stoma to relieve colonic distention or obstruction, such as in volvulus or megacolon. The endoscopist may place a decompression tube as part of the procedure. It is typically performed by a gastroenterologist or surgeon in a facility setting when endoscopic access through the stoma is indicated.
Report the code when the documented service is therapeutic decompression through the stoma, rather than inspection alone or a different intervention such as dilation or tissue sampling. The record should support the indication, route through the stoma, decompressive work, and tube placement if performed. CMS assigns a 0-day global period, so same-day preoperative and postoperative care is included. When related endoscopies occur together, endoscopy-family pricing applies. Modifier 50 is inappropriate; an assistant at surgery is not paid, and co-surgeons and team surgery are not permitted.
CMS billing rules for 44408
- 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 RVU4.04 · 66%
- Practice expense (office) RVU1.62 · 27%
- Malpractice RVU0.44 · 7%
24
Medicare services in 2024 · #5815 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.
44408 compared with similar codes
Office rates for Iowa, from the same CMS release.
$565.05
44405 is for dilation through the stoma. Choose 44408 when the procedure's purpose is colonic decompression.
No office rate
44407 covers needle aspiration or biopsy through the stoma. It does not describe decompression.
$324.08
44388 describes diagnostic colonoscopy through a stoma. Use 44408 when therapeutic decompression is performed.
Compare 44408 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
Iowa →
Office / nonfacility
Unavailable
Facility
$190.28
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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 44408 in Iowa.
PPRRVU2026_Oct_nonQPP.csv
5,423
- Code
- 44408
- Physician work
- 4.04
- Practice expense
- 1.62
- Malpractice
- 0.44
GPCI2026.csv
53
- Locality
- Iowa
- Physician work
- 1.000
- Practice expense
- 0.915
- Malpractice
- 0.397
| Component | RVU | Locality factor | Adjusted |
|---|---|---|---|
| Physician work | 4.04 | × 1.000 | 4.0400 |
| Practice expense | 1.62 | × 0.915 | 1.4823 |
| Malpractice | 0.44 | × 0.397 | 0.1747 |
| Total RVUs | 5.6970 | ||
| Conversion factor | × 33.4009 | ||
Facility rate, Iowa$190.28
Explore RVUs, geographic factors and the full formula
Facility
| Component | RVU | Local GPCI |
|---|---|---|
| Work | 4.04 | 1 |
| Practice expense | 1.62 | 0.915 |
| Malpractice | 0.44 | 0.397 |
(4.04 × 1 + 1.62 × 0.915 + 0.44 × 0.397) × $33.4009 = $190.28
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.
44408 billing questions
How does this differ from 45393?
44408 describes decompression performed through a stoma. Use 45393 for the comparable decompression procedure performed through the anus.
Is placement of a decompression tube separately reported?
Tube placement, when performed as part of the decompression, is included in this service.
Can modifier 50 be appended?
No. CMS identifies bilateral adjustment as inappropriate for this code.
Can a diagnostic colonoscopy through the stoma be billed separately?
The inspection associated with the decompression is part of the therapeutic service. Do not separately report a diagnostic examination for the same session and service.
What documentation supports reporting 44408?
Document the clinical reason for decompression, that the scope was passed through the stoma, the decompressive maneuver, and whether a tube was placed.
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.
5,42044405,,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
5,4254450F,,Self-care ed provided to pt,I,,0.00,0.00,,0.00,,0.00,0.00,0.00,9,XXX,0.00,0.00,0.00,9,9,9,9,9,9,,33.4009,09,0,99,0.00,0.00,0.00
5,42644602,,Suture small intestine,A,,24.10,8.53,NA,8.53,,6.00,38.63,38.63,0,090,0.09,0.81,0.10,2,0,2,1,0,9,,33.4009,09,0,99,0.00,0.00,0.00
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
5607202,LA,01,NEW ORLEANS,1.000,0.941,1.136