$365.68–$404.63
44388 describes colonoscopy through a stoma without a therapeutic intervention. Choose 44391 when the endoscopist controls bleeding during the procedure.
On this page
CMS RVU26D · Effective 2026-10-01
44391 Colonoscopy through stoma Medicare reimbursement rates in Massachusetts
Reports colonoscopy performed through a stoma to locate and treat a bleeding site using an endoscopic hemostasis method. Compare 44391 office and facility rates across CMS payment localities in Massachusetts.
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 44391 in Massachusetts?
Massachusetts has 2 payment localities in this comparison. Use the service location to choose the applicable amount. These are the supported base rates for the 2 payment areas shown below, using the same CMS release.
Office / nonfacility
$729.96–$812.58
2 of 2 localities have a supported rate.
Facility setting
$204.85–$217.16
2 of 2 localities have a supported rate.
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 44391: Colonoscopy through stoma with bleeding control
Reports colonoscopy performed through a stoma to locate and treat a bleeding site using an endoscopic hemostasis method.
A gastroenterologist or surgeon advances a colonoscope through a colostomy or other stoma to examine the colon and control active bleeding. The service includes endoscopic hemostasis, such as treatment of a bleeding lesion identified during the examination. It is typically performed in a hospital or ambulatory endoscopy facility when a patient with a stoma has gastrointestinal bleeding requiring endoscopic treatment.
Report this code when the colonoscopy reaches the colon through the stoma and bleeding is treated; documentation should identify the route, the bleeding site or source when found, and the hemostasis performed. It is not the code for a routine examination through a stoma or for treatment of a polyp instead of bleeding. 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. CMS does not pay an assistant at surgery, and co-surgeons and team surgery are not permitted.
CMS billing rules for 44391
- 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 RVU4.02 · 19%
- Practice expense (office) RVU16.52 · 79%
- Malpractice RVU0.47 · 2%
160
Medicare services in 2024 · #4513 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.
44391 compared with similar codes
Office rates for Massachusetts, from the same CMS release.
$474.79–$527.28
44389 is for biopsy through a stoma; 44391 is for endoscopic control of bleeding. A biopsy alone does not establish bleeding control.
$445.82–$492.49
44392 covers removal of a lesion through a stoma using specified methods. Use 44391 when the treated problem is bleeding and the service is hemostasis.
$758.96–$843.51
Both codes describe colonoscopic bleeding control. 44391 is for access through a stoma; 45382 applies when the colon is approached by the route covered by that code.
Compare 44391 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.
2 of 2 payment localities
Metropolitan Boston →
Office / nonfacility
$812.58
Facility
$217.16
Rest Of Massachusetts →
Office / nonfacility
$729.96
Facility
$204.85
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44391 billing questions
How is this different from colonoscopy through a stoma without a therapeutic intervention?
Use 44391 when the endoscopist controls bleeding during the examination. A diagnostic examination through a stoma without bleeding control is represented by 44388.
Can a diagnostic colonoscopy through the stoma be reported separately?
The examination used to locate and treat the bleeding is part of the therapeutic service. When related endoscopies are performed together, CMS endoscopy family pricing applies.
Can modifier 50 be added for bilateral treatment?
No. CMS identifies bilateral adjustment as inappropriate for this code because of its descriptor or anatomy.
Can an assistant surgeon or co-surgeon be reported?
CMS does not pay an assistant at surgery for this code. Co-surgeons and team surgery are not permitted.
What documentation supports reporting 44391?
Document that the colonoscope entered through the stoma, the bleeding site or source when identified, and the method used to control bleeding.
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.
5,41044388,53,Colonoscopy thru stoma spx,A,,1.33,3.76,,0.58,,0.21,5.30,2.12,0,000,0.00,0.00,0.00,2,0,1,0,0,9,,33.4009,09,0,99,0.00,0.00,0.00
5,41144389,,Colonoscopy with biopsy,A,,2.94,10.36,,1.26,,0.40,13.70,4.60,0,000,0.00,0.00,0.00,3,0,1,0,0,9,44388,33.4009,09,0,99,0.00,0.00,0.00
5,41244390,,Colonoscopy for foreign body,A,,3.65,9.39,,1.50,,0.41,13.45,5.56,0,000,0.00,0.00,0.00,3,0,1,0,0,9,44388,33.4009,09,0,99,0.00,0.00,0.00
5,41344391,,Colonoscopy for bleeding,A,,4.02,16.52,,1.59,,0.47,21.01,6.08,0,000,0.00,0.00,0.00,3,0,1,0,0,9,44388,33.4009,09,0,99,0.00,0.00,0.00
5,41444392,,Colonoscopy & polypectomy,A,,3.44,8.91,,1.35,,0.59,12.94,5.38,0,000,0.00,0.00,0.00,3,0,1,0,0,9,44388,33.4009,09,0,99,0.00,0.00,0.00
5,41544394,,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