No office rate
Use 44404 when the colonoscopy includes directed submucosal injection, such as lesion marking. Use 44403 when the service includes endoscopic tissue resection.
On this page
CMS RVU26D · Effective 2026-10-01
44404 Colonoscopy Medicare reimbursement rates in North Dakota
Reports colonoscopy with a substance injected into the colonic submucosa, such as tattoo ink used to mark a lesion for later localization. Compare 44404 office and facility rates across CMS payment localities in North Dakota.
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 44404 in North Dakota?
North Dakota 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
$457.87
1 of 1 localities have a supported rate.
Payment area: North Dakota**
One mapped payment locality.
Facility setting
$145.24
1 of 1 localities have a supported rate.
Payment area: North Dakota**
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 44404: Colonoscopy with submucosal injection
Reports colonoscopy with a substance injected into the colonic submucosa, such as tattoo ink used to mark a lesion for later localization.
During this flexible colonoscopy, the endoscopist directs one or more injections into the submucosal layer of the colon. A common purpose is tattooing a lesion, such as a polyp or suspected tumor, so it can be located during later endoscopy or surgery. Gastroenterologists and other clinicians trained in colonoscopy perform the service, typically in a hospital outpatient department or ambulatory surgery center.
Select this code when the colonoscopy includes directed submucosal injection, rather than choosing a code for a different endoscopic intervention such as resection or dilation. The procedure report should identify the site and purpose of the injection and the substance used when documented. This minor procedure has 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-surgery and team surgery are not permitted.
CMS billing rules for 44404
- 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 RVU2.94 · 21%
- Practice expense (office) RVU10.61 · 76%
- Malpractice RVU0.39 · 3%
194
Medicare services in 2024 · #4350 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.
44404 compared with similar codes
Office rates for North Dakota, from the same CMS release.
Compare 44404 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
North Dakota** →
Office / nonfacility
$457.87
Facility
$145.24
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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 44404 in North Dakota**.
PPRRVU2026_Oct_nonQPP.csv
5,419
- Code
- 44404
- Physician work
- 2.94
- Practice expense
- 10.61
- Malpractice
- 0.39
GPCI2026.csv
84
- Locality
- North Dakota**
- Physician work
- 1.000
- Practice expense
- 1.000
- Malpractice
- 0.406
| Component | RVU | Locality factor | Adjusted |
|---|---|---|---|
| Physician work | 2.94 | × 1.000 | 2.9400 |
| Practice expense | 10.61 | × 1.000 | 10.6100 |
| Malpractice | 0.39 | × 0.406 | 0.1583 |
| Total RVUs | 13.7083 | ||
| Conversion factor | × 33.4009 | ||
Office / nonfacility rate, North Dakota**$457.87
Explore RVUs, geographic factors and the full formula
Office / nonfacility
| Component | RVU | Local GPCI |
|---|---|---|
| Work | 2.94 | 1 |
| Practice expense | 10.61 | 1 |
| Malpractice | 0.39 | 0.406 |
(2.94 × 1 + 10.61 × 1 + 0.39 × 0.406) × $33.4009 = $457.87
Facility
| Component | RVU | Local GPCI |
|---|---|---|
| Work | 2.94 | 1 |
| Practice expense | 1.25 | 1 |
| Malpractice | 0.39 | 0.406 |
(2.94 × 1 + 1.25 × 1 + 0.39 × 0.406) × $33.4009 = $145.24
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.
44404 billing questions
When should this code be chosen instead of the colonoscopy resection code?
Choose this code for directed injection into the colonic submucosa, such as tattooing a lesion. Use the resection code when the service includes endoscopic removal of tissue.
Can injection and another endoscopic service be reported at the same encounter?
The code describes the injection service. When related endoscopies are performed together, CMS endoscopy family pricing applies; the procedure documentation should show which services were performed.
Should modifier 50 be appended for injections on both sides of the colon?
No. The CMS bilateral adjustment does not apply to this code, and modifier 50 is inappropriate.
Is same-day care included in the payment?
Yes. The 0-day global period includes same-day preoperative and postoperative care.
Can an assistant, co-surgeon, or surgical team be paid for this procedure?
Medicare does not pay an assistant at surgery for this service. 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.
5,41644401,,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
5,41744402,,Colonoscopy w/stent plcmt,A,,4.58,1.78,NA,1.78,,0.50,6.86,6.86,0,000,0.00,0.00,0.00,3,0,1,0,0,9,44388,33.4009,09,0,99,0.00,0.00,0.00
5,41844403,,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
8113292,NY,04,QUEENS,1.064,1.182,1.442
8213282,NY,99,REST OF NEW YORK,1.000,0.950,0.703
8311502,NC,00,NORTH CAROLINA,1.000,0.933,0.639
8403302,ND,01,NORTH DAKOTA**,1.000,1.000,0.406
8515202,OH,00,OHIO,1.000,0.913,1.008
8604312,OK,00,OKLAHOMA,1.000,0.893,0.777
8702302,OR,01,PORTLAND,1.016,1.111,0.744