Billing code 44405: ColonoscopyMedicare rate & RVUs in Utah
Reports colonoscopy during which a narrowed colonic segment is therapeutically dilated, typically with a balloon passed through the endoscope.
Medicare pays $583.51 for 44405 in the office in Utah (Utah). Which amount applies depends on the service address.
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 44405 covers
A flexible colonoscope is advanced to a narrowed area of the colon, and a dilation device is used through the scope to widen the stenosis. Gastroenterologists and colorectal surgeons commonly perform this treatment for symptomatic narrowing, including a stricture at a surgical anastomosis, in a hospital outpatient department or ambulatory surgery center. The service is therapeutic rather than a routine colonoscopy alone.
Select this code when dilation is performed during the colonoscopy. Document the indication, stricture location and findings, dilation method, and procedural result. 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 governs payment rather than independent pricing for each procedure. An assistant at surgery is not paid under the statutory restriction; co-surgeons and team surgery 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.
44405 in Utah
| Payment locality | Office | Facility |
|---|---|---|
| Utah | $583.51 | $158.71 |
How the 44405 rate is calculated
Each of 44405’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 · 44405
RVUs × geographic indexes × conversion factor
Work3.15
3.15 RVUs× 1.000 GPCI
Practice expense14.89
14.89 RVUs× 1.000 GPCI
Malpractice0.36
0.36 RVUs× 1.000 GPCI
Adjusted RVUs
18.4000
Conversion factor
$33.4009
Medicare rate
$614.58
Every GPCI starts at 1.000, the national rate. Enter a ZIP or drag a slider.
Payment rules and modifiers for 44405
The CMS indicators that decide how 44405 is paid alongside other services.
CMS payment indicators · 44405
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
44405 without 51 · national office
$614.58
Colonoscopy
44405-51 · Second procedure: 50%
$307.29
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%).
44405 compared with similar codes
Compare codes · National
4 codes, side by side
How to choose
- 44402Colonoscopy
- Choose 44405 for dilation of a narrowed segment; choose 44402 when the colonoscopy includes stent placement.
- 44403Colonoscopy
- 44405 addresses widening a stenosis. 44403 is for endoscopic resection of a lesion.
- 44404Colonoscopy
- Use 44405 for dilation; 44404 represents colonoscopic injection rather than dilation.
44405 billing questions
When should this code be chosen instead of a colonoscopy with stent placement?
Use this code when the colonoscopic treatment is dilation of a narrowing. A procedure that places a stent is represented by the stent-placement service instead.
What documentation supports reporting dilation?
Record the reason for treatment, the narrowed segment and its findings, the dilation technique, and the result. The record should show that dilation was actually performed.
How are related endoscopies priced when performed together?
CMS applies endoscopy-family pricing to related endoscopies performed together, rather than treating each as independently priced.
Is same-day postoperative care included?
Yes. This code has a 0-day global period, which includes same-day preoperative and postoperative care.
Can an assistant, co-surgeon, or surgical team be billed?
An assistant at surgery is not paid under the statutory restriction. Co-surgeons and team surgery are not permitted for this 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
Fee sheets
Put 44405 and the rest of your codes on one sheet
Build a fee sheet from your own code list at your locality, put your payer contracts beside Medicare, and see what changed each quarter.
Build my fee sheetOr price your code list free →