How Much Does Colonoscopy with Biopsy Cost?
Also known as: Colonoscopy and biopsy (CPT 45380)
An exam of the entire colon using a flexible camera, with tissue samples taken from suspicious areas.
Colonoscopy with Biopsy (CPT 45380) costs $178 at Medicare rates. Hospital outpatient rate: $1.
Cost Comparison by Payer
How much Colonoscopy and biopsy costs across different settings and payers
Patient Guide: Colonoscopy with Biopsy
What you need to know before your appointment
What to Expect
Under sedation, a flexible scope is inserted through the rectum to examine the entire colon. The doctor may remove polyps or take tissue samples.
How Long Does It Take?
30-60 minutes procedure, 30-60 minutes recovery
Common Reasons Doctors Order This
Colon cancer screening, abnormal bleeding, polyp removal, inflammatory bowel disease evaluation
How to Prepare
Follow bowel preparation instructions exactly. Fast as directed. Arrange a ride home. Clear your schedule for the full day.
Procedures Commonly Done Together
These procedures are frequently performed alongside Colonoscopy and biopsy
How to Reduce Your Cost for Colonoscopy and biopsy
Practical tips that can save you hundreds or thousands of dollars
- 1 Ask about cash-pay discounts
Many hospitals and clinics offer 20-40% discounts for self-pay patients. Always ask before scheduling.
- 2 Compare facility vs. office setting costs
For this procedure, the office rate ($480) differs from the facility rate ($178). Ask if it can be done in an office setting.
- 3 Shop around — costs vary significantly
Costs can vary 2-3x between providers in the same city. Get quotes from multiple facilities.
- 4 Check ambulatory surgery centers (ASCs)
This procedure is available at ASCs for $657, compared to $1 at hospital outpatient departments. ASCs often offer lower costs with comparable quality.
How is the Price Calculated?
Medicare calculates procedure payments using Relative Value Units (RVUs). Each procedure has three components multiplied by a conversion factor ($33.40 in 2026) and adjusted by geographic cost indices.
Payment = Total RVU (14.37) x CF ($33.40) = $480
Related Procedures
Similar procedures in the same category or body system
Frequently Asked Questions
How much does Colonoscopy and biopsy cost?
The Medicare facility rate for Colonoscopy and biopsy is $178. In a hospital outpatient setting, the rate is $1. At an ambulatory surgery center, the rate is $657. Commercial insurance rates typically range from 150% to 250% of Medicare (varies by plan).
How much does Colonoscopy and biopsy cost without insurance?
Without insurance, the cost of Colonoscopy and biopsy can range from 150% of Medicare to 500% of Medicare depending on the facility. Many hospitals and clinics offer self-pay discounts of 20-40% off their chargemaster price. Always ask about cash pricing before your visit.
Does insurance cover Colonoscopy and biopsy?
Most commercial health insurance plans and Medicare cover Colonoscopy and biopsy when ordered by a physician for a medically necessary reason. Your out-of-pocket cost depends on your plan's deductible, copay/coinsurance structure, and whether you use an in-network provider. Check with your insurance company before scheduling to confirm coverage and get a cost estimate.
Why does the cost vary so much by location?
Medicare adjusts payments using Geographic Practice Cost Indices (GPCIs) that reflect local differences in physician work costs, practice expenses, and malpractice insurance. Manhattan, San Francisco, and other high-cost areas pay significantly more than rural regions. Commercial insurers follow similar geographic patterns.