Colonoscopy and biopsy vs Diagnostic colonoscopy
Side-by-side cost comparison of CPT 45380 and CPT 45378 (+8% difference)
CPT 45380
Colonoscopy and biopsy
CategorySurgery - Digestive
Body SystemDigestive
Total RVU14.37
Medicare Rate$178
CPT 45378
Diagnostic colonoscopy
CategorySurgery - Digestive
Body SystemDigestive
Total RVU11.32
Medicare Rate$165
Cost Comparison by Setting
Medicare Facility CMS PFS 2026 national facility rate
45380
$178
45378
$165
Medicare Non-Facility CMS PFS 2026 non-facility (office) rate
45380
$480
45378
$378
Hospital Outpatient (OPPS) CMS OPPS hospital outpatient rate
45380
45378
Ambulatory Surgery Center CMS ASC surgery center rate
45380
45378
Est. Commercial (Low) Estimated commercial insurance (150% Medicare)
45380
$267
45378
$247
Est. Commercial (High) Estimated commercial insurance (250% Medicare)
45380
$444
45378
$412
Which One Do You Need?
CPT 45380: Colonoscopy and biopsy
This is the higher-cost option in the Surgery - Digestive category. It is a more complex procedure (higher RVU) requiring more physician work, time, or resources.
CPT 45378: Diagnostic colonoscopy
This is the lower-cost option in the Surgery - Digestive category. It is a less complex procedure (lower RVU) typically requiring less time or fewer resources.
Your doctor determines which CPT code applies based on the specific clinical situation. This comparison is for informational purposes to help you understand the cost differences.