CPT 45380 Surgery - Digestive

How Much Does Colonoscopy with Biopsy Cost?

Also known as: Colonoscopy and biopsy (CPT 45380)

A colonoscopy with biopsy, where small tissue samples are taken from the colon lining for laboratory analysis.

The total estimated cost of Colonoscopy with Biopsy (CPT 45380) is $597 to $1,120, including hospital fees, anesthesia, and supplies. The surgeon's Medicare fee alone is $178.

Total Estimated Cost of Care

$597 — $1,120

This estimate includes hospital facility fees, anesthesia, and supplies .

Surgeon/Physician Fee
$178
Hospital Facility Fee
$533
Anesthesia (est.)
$36
Important: The physician fee of $178 shown in the cost cards below is what Medicare pays the surgeon/doctor only. The hospital charges a separate facility fee that typically makes up 70-85% of the total cost.
Medicare Physician Fee (Facility Setting)
$178
Physician component only — CMS PFS 2026
Medicare Physician Fee (Office/Clinic)
$480
Non-facility setting

Patient Guide: Colonoscopy with Biopsy

What you need to know before your appointment

What to Expect

During the colonoscopy, the doctor takes small pinch-sized tissue samples using a tiny tool passed through the scope. You will not feel the biopsies. The samples are sent to a lab.

How Long Does It Take?

30-60 minutes (plus recovery)

Common Reasons Doctors Order This

Evaluation of inflammation, screening for microscopic colitis, inflammatory bowel disease (Crohn or ulcerative colitis), abnormal-looking tissue

How to Prepare

Same preparation as a standard colonoscopy. Inform your doctor about blood thinners, as some may need to be stopped before biopsy.

Procedures Commonly Done Together

These procedures are frequently performed alongside Colonoscopy and biopsy

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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.

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.

3.47
Work RVU
1.43
Practice Expense RVU
0.42
Malpractice RVU
14.37
Total RVU

Payment = Total RVU (14.37) x CF ($33.40) = $480

People Also Ask

Common questions people search for about this procedure

How much do colonoscopies cost without insurance?
Source: www.carecredit.com See our data-backed answer →
Can I get a free colonoscopy?

Below are some options to contact for a free colonoscopy: The Colorectal Cancer Alliance provides resources to access free screenings and financial assistance for those that are eligible. In some states, the Department of Health provides free screenings, including colonoscopies.

Source: www.cancercare.org See our data-backed answer →
Is a colonoscopy fully covered by insurance?

The Affordable Care Act requires recommended preventative services, such as colonoscopies, be covered at no cost to the patient. However, strict guidelines are used by insurance companies to determine whether a colonoscopy is categorized as preventative or diagnostic, which can impact your potential out of pocket cost.

Source: www.crspecialists.com See our data-backed answer →
Is a colonoscopy covered by Medicare?

For patients with Medicare and PHI cover Colonoscopy Clinic is a 'no gap' practice for standard endoscopy, colonoscopy and endo/colon procedures. This means that there are no extra costs for you to pay for your procedure above the excess amount that you pay in relation to your private health fund.

Source: www.colonoscopyclinic.com.au See our data-backed answer →

Frequently Asked Questions

How much does Colonoscopy and biopsy cost?

The Medicare facility rate for Colonoscopy and biopsy is $178. 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.

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