Colonoscopy Costs: State-by-State Guide

Colonoscopy is one of the most important preventive procedures in medicine — it's the gold standard for colorectal cancer screening. But what does it actually cost? We looked at two key colonoscopy codes in the 2023 Medicare data.

Two Key Colonoscopy Codes

Colonoscopy with Biopsy (45380)

Code 45380 — colonoscopy with biopsy — is the more common of the two because polyps are frequently found and biopsied during routine screening. The Medicare-allowed amount is $233.31, but hospitals charge an average of $1,709.

With 1.3M services performed by 26.1K providers, this is one of the highest-volume surgical procedures in Medicare.

State-by-State Variation

Colonoscopy costs vary significantly by state due to Medicare's geographic payment adjustments. States with higher costs of living — particularly in the Northeast and West Coast — tend to have higher allowed amounts, sometimes 30-40% above the national average.

Rural states in the South and Midwest tend to have lower costs, but may also have fewer gastroenterologists, leading to longer wait times.

See the full state-by-state breakdown for colonoscopy with biopsy →

See the full data for diagnostic colonoscopy →

Screening vs Diagnostic

An important distinction: screening colonoscopies for patients over 45 are covered at 100% by Medicare with no cost-sharing (thanks to the ACA). However, if a polyp is found and removed during screening, it may be reclassified as "diagnostic" — potentially triggering cost-sharing. This billing practice has been controversial and is the subject of ongoing legislative efforts.