Colonoscopy With Polyp Removal
Colonoscopy w/lesion removal
National Average Cost (2026)
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Procedure Details
Understanding the Cost
Medicare rate is the amount Medicare pays providers. If you have Medicare, you typically pay 20% of this amount after your deductible.
Private insurance plans negotiate their own rates, typically 130-200% of Medicare. Your out-of-pocket cost depends on your deductible, copay, and coinsurance.
Self-pay/cash prices vary widely. Many providers offer cash discounts of 20-40% off their standard charges. Always ask about cash pricing.
Office vs Hospital: the same procedure often costs less in a doctor's office than a hospital, because hospitals charge a separate facility fee.
Ways to Save on This Procedure
Compare Insurance Plans
Uninsured? Comparing marketplace plans could save you thousands on procedures like this.
Compare plans on eHealth →Try Telehealth First
Many consultations can be done virtually for $50-100, saving hundreds vs an in-person visit.
Book on Sesame Care →Save on Prescriptions
If this procedure leads to a prescription, check discount cards for up to 80% savings.
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More ways to save →Colonoscopy With Polyp Removal (CPT 45385): Frequently Asked Questions
How much does colonoscopy with polyp removal cost?
The 2026 national Medicare rate for colonoscopy with polyp removal (CPT 45385) is $500.01 in an office setting and $223.45 in a hospital. Private insurance usually pays $650 to $1,000, and self-pay cash prices often run $400 to $750. Enter your ZIP code for a locality-adjusted rate.
Why does colonoscopy with polyp removal cost more in a hospital than an office?
Medicare pays a separate facility fee to hospitals, so the hospital (facility) rate of $223.45 differs from the office (non-facility) rate of $500.01. Where clinically appropriate, having the procedure in an office or outpatient setting is often cheaper.
What is CPT code 45385?
CPT code 45385 is the standard medical billing code for colonoscopy with polyp removal. Providers use it to bill insurers, and Medicare sets a national reimbursement rate for it that is adjusted by geographic locality.
How can I pay less for colonoscopy with polyp removal?
Ask the provider for a self-pay or cash price before booking, as many discount 20-40% for upfront payment. If you are uninsured, compare marketplace insurance plans, consider telehealth for the consultation, and check prescription discount cards for any follow-up medication.