CPT45385

Colonoscopy With Polyp Removal Cost in Colorado

Colonoscopy w/lesion removal

$1,446Hospital outpatient total2026 Medicare, physician + facility
Hospital payments are wage-adjusted by locality, so the ZIP changes the numbers.
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Colorado Medicare physician rate (2026)

+3.9% vs national

Single statewide locality.

Colorado (Hospital)
$225.19
Facility physician fee
Private plan est.
$675–$1,039
~130–200% of Medicare
Cash / self-pay est.
$416–$779
~80–150% of Medicare

What the whole procedure costs

The rate above is the physician’s fee on its own. The facility bills separately, and for most procedures the facility is the larger half of the bill. These are 2026 national Medicare amounts.

Surgery centre, total
$880
$223 physician + $657 facility
Physician fee alone
$223
Only 15% of the hospital total

Choosing a surgery centre over a hospital saves about $566 on the Medicare allowed amount for colonoscopy with polyp removal. Ask whether your procedure can be done at an ambulatory surgery centre.

This is Medicare's separate payment to the facility on top of the physician's fee. Medicare allowed amounts are not what an uninsured patient is charged, and not a quote. Private plans typically allow more.

Your ZIP in Colorado

Enter a ZIP code to compare your area of Colorado, from Denver, Boulder, Fort Collins, and Colorado Springs to Grand Junction, the mountain resort counties, and the Eastern Plains.

What colonoscopy with polyp removal costs at hospitals near you

Everything above is a national average. The hospital you pick in Colorado moves the bill more than anything else you control.

Locked

Rates for your ZIP, 5 named hospitals with CMS ratings, the add-on codes, and the scheduler script.

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What these numbers are

Every figure on this page is a 2026 Medicare allowed amount: the physician line comes from the Physician Fee Schedule adjusted by geographic practice-cost indices, and the facility totals come from the CMS hospital outpatient (OPPS) and ambulatory surgery centre rates. None of them is a hospital chargemaster price, your insurer's contracted rate, or a quote. Anesthesia, pathology, imaging reads and follow-up care are billed under their own codes when they apply, and an inpatient stay is paid a different way again. In Colorado the office and hospital physician lines for this CPT differ by $294.26.

National vs Colorado

National office$500.01
National hospital (physician)$223.45
Colorado vs national4% above the national office rate of $500.01

Where Colorado ranks for this CPT

Rank (lowest physician fee first)#43 of 51
Lowest stateArkansas ($444.65)
Highest stateAlaska ($588.56)

Colonoscopy With Polyp Removal and how Colorado is priced

Colorado's physician fees are set through a single statewide locality, so the Front Range and the Western Slope share one set of geographic adjustments despite very different local economies. The state's indices run modestly above the national midpoint, reflecting Denver-area wages and rents averaged against lower-cost rural areas. Because the locality is unified, mountain resort towns do not carry a higher Medicare fee schedule even though their private-market prices are famously steep. That gap between Medicare's uniform pricing and wide private-price variation is a defining feature of the Colorado market.

Care is concentrated along the Front Range from Fort Collins through Denver to Colorado Springs and Pueblo, where several large systems and an academic medical center compete. Mountain and plains communities depend on smaller hospitals, and residents there commonly drive to Denver or Grand Junction for specialty procedures. Resort-area facilities can bill far above what the corridor cities charge, so location shopping pays off in this state.

This procedure: This colonoscopy code means the physician found one or more polyps and removed them using a snare, a thin wire loop that lassoes the polyp and cuts it free, often with cauterizing current. Snare removal is the standard technique for larger polyps and is the step that gives colonoscopy its cancer-preventing power, since removing precancerous polyps stops them from progressing. The patient experience is unchanged from any colonoscopy: prep, IV sedation, a 20 to 45 minute procedure, and same-day discharge.

What Is Colonoscopy With Polyp Removal?

This colonoscopy code means the physician found one or more polyps and removed them using a snare, a thin wire loop that lassoes the polyp and cuts it free, often with cauterizing current. Snare removal is the standard technique for larger polyps and is the step that gives colonoscopy its cancer-preventing power, since removing precancerous polyps stops them from progressing. The patient experience is unchanged from any colonoscopy: prep, IV sedation, a 20 to 45 minute procedure, and same-day discharge.

What Affects the Cost

  • Every removed polyp goes to pathology in its own container, and each container is a separate lab charge.
  • The physician fee for snare polypectomy is the highest of the common colonoscopy codes, above both biopsy (45380) and diagnostic (45378).
  • Facility setting remains the biggest overall cost lever, with hospitals charging far more than endoscopy centers.
  • Separately billed anesthesia adds its own professional fee.
  • Large or complex polyps may require advanced removal techniques or clips to close the site, which can add device and procedure charges.
  • Finding polyps shortens your recommended interval to the next colonoscopy, pulling that future cost closer.

Questions to Ask Before Booking

  • 1.If polyps are removed during my screening, will the procedure still be billed with the preventive modifier at no cost share to me?
  • 2.What will the pathology lab charge per polyp, and is that lab in network?
  • 3.For Medicare: what percentage coinsurance applies to polyp removal during a screening this year?
  • 4.If you find a large polyp needing a special technique or clips, how does the cost change?
  • 5.How soon will I need my next colonoscopy if polyps are found, and will that one count as screening or surveillance for coverage?

Colonoscopy With Polyp Removal in Colorado: questions

Colorado is a single Medicare locality for this fee schedule. The 2026 physician rate for CPT 45385 is $519.45 in an office and $225.19 in a hospital, statewide. A ZIP lookup still confirms the locality mapping.

Not on the physician fee schedule. Colorado uses one locality, so the Medicare physician rate is the same from one end of the state to the other. What still changes is site of service (office vs hospital) and any facility fee the hospital bills on its own claim.

After the Part B deductible, coinsurance is usually 20% of the allowed amount: about $104 for the office physician line or $45 for the hospital physician line in Colorado. Medigap may cover that 20%. This is not the hospital facility fee.

No. $519.45 is only the physician's share. Adding Medicare's facility payment brings the total to about $1,446 in a hospital outpatient department, or about $880 at an ambulatory surgery centre. Anesthesia, pathology and other codes billed the same day are extra. Colorado ranks #43 of 51 states on the physician line (4% above the national office rate of $500.01).

Data source: 2026 Medicare Physician Fee Schedule (CMS PPRRVU26B, released March 2026). Conversion factor: $33.4009. Prices shown are Medicare allowed amounts for the physician service and may not match what you are billed. Private insurance and self-pay ranges, when shown, are labeled estimates (typical multiples of Medicare), not quotes. This site is an independent cost tool, not medical advice.