Colonoscopy With Polyp Removal Cost in Massachusetts
Colonoscopy w/lesion removal
$1,446Hospital outpatient total2026 Medicare, physician + facility- ✓Your ZIP's wage-adjusted hospital and surgery centre rates
- ✓Five nearby hospitals by name, with CMS star ratings
- ✓The add-on codes that typically land on the bill
- ✓A word-for-word script for asking for a good-faith estimate
- ✓A private link you can reopen and share
- ✓Everything in the Premium report
- ✓15 nearby hospitals instead of five
- ✓Filled good-faith-estimate request letter
- ✓Bill-negotiation letter
- ✓Printable PDF download
Massachusetts Medicare physician rate (2026)
+8.6% vs nationalAverage of 2 localities. Office range $516.64–$569.04.
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.
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 Massachusetts
Look up your ZIP to see whether metro Boston or rest-of-state pricing applies, from Boston and Cambridge to Worcester, Springfield, the North and South Shores, and Cape Cod.
What colonoscopy with polyp removal costs at hospitals near you
Everything above is a national average. The hospital you pick in Massachusetts moves the bill more than anything else you control.
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 Massachusetts the office and hospital physician lines for this CPT differ by $310.71.
National vs Massachusetts
Where Massachusetts ranks for this CPT
CPT 45385 by Massachusetts locality
| Locality | Office |
|---|---|
| metropolitan boston | $569.04 |
| rest of massachusetts | $516.64 |
PE GPCI ranges from 1.053 to 1.194 in Massachusetts. That index is why the same CPT is not one price statewide.
Colonoscopy With Polyp Removal and how Massachusetts is priced
Massachusetts is priced through two localities: metro Boston and the rest of the state. Boston's locality carries clearly higher geographic adjustments, reflecting some of the highest medical wages and office costs in the nation, while Worcester, Springfield, and the Cape share the lower rest-of-state factors. The split means the fee schedule itself acknowledges what everyone in the state already knows about Boston prices. Even so, rest-of-state Massachusetts still prices above most of the country.
Boston has arguably the densest concentration of academic medical centers anywhere, and its teaching hospitals pull referrals from all of New England and beyond. That prestige comes with a high-cost market structure that state policymakers have scrutinized for years. Western Massachusetts operates more like a regional market centered on Springfield, and Cape and islands residents contend with seasonal capacity strain.
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?
Other featured procedures in Massachusetts
Colonoscopy With Polyp Removal in other states
Colonoscopy With Polyp Removal in Massachusetts: questions
The 2026 Medicare physician office rate for CPT 45385 averages $542.84 across 2 Massachusetts localities, from $516.64 in REST OF MASSACHUSETTS to $569.04 in METROPOLITAN BOSTON. The hospital physician rate averages $232.13. Enter a ZIP for the exact locality.
Yes. CMS splits Massachusetts into 2 payment localities. For this CPT the office physician fee spans $52.40 from the lowest to highest locality. Look up your ZIP to see whether metro Boston or rest-of-state pricing applies, from Boston and Cambridge to Worcester, Springfield, the North and South Shores, and Cape Cod.
After the Part B deductible, coinsurance is usually 20% of the allowed amount: about $109 for the office physician line or $46 for the hospital physician line in Massachusetts. Medigap may cover that 20%. This is not the hospital facility fee.
No. $542.84 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. Massachusetts ranks #45 of 51 states on the physician line (9% above the national office rate of $500.01).