Colonoscopy With Polyp Removal Cost in Missouri
Colonoscopy w/lesion removal
Missouri Medicare physician rate (2026)
-5.6% vs nationalAverage of 3 localities. Office range $453.48–$484.01.
Your ZIP in Missouri
Enter a ZIP code to see which Missouri locality covers you: metro St. Louis, metro Kansas City, or rest-of-state areas like Springfield, Columbia, Joplin, and the Bootheel.
What this number is
The figures on this page are 2026 Medicare physician allowed amounts for a specific CPT code: the professional fee, adjusted by geographic practice-cost indices. They are not a hospital chargemaster price, not your insurer's contracted rate, and not a quote. Hospital facility fees, anesthesia, implants, imaging reads, and pathology are billed separately when they apply. In Missouri the office and hospital physician lines for this CPT differ by $253.79.
National vs Missouri
Where Missouri ranks for this CPT
CPT 45385 by Missouri locality
| Locality | Office |
|---|---|
| metropolitan st. louis | $484.01 |
| metropolitan kansas city | $479.25 |
| rest of missouri | $453.48 |
PE GPCI ranges from 0.862 to 0.952 in Missouri. That index is why the same CPT is not one price statewide.
Colonoscopy With Polyp Removal and how Missouri is priced
Missouri is a three-locality state: metropolitan St. Louis and metropolitan Kansas City are each priced separately, and everywhere else falls into a rest-of-state locality with lower geographic adjustments. Both metro localities approve higher amounts than outstate Missouri, and the Kansas City locality applies only to the Missouri side of that metro, since the Kansas side prices under Kansas's statewide locality. Springfield, Columbia, and the rural counties all share rest-of-state factors. The metro-versus-outstate gap is the main pricing story here.
St. Louis and Kansas City hold the state's academic medical centers and most of its specialty depth, drawing patients from far beyond Missouri's borders, including southern Illinois and eastern Kansas. Outstate Missouri is served by regional hubs in Springfield, Columbia, and Cape Girardeau, with the Ozarks and Bootheel among the harder places to reach specialty care. Rural hospital viability has been a persistent concern across the 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?
Other featured procedures in Missouri
Colonoscopy With Polyp Removal in other states
Colonoscopy With Polyp Removal in Missouri: questions
How much does colonoscopy with polyp removal cost in Missouri?
The 2026 Medicare physician office rate for CPT 45385 averages $472.25 across 3 Missouri localities, from $453.48 in REST OF MISSOURI to $484.01 in METROPOLITAN ST. LOUIS. The hospital physician rate averages $218.46. Enter a ZIP for the exact locality.
Does the rate change inside Missouri?
Yes. CMS splits Missouri into 3 payment localities. For this CPT the office physician fee spans $30.53 from the lowest to highest locality. Enter a ZIP code to see which Missouri locality covers you: metro St. Louis, metro Kansas City, or rest-of-state areas like Springfield, Columbia, Joplin, and the Bootheel.
What will a Medicare patient owe for the physician fee?
After the Part B deductible, coinsurance is usually 20% of the allowed amount: about $94 for the office physician line or $44 for the hospital physician line in Missouri. Medigap may cover that 20%. This is not the hospital facility fee.
Is this the full colonoscopy with polyp removal bill in Missouri?
No. $472.25 is the Medicare physician allowed amount for CPT 45385. Anesthesia, facility fees, implants, and other CPT codes billed the same day are extra. Missouri ranks #17 of 51 states on this physician line (6% below the national office rate of $500.01).