Colonoscopy With Polyp Removal Cost in New York
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
New York Medicare physician rate (2026)
+10.4% vs nationalAverage of 5 localities. Office range $478.25–$587.27.
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 New York
New York's multiple localities make a ZIP-level check essential: compare Manhattan, Queens and the outer boroughs, Long Island, the Hudson Valley near Poughkeepsie, and upstate cities like Buffalo, Rochester, Syracuse, and Albany.
What colonoscopy with polyp removal costs at hospitals near you
Everything above is a national average. The hospital you pick in New York 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 New York the office and hospital physician lines for this CPT differ by $308.53.
National vs New York
Where New York ranks for this CPT
CPT 45385 by New York locality
| Locality | Office |
|---|---|
| nyc suburbs/long island | $587.27 |
| queens | $577.86 |
| manhattan | $573.64 |
| poughkpsie/n nyc suburbs | $542.02 |
| rest of new york | $478.25 |
PE GPCI ranges from 0.950 to 1.189 in New York. That index is why the same CPT is not one price statewide.
Colonoscopy With Polyp Removal and how New York is priced
New York has one of the most complex locality maps in the country, with around five payment areas: Manhattan is its own locality, Queens is separately priced, the NYC suburbs and Long Island form another high-cost locality, the Poughkeepsie area has its own, and the rest of the state, including Buffalo, Rochester, Syracuse, and Albany, shares a distinctly lower-priced upstate locality. The spread between Manhattan and upstate adjustments is among the widest within any state. A knee MRI or office visit is approved at meaningfully different amounts in Manhattan, Mineola, and Rochester. Upstate New York prices closer to the Midwest than to the five boroughs.
New York City is a global medical capital with world-famous academic medical centers competing within blocks of each other, while upstate cities each center on their own regional academic hubs. Long Island and the lower Hudson Valley support dense suburban hospital markets of their own. The upstate-downstate divide runs through everything in New York health care, including what providers charge and what patients can access locally.
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?
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Colonoscopy With Polyp Removal in other states
Colonoscopy With Polyp Removal in New York: questions
The 2026 Medicare physician office rate for CPT 45385 averages $551.81 across 5 New York localities, from $478.25 in REST OF NEW YORK to $587.27 in NYC SUBURBS/LONG ISLAND. The hospital physician rate averages $243.28. Enter a ZIP for the exact locality.
Yes. CMS splits New York into 5 payment localities. For this CPT the office physician fee spans $109.02 from the lowest to highest locality. New York's multiple localities make a ZIP-level check essential: compare Manhattan, Queens and the outer boroughs, Long Island, the Hudson Valley near Poughkeepsie, and upstate cities like Buffalo, Rochester, Syracuse, and Albany.
After the Part B deductible, coinsurance is usually 20% of the allowed amount: about $110 for the office physician line or $49 for the hospital physician line in New York. Medigap may cover that 20%. This is not the hospital facility fee.
No. $551.81 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. New York ranks #48 of 51 states on the physician line (10% above the national office rate of $500.01).