CPT45385

Colonoscopy With Polyp Removal Cost in South Carolina

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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South Carolina Medicare physician rate (2026)

-5.6% vs national

Single statewide locality.

South Carolina (Hospital)
$216.53
Facility physician fee
Private plan est.
$614–$944
~130–200% of Medicare
Cash / self-pay est.
$378–$708
~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 South Carolina

Check your ZIP code for your region of South Carolina, whether Charleston and the Lowcountry, Columbia and the Midlands, Greenville-Spartanburg in the Upstate, or Myrtle Beach and the Grand Strand.

What colonoscopy with polyp removal costs at hospitals near you

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

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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 South Carolina the office and hospital physician lines for this CPT differ by $255.54.

National vs South Carolina

National office$500.01
National hospital (physician)$223.45
South Carolina vs national6% below the national office rate of $500.01

Where South Carolina ranks for this CPT

Rank (lowest physician fee first)#16 of 51
Lowest stateArkansas ($444.65)
Highest stateAlaska ($588.56)

Colonoscopy With Polyp Removal and how South Carolina is priced

South Carolina prices through one statewide locality with indices a bit below the national average, so Charleston, Columbia, Greenville, and the rural Pee Dee share the same Medicare-approved amounts. Rapid coastal growth has not led CMS to break out a separate locality, keeping the fee schedule uniform from the mountains to the sea islands. The single set of adjustments makes the statewide figures here directly usable anywhere in the state. Facility fees at hospital-owned locations remain the largest source of price variation for patients.

The state's medical firepower splits three ways: an academic medical center and strong hospital market in Charleston, the capital-region systems in Columbia, and a large Upstate network centered on Greenville. Retiree-heavy coastal areas like Hilton Head and Myrtle Beach have booming demand for Medicare-age care, while the rural I-95 corridor faces some of the state's worst access gaps. Some border residents use Charlotte or Augusta providers.

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 South Carolina: questions

South Carolina is a single Medicare locality for this fee schedule. The 2026 physician rate for CPT 45385 is $472.07 in an office and $216.53 in a hospital, statewide. A ZIP lookup still confirms the locality mapping.

Not on the physician fee schedule. South Carolina 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 $94 for the office physician line or $43 for the hospital physician line in South Carolina. Medigap may cover that 20%. This is not the hospital facility fee.

No. $472.07 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. South Carolina ranks #16 of 51 states on the physician line (6% below 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.