Colonoscopy With Polyp Removal Cost in West Virginia
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
West Virginia Medicare physician rate (2026)
-7.3% vs nationalSingle statewide locality.
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 West Virginia
Run a ZIP lookup for your part of West Virginia, whether Morgantown, Charleston, Huntington, Wheeling, the Eastern Panhandle near Martinsburg, or the southern coalfields.
What colonoscopy with polyp removal costs at hospitals near you
Everything above is a national average. The hospital you pick in West Virginia 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.
One-off payment, no account and no subscription. You get a private link and an email. No medical records and no insurance card, ever.
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 West Virginia the office and hospital physician lines for this CPT differ by $240.33.
National vs West Virginia
Where West Virginia ranks for this CPT
Colonoscopy With Polyp Removal and how West Virginia is priced
West Virginia is one statewide payment locality with geographic indices among the lowest in the eastern United States, so its published Medicare rates apply identically from the Eastern Panhandle to the southern coalfields. The uniform pricing spans a state whose mountainous terrain makes actual travel to care unusually difficult relative to straight-line distances. CMS's work index floor supports the state's low-cost profile. Morgantown, Charleston, and Huntington all bill against the same geographic factors.
The state's care concentrates around its academic medical centers in Morgantown and Huntington and the capital-region hospitals in Charleston, each serving long mountain catchments. West Virginia's population is among the oldest and highest-need in the country, and hospital finances have been fragile in many counties. Eastern Panhandle residents commonly use Maryland or Virginia providers, and northern residents look to Pittsburgh.
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 West Virginia
Colonoscopy With Polyp Removal in other states
Colonoscopy With Polyp Removal in West Virginia: questions
West Virginia is a single Medicare locality for this fee schedule. The 2026 physician rate for CPT 45385 is $463.60 in an office and $223.27 in a hospital, statewide. A ZIP lookup still confirms the locality mapping.
Not on the physician fee schedule. West Virginia 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 $93 for the office physician line or $45 for the hospital physician line in West Virginia. Medigap may cover that 20%. This is not the hospital facility fee.
No. $463.60 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. West Virginia ranks #9 of 51 states on the physician line (7% below the national office rate of $500.01).