Cost analysis for CPT 45380 — Biopsy of large bowel using a flexible endoscope
Average Medicare Payment
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Total Payments (Latest)
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Services (Latest)
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Price Change (–)
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The most expensive state pays 2.1x more than the cheapest for this procedure. NV averages $251.98 vs VT at $118.46.
| State | Avg Payment | Total Payments | Services | Providers |
|---|---|---|---|---|
| NV | $251.98 | $2.7M | 10.7K | 94 |
| PR | $250.47 | $86.9K | 347 | 19 |
| AK | $233.59 | $916.4K | 3.9K | 61 |
| CA | $229.72 | $34.6M | 150.7K | 1.5K |
| NJ | $226.67 | $12.6M | 55.7K | 594 |
| NY | $226.45 | $18.3M | 80.7K | 1.2K |
| MD | $222.45 | $9.8M | 44.1K | 372 |
| AZ | $210.87 | $7.5M | 35.4K | 349 |
| WY | $210.04 | $732.0K | 3.5K | 43 |
| HI | $207.08 | $904.3K | 4.4K | 56 |
| RI | $204.57 | $1.1M | 5.3K | 61 |
| CO | $202.64 | $4.5M | 22.3K | 271 |
| DE | $202.42 | $1.1M | 5.3K | 60 |
| OR | $200.19 | $2.6M | 12.9K | 216 |
| GA | $197.01 | $7.0M | 35.5K | 474 |
| FL | $195.51 | $21.8M | 111.3K | 1.2K |
| TX | $192.93 | $19.1M | 98.9K | 1.2K |
| NE | $188.11 | $2.0M | 10.6K | 134 |
| MS | $187.78 | $3.1M | 16.6K | 121 |
| WA | $187.40 | $6.1M | 32.7K | 373 |
| CT | $186.28 | $2.8M | 15.1K | 243 |
| TN | $185.92 | $4.8M | 26.0K | 315 |
| NM | $184.05 | $1.2M | 6.6K | 70 |
| NC | $183.58 | $7.1M | 38.7K | 519 |
| PA | $182.82 | $10.5M | 57.5K | 843 |
| KS | $180.36 | $2.0M | 11.3K | 143 |
| AR | $179.67 | $1.6M | 8.7K | 125 |
| UT | $175.54 | $1.6M | 9.3K | 118 |
| SC | $174.69 | $4.9M | 27.8K | 257 |
| LA | $173.14 | $2.5M | 14.5K | 217 |
| MI | $170.07 | $4.6M | 27.1K | 492 |
| MA | $162.44 | $5.5M | 33.9K | 462 |
| VA | $161.98 | $5.1M | 31.6K | 396 |
| IL | $161.89 | $8.5M | 52.8K | 670 |
| MT | $161.54 | $698.3K | 4.3K | 43 |
| MN | $159.59 | $2.3M | 14.3K | 313 |
| AL | $158.03 | $2.1M | 13.4K | 192 |
| OH | $156.81 | $6.0M | 38.2K | 669 |
| IA | $155.79 | $1.7M | 10.8K | 147 |
| OK | $153.21 | $2.1M | 13.4K | 162 |
| ND | $152.96 | $479.5K | 3.1K | 42 |
| ID | $152.30 | $1.1M | 6.9K | 89 |
| MO | $151.06 | $3.2M | 21.0K | 347 |
| NH | $147.29 | $997.9K | 6.8K | 93 |
| DC | $146.48 | $388.5K | 2.7K | 52 |
| KY | $145.90 | $2.2M | 15.3K | 237 |
| IN | $144.64 | $3.0M | 20.4K | 343 |
| SD | $134.40 | $571.9K | 4.3K | 58 |
| WI | $132.51 | $2.3M | 17.0K | 298 |
| WV | $122.25 | $310.3K | 2.5K | 65 |
| ME | $118.89 | $334.7K | 2.8K | 63 |
| Provider | Specialty | State | Payments | Services | Avg/Service |
|---|---|---|---|---|---|
| Digestivecare, Llc | Ambulatory Surgical Center | TN | $1.4M | 3.9K | $357.22 |
| Jacksonville Endoscopy Centers Llc | Ambulatory Surgical Center | FL | $688.1K | 2.0K | $351.79 |
| Endoscopy Center Of Santa Maria Inc | Ambulatory Surgical Center | CA | $637.8K | 1.6K | $406.25 |
| Mngi Endoscopy Asc Inc | Ambulatory Surgical Center | MN | $626.3K | 1.8K | $352.67 |
| Austin Gi Surgicenter, Llc | Ambulatory Surgical Center | TX | $610.4K | 1.7K | $358.63 |
| Gastrointestinal Associates Endoscopy Center, Llc | Ambulatory Surgical Center | MS | $604.3K | 1.7K | $351.57 |
| Carnegie Hill Endoscopy Llc | Ambulatory Surgical Center | NY | $573.5K | 1.3K | $444.95 |
| Midwest Endoscopy Services Llc | Ambulatory Surgical Center | NE | $559.0K | 1.6K | $358.58 |
| Voorhees Nj Endoscopy Asc Llc | Ambulatory Surgical Center | NJ | $557.4K | 1.5K | $373.87 |
| Greenville Endoscopy Center Inc | Ambulatory Surgical Center | SC | $555.2K | 1.5K | $358.42 |
| Medical Center Endoscopy, Llc | Ambulatory Surgical Center | TX | $548.1K | 1.5K | $366.84 |
| San Francisco Endoscopy Center Llc | Ambulatory Surgical Center | CA | $510.7K | 875 | $583.69 |
| The Maryland Center For Digestive Health Llc | Ambulatory Surgical Center | MD | $507.3K | 1.4K | $352.81 |
| Yorkville Endoscopy, Llc | Ambulatory Surgical Center | NY | $492.6K | 1.2K | $410.86 |
| Roseville Endoscopy Center, Llc | Ambulatory Surgical Center | CA | $478.3K | 1.0K | $470.79 |
| Southwest Endoscopy Ltd | Ambulatory Surgical Center | NM | $446.7K | 1.2K | $367.32 |
| Baylor Surgicare At Plano, Llc | Ambulatory Surgical Center | TX | $443.4K | 1.1K | $403.48 |
| Monterey Bay Endoscopy Center Llc | Ambulatory Surgical Center | CA | $438.4K | 959 | $457.15 |
| Digestive Health Specialists Endoscopy Center Arizona, Llc | Ambulatory Surgical Center | AZ | $423.9K | 1.2K | $363.24 |
| Gulf Coast Endoscopy Center Of Venice Llc | Ambulatory Surgical Center | FL | $420.7K | 1.3K | $324.85 |
The data suggests significant pricing inconsistencies for CPT 45380. With a 2.1x price gap between the most and least expensive states, geography plays an outsized role in what Medicare pays for this procedure.
Costs have remained relatively stable over time, but the geographic variation suggests Medicare's geographic adjustment factors may not fully capture the true cost differences across states.
This analysis is based on publicly available CMS data and does not account for patient complexity, comorbidities, or facility-specific factors that may justify pricing differences.
Note: All data is from publicly available Medicare records. OpenMedicare is an independent journalism project not affiliated with CMS.