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Data Sources: Centers for Medicare & Medicaid Services (CMS), Medicare Provider Utilization and Payment Data
Disclaimer: This site is an independent journalism project. Data analysis and editorial content are not affiliated with or endorsed by CMS or any government agency. All spending figures are based on publicly available Medicare payment records.
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Methodology•Download Data
  1. Home
  2. Procedures
  3. 45380
  4. Cost Analysis

How Much Does Biopsy of large bowel using a flexible endoscope Cost on Medicare?

Cost analysis for CPT 45380 — Biopsy of large bowel using a flexible endoscope

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Average Medicare Payment

N/A

Total Payments (Latest)

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Services (Latest)

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Price Change (–)

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🗺️ State-by-State Cost Variation

The most expensive state pays 2.1x more than the cheapest for this procedure. NV averages $251.98 vs VT at $118.46.

StateAvg PaymentTotal PaymentsServicesProviders
NV$251.98$2.7M10.7K94
PR$250.47$86.9K34719
AK$233.59$916.4K3.9K61
CA$229.72$34.6M150.7K1.5K
NJ$226.67$12.6M55.7K594
NY$226.45$18.3M80.7K1.2K
MD$222.45$9.8M44.1K372
AZ$210.87$7.5M35.4K349
WY$210.04$732.0K3.5K43
HI$207.08$904.3K4.4K56
RI$204.57$1.1M5.3K61
CO$202.64$4.5M22.3K271
DE$202.42$1.1M5.3K60
OR$200.19$2.6M12.9K216
GA$197.01$7.0M35.5K474
FL$195.51$21.8M111.3K1.2K
TX$192.93$19.1M98.9K1.2K
NE$188.11$2.0M10.6K134
MS$187.78$3.1M16.6K121
WA$187.40$6.1M32.7K373
CT$186.28$2.8M15.1K243
TN$185.92$4.8M26.0K315
NM$184.05$1.2M6.6K70
NC$183.58$7.1M38.7K519
PA$182.82$10.5M57.5K843
KS$180.36$2.0M11.3K143
AR$179.67$1.6M8.7K125
UT$175.54$1.6M9.3K118
SC$174.69$4.9M27.8K257
LA$173.14$2.5M14.5K217
MI$170.07$4.6M27.1K492
MA$162.44$5.5M33.9K462
VA$161.98$5.1M31.6K396
IL$161.89$8.5M52.8K670
MT$161.54$698.3K4.3K43
MN$159.59$2.3M14.3K313
AL$158.03$2.1M13.4K192
OH$156.81$6.0M38.2K669
IA$155.79$1.7M10.8K147
OK$153.21$2.1M13.4K162
ND$152.96$479.5K3.1K42
ID$152.30$1.1M6.9K89
MO$151.06$3.2M21.0K347
NH$147.29$997.9K6.8K93
DC$146.48$388.5K2.7K52
KY$145.90$2.2M15.3K237
IN$144.64$3.0M20.4K343
SD$134.40$571.9K4.3K58
WI$132.51$2.3M17.0K298
WV$122.25$310.3K2.5K65
ME$118.89$334.7K2.8K63

💰 Who Bills the Most for This Procedure?

ProviderSpecialtyStatePaymentsServicesAvg/Service
Digestivecare, LlcAmbulatory Surgical CenterTN$1.4M3.9K$357.22
Jacksonville Endoscopy Centers LlcAmbulatory Surgical CenterFL$688.1K2.0K$351.79
Endoscopy Center Of Santa Maria IncAmbulatory Surgical CenterCA$637.8K1.6K$406.25
Mngi Endoscopy Asc IncAmbulatory Surgical CenterMN$626.3K1.8K$352.67
Austin Gi Surgicenter, LlcAmbulatory Surgical CenterTX$610.4K1.7K$358.63
Gastrointestinal Associates Endoscopy Center, LlcAmbulatory Surgical CenterMS$604.3K1.7K$351.57
Carnegie Hill Endoscopy LlcAmbulatory Surgical CenterNY$573.5K1.3K$444.95
Midwest Endoscopy Services LlcAmbulatory Surgical CenterNE$559.0K1.6K$358.58
Voorhees Nj Endoscopy Asc LlcAmbulatory Surgical CenterNJ$557.4K1.5K$373.87
Greenville Endoscopy Center IncAmbulatory Surgical CenterSC$555.2K1.5K$358.42
Medical Center Endoscopy, LlcAmbulatory Surgical CenterTX$548.1K1.5K$366.84
San Francisco Endoscopy Center LlcAmbulatory Surgical CenterCA$510.7K875$583.69
The Maryland Center For Digestive Health LlcAmbulatory Surgical CenterMD$507.3K1.4K$352.81
Yorkville Endoscopy, LlcAmbulatory Surgical CenterNY$492.6K1.2K$410.86
Roseville Endoscopy Center, LlcAmbulatory Surgical CenterCA$478.3K1.0K$470.79
Southwest Endoscopy LtdAmbulatory Surgical CenterNM$446.7K1.2K$367.32
Baylor Surgicare At Plano, LlcAmbulatory Surgical CenterTX$443.4K1.1K$403.48
Monterey Bay Endoscopy Center LlcAmbulatory Surgical CenterCA$438.4K959$457.15
Digestive Health Specialists Endoscopy Center Arizona, LlcAmbulatory Surgical CenterAZ$423.9K1.2K$363.24
Gulf Coast Endoscopy Center Of Venice LlcAmbulatory Surgical CenterFL$420.7K1.3K$324.85

🤔 Is Biopsy of large bowel using a flexible endoscope Overpriced?

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.

Data Sources

  • • Centers for Medicare & Medicaid Services (CMS)
  • • Medicare Provider Utilization and Payment Data (2014-2023)
  • • Medicare Physician Fee Schedule

Note: All data is from publicly available Medicare records. OpenMedicare is an independent journalism project not affiliated with CMS.