Colonoscopy W/Lesion Removal: What It Costs and What's Fair
CPT 45385 · Medicare rate: $223 · National avg charge: $3,241 · BillKarma data from 101 providers
Reviewed 2026-04-04 · Pricing data year: 2026
Estimates assume 20% coinsurance after deductible. Actual costs depend on your plan's negotiated rates, coinsurance, and out-of-pocket maximum. .
Your Insurance Plan
Colonoscopy W/Lesion Removal (CPT 45385) is a surgical procedure typically performed in a hospital or accredited outpatient surgical center. It is usually recommended after more conservative treatments—such as medication or physical therapy—have not resolved the underlying problem. Recovery time ranges from a few days to several weeks depending on patient health and procedure complexity.
Cost by Billing Grade
| Grade | Avg Hospital Charge | Medicare Rate | Est. Patient Cost* | Hospitals |
|---|---|---|---|---|
| C | $1,300 | $223 | $260 | 24 |
| D | $1,049 | $223 | $210 | 3 |
| F | $3,763 | $223 | $753 | 56 |
| N/A | $4,572 | $223 | $914 | 18 |
*Estimated patient cost assumes 20% coinsurance after deductible is met. Actual cost depends on your specific plan, deductible status, and network.
Cost Range Across Hospitals
What This Procedure Typically Costs by Facility Type
Find Providers Near You for This Procedure
Showing 10 lowest-markup providers nationally across hospitals, surgery centers, and imaging centers. Enter ZIP code to compare local providers side by side.
| Provider | Type | Location | Grade | Charge | Benchmark | Markup |
|---|---|---|---|---|---|---|
| AdventHealth East Orlando | Hospital | Orlando, FL | D | $448 |
$223
Medicare OPPS
|
2.0x |
| ASCENSION CALUMET HOSPITAL | Hospital | CHILTON, WI | C | $778 |
$223
Medicare OPPS
|
3.5x |
| Avera St. Luke’s Hospital | Hospital | ABERDEEN, SD | N/A | $810 |
$223
Medicare OPPS
|
3.6x |
| ASCENSION PROVIDENCE ROCHESTER HOSPITAL | Hospital | ROCHESTER, MI | F | $903 |
$223
Medicare OPPS
|
4.0x |
| BEN TAUB GENERAL HOSPITAL | Hospital | HOUSTON, TX | N/A | $1,017 |
$223
Medicare OPPS
|
4.6x |
| Eastern Maine Medical Center | Hospital | Bangor, ME | C | $1,049 |
$223
Medicare OPPS
|
4.7x |
| Eastern Maine Healthcare Systems Inland Hospital | Hospital | Waterville, ME | C | $1,188 |
$223
Medicare OPPS
|
5.3x |
| ASCENSION MEDICAL GROUP ST. VINCENT | Hospital | NORTH VERNON, IN | C | $1,197 |
$223
Medicare OPPS
|
5.4x |
| ADVENTHEALTH LAKE WALES | Hospital | LAKE WALES, FL | C | $1,350 |
$223
Medicare OPPS
|
6.0x |
| ADVENTIST HEALTH SYSTEM/SUNBELT, INC. | Hospital | TAMPA, FL | C | $1,350 |
$223
Medicare OPPS
|
6.0x |
What Is a Fair Price for This Procedure?
Medicare pays $223 for Colonoscopy W/Lesion Removal (CPT 45385). This rate is set by CMS based on the actual cost of delivering the procedure, including physician time, overhead, and equipment. It's the most reliable national benchmark for what the procedure is worth.
A hospital charging $447 (2x Medicare) or less earns an A billing grade — these are the most fairly priced facilities for this procedure. The national average charge is $3,241 (14.5x Medicare).
If your bill shows more than $670 (3x Medicare) for this procedure, it may be worth reviewing the charges carefully. Upload your bill to check →
Frequently Asked Questions
How much does Colonoscopy W/Lesion Removal cost with insurance?
Does where I have Colonoscopy W/Lesion Removal done affect my recovery?
How do I negotiate the cost of Colonoscopy W/Lesion Removal if I'm on a high-deductible plan?
Related Procedures
- Upper GI Endoscopy with Biopsy · avg $4,683
- Colonoscopy · avg $3,682
- Laparoscopy Appendectomy · avg $11,291
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