45390

Removal of large bowel tissue using a flexible endoscope

Medicare pricing data for 5,318 providers across 50 states

🤖AI Overview

Prices vary significantly by location — from $317 in West Virginia to $726 in Idaho. Where you get this procedure matters more than almost any other factor. Note: These costs reflect the Medicare physician/supplier component. Hospital facility fees are billed separately and can be 2-5x the physician fee.

💡 What You Should Know

Removal of large bowel tissue using a flexible endoscope (HCPCS code 45390) is a medical procedure billed to Medicare. The average Medicare-allowed cost is $485.49, but hospitals typically charge $1,690 — a 3.5x markup. Prices vary significantly by state and provider.

🏷️ Typical Out-of-Pocket Cost

$97.10

Medicare patients typically pay about 20% of the allowed amount as coinsurance. Based on the average allowed cost of $485.49, your out-of-pocket cost would be approximately $97.10. Actual costs depend on your specific plan, deductible, and whether you've met your annual out-of-pocket maximum.

Average Allowed Cost
$485.49
Average Hospital Charge
$1,690
Markup Ratio
3.5x

What Hospitals Charge vs. What Medicare Pays

Hospital Charge$1,690.40
Medicare Allowed$485.49
Medicare Payment$395.56

Hospitals charge 3.5x more than what Medicare allows for this procedure. Medicare actually pays $395.56 on average.

Cost by State

Medicare-allowed amounts vary significantly by state

StateAllowed CostHospital ChargeProvidersServicesvs. National
Idaho$726$2,38414149+49.6%
California$667$2,1634905,005+37.3%
Maryland$599$1,2161221,215+23.3%
New Jersey$571$2,3601921,213+17.6%
Wyoming$567$1,826723+16.9%
Washington$566$1,4051491,087+16.5%
Colorado$543$1,85282442+11.8%
North Carolina$537$1,5112221,432+10.6%
New Hampshire$523$2,57731221+7.8%
Kansas$510$1,44262418+5.1%
Nebraska$507$1,35938284+4.4%
Mississippi$502$1,62243232+3.4%
Louisiana$500$1,50983391+3.0%
South Dakota$500$1,99913115+3.0%
Florida$499$1,8274482,809+2.8%
Arkansas$487$1,60034216+0.4%
Oregon$478$1,46654244-1.6%
Arizona$470$1,56779469-3.2%
Georgia$466$1,557115544-4.1%
Oklahoma$464$1,40428150-4.3%
Hawaii$451$1,5781533-7.2%
Connecticut$445$1,76958302-8.4%
Vermont$441$2,1371776-9.2%
Montana$439$1,3091057-9.6%
Wisconsin$437$3,000113491-9.9%
Virginia$428$1,7781621,329-11.9%
Kentucky$425$1,23180528-12.4%
Rhode Island$422$1,580820-13.0%
Nevada$420$9792777-13.4%
Texas$417$1,6153411,543-14.1%
Indiana$417$1,657120907-14.2%
Ohio$413$1,267201910-14.9%
Pennsylvania$412$1,4192881,647-15.2%
New York$400$1,9193621,758-17.7%
Iowa$398$1,11836369-18.1%
Michigan$393$1,151148682-19.1%
Utah$389$1,0472261-19.9%
Illinois$389$1,5632121,288-19.9%
Minnesota$389$1,87587554-20.0%
New Mexico$386$9122294-20.4%
Massachusetts$380$1,5131961,113-21.7%
South Carolina$375$1,330109903-22.8%
Missouri$372$1,203114681-23.3%
District of Columbia$361$1,24231175-25.5%
Alabama$359$1,30057260-26.1%
Tennessee$339$1,25364284-30.2%
North Dakota$336$1,0831582-30.8%
Delaware$328$6141265-32.5%
Maine$321$95322123-33.9%
West Virginia$317$1,22822193-34.6%

⚠️ Important: These costs reflect the Medicare physician/supplier component. Hospital facility fees may be billed separately. Total out-of-pocket costs may be higher.

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💊 Need post-procedure medications? Check costs on OpenPrescriber