Colonoscopy: how much does Medicare pay?

Nationally, the Q3 2026 Physician Fee Schedule pays $378.10 in an office (non-facility) setting and $164.67 in a facility setting for 45378. Your local amount differs — the national figure applies geographic index values of 1.000, and Medicare then pays 80% of the allowed amount after the deductible is met.

Procedure · Updated Aug 1, 2026

Colonoscopy: CPT code and Medicare rate

An examination of the colon with a flexible scope. 45378 is the diagnostic version, used to investigate symptoms such as bleeding, anemia, or a change in bowel habits.

Also called: scope of the colon, bowel scope, lower endoscopy.

Usually billed as

45378 Diagnostic Colonoscopy

Office (non-facility): $378.10
Facility: $164.67

National amounts for the Q3 2026 release (July 1 – September 30, 2026), using geographic index values of 1.000. Your local rate differs — open the code page for the locality breakdown.

A colonoscopy done purely for screening uses a different code — see screening colonoscopy.

Related codes

Codes worth checking before you settle on 45378.

Code	What it covers	Office	Facility
45385	Colonoscopy with Lesion Removal (Snare)	$500.01	$223.45
G0121	Screening Colonoscopy, Average Risk	$378.43	$165.00
G0105	Colonoscopy Screening, High-Risk Patient	$378.10	$164.67

A dash means the code has no national amount in this release — it may be carrier-priced, bundled, or not separately payable. That is never the same as $0.

Common questions

Colonoscopy: which code is it?: 45378 — Diagnostic Colonoscopy. An examination of the colon with a flexible scope. 45378 is the diagnostic version, used to investigate symptoms such as bleeding, anemia, or a change in bowel habits.
Colonoscopy: how much does Medicare pay?: Nationally, the Q3 2026 Physician Fee Schedule pays $378.10 in an office (non-facility) setting and $164.67 in a facility setting for 45378. Your local amount differs — the national figure applies geographic index values of 1.000, and Medicare then pays 80% of the allowed amount after the deductible is met.
Colonoscopy: what else affects the billing?: A colonoscopy done purely for screening uses a different code — see screening colonoscopy.

Need the rate where you practice?

Every code page carries the full locality breakdown, the RVU and GPCI inputs, and the release that answered.

Open the code page

Keep exploring

All procedures How Medicare pays Office vs. facility rates Check a medical bill

This page maps everyday language to the code a claim normally carries. It is general information about how Medicare prices a service, not coding advice for a specific claim — the correct code always depends on what was actually documented and performed.

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