CPT 45380

Colonoscopy W/Biopsy Single/Multiple

CPT 45380 pays $479.97 in a non-facility setting and $177.69 in a facility setting under the 2026 Medicare Physician Fee Schedule, before geographic adjustment. After geographic adjustment, state amounts run from $423.81 in Arkansas to $554.38 in Alaska, a 31% spread.

National non-facility rate

$479.97

Office and other outpatient settings

Facility rate
$177.69

Hospital and ASC settings

Highest state
$554.38

Alaska

Lowest state
$423.81

Arkansas · 31% spread

Medicare rate by state

53 Medicare jurisdictions, highest to lowest. State values average every locality in the jurisdiction at a 33.4009 conversion factor.

Non-facilityFacilityNational $479.97
CPT 45380 Medicare reimbursement rate by state, 33.4009 conversion factor, 2026 Physician Fee Schedule. National non-facility $479.97, national facility $177.69.
StateRate compared visuallyNon-facilityFacility
Alaska
$554.38$232.45
District of Columbia
$550.12$194.04
California
$541.86$184.18
New Jersey
$531.20$190.84
New York
$530.97$193.75
Washington
$529.67$185.07
Massachusetts
$524.31$184.70
Hawaii
$522.02$178.33
Connecticut
$512.19$186.63
Colorado
$500.69$179.07
Maryland
$497.44$182.32
Oregon
$495.75$177.30
Florida
$494.42$191.13
New Hampshire
$492.57$177.90
Rhode Island
$492.21$179.96
Puerto Rico
$483.61$178.01
Virgin Islands
$483.61$178.01
Illinois
$481.34$189.27
Minnesota
$480.25$169.20
Montana
$479.94$177.66
Nevada
$477.98$175.40
Wyoming
$476.32$174.05
Delaware
$474.93$176.28
Pennsylvania
$474.81$178.72
Texas
$474.18$176.59
North Dakota
$471.64$169.36
South Dakota
$470.66$168.38
Virginia
$469.90$172.76
Vermont
$469.54$170.29
Arizona
$467.10$174.19
Georgia
$466.80$178.43
Michigan
$464.33$180.50
Maine
$459.15$170.33
Utah
$457.54$173.40
Wisconsin
$455.56$165.98
New Mexico
$453.74$176.55
North Carolina
$451.45$169.43
South Carolina
$451.26$171.96
Missouri
$450.93$173.54
Louisiana
$450.18$174.20
Ohio
$449.63$173.65
Indiana
$447.21$167.00
Idaho
$444.57$166.48
Nebraska
$444.29$165.29
Iowa
$441.76$165.17
Tennessee
$441.62$166.85
West Virginia
$440.16$177.48
Kentucky
$439.92$171.20
Kansas
$439.41$166.15
Oklahoma
$439.39$169.45
Alabama
$430.13$165.63
Mississippi
$427.65$167.39
Arkansas
$423.81$164.15

Billed by 2 specialties

Commercial rates for 45380

Medicare is the floor, not the market. See what UHC, Aetna, Cigna and BCBS actually pay — down to the TIN.

See negotiated rates