CPT 45378: colonoscopy (diagnostic). What Medicare pays and what to ask
A colonoscopy can lead to many separate charges. Here is what 45378 covers and what Medicare's rate represents.
What this code means
CPT 45378 is a colonoscopy: a flexible camera exam of the colon, including taking samples by brushing or washing.
Other codes apply if tissue is taken (biopsy), polyps are removed or other steps are done.
Why the bill can be much higher than the Medicare rate
The rate shown is the doctor's fee. The facility, the anesthesia and the pathology lab are billed separately.
Whether a colonoscopy is billed as screening or diagnostic can change what you owe, even for the same procedure.
| If a line is billed at | It would be |
|---|---|
| 5x the Medicare rate | $1,890.50 |
| 10x the Medicare rate | $3,781.00 |
| 20x the Medicare rate | $7,562.00 |
The Medicare rate is a published benchmark, not a legal ceiling on what a provider may charge. Our free scan flags a line as worth a closer look when it is billed at more than 10 times the Medicare rate.
Questions worth asking before you pay
- Was my colonoscopy billed as screening or diagnostic, and what changed during it?
- What are the separate charges for the facility, anesthesia and pathology?
- If polyps were removed, which codes were added?
Check every line against the official Medicare rates in about a minute. The scan is free.
Related codes
Source: Medicare Physician Fee Schedule (CMS, July 2026 release), national payment amount, non-facility setting. Last updated October 2026. This page is general information, not legal or medical advice. Rates change each year and a hospital bill can include charges that the benchmark does not cover.