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Colonoscopy Cost: Medicare's 2026 Price in Every State, and What You Pay
Medicare's 2026 approved amount for a routine screening colonoscopy is about $675 when it is done at a surgery center and $1,115 in a hospital outpatient department. That is the gastroenterologist's fee ($164.59 in the middle of Medicare's 107 fee areas1) plus the facility's fee ($510.49 at a surgery center2, $950.10 at a hospital3).
If the doctor finds and removes a polyp, the visit is billed as a different procedure and the total climbs to about $952 at a surgery center or $1,517 at a hospital, lab included. These are Medicare rates, the floor most other prices are measured against, not the list price a hospital puts on a self-pay bill.
What you actually pay
For most people, a screening colonoscopy costs nothing out of pocket. Marketplace health plans cover colorectal cancer screening for adults 45 to 75, generally at no cost when you use an in-network doctor6. On Medicare, you pay nothing for a screening if the doctor accepts assignment, and that includes the follow-up colonoscopy after a positive stool test4.
The bill changes in two cases:
- A polyp is removed during a screening. On Medicare, you pay 15% of the approved amount for the doctor and 15% to the surgery center or hospital, and the Part B deductible does not apply4.
- The colonoscopy is diagnostic, not a screening. If you go in because of symptoms (bleeding, a change in bowel habits) it is billed as a diagnostic test. Medicare then works like any Part B service: the $283 deductible for 2026, then usually 20%5. The hospital file lists a $190.02 national copayment for a diagnostic colonoscopy at a hospital, 20% of its $950.10 rate3.
Price your own colonoscopy
Pick your Medicare fee area, where the procedure is done and what happens during it. The doctor and lab fees are this year's rate for your area1. The facility fee is CMS's national rate23; Medicare raises or lowers part of it for local wages, so in a high-cost city it will run a little above this.
Our math on CMS's 2026 files. A Medigap or Medicare Advantage plan can change your share. Anesthesia, if you have it, is a separate bill (see below).
A worked example: Riverside County, California
Riverside and San Bernardino counties are one Medicare fee area. Say a 68-year-old on Original Medicare goes in for a routine screening at a surgery center and the doctor takes out one polyp.
Had nothing been found, the patient would have paid $0. Had the same patient gone in for rectal bleeding (a diagnostic colonoscopy, nothing removed) with no Part B bills yet that year, the approved amount would be $679.35 and their share $362.27: the $283 deductible plus 20% of the rest5. Same scope, same doctor, a very different bill depending on why you went in.
Hospital or surgery center: the biggest lever
The doctor's fee barely moves between fee areas. The facility fee is where the money is. Medicare pays a hospital outpatient department $950.10 for a screening, against $510.49 at an ambulatory surgery center32. That is $440 more for the same procedure, and on a polyp removal the gap is $566. If you have a high-deductible plan, or you are paying 15% or 20%, ask your gastroenterologist whether they operate at a surgery center.
Where the doctor's fee is highest and lowest
Medicare adjusts the doctor's fee for local rent, wages and malpractice cost. For a colonoscopy with polyp removal, the highest-paid fee areas are:
- Alaska$294.02
- NYC Suburbs/Long IslandNew York$258.44
- San Jose-Sunnyvale-Santa Clara (San Benito County)California$257.33
- San Jose-Sunnyvale-Santa Clara (Santa Clara County)California$254.96
- ManhattanNew York$252.27
- San Francisco-Oakland-Berkeley (Marin County)California$251.94
- MiamiFlorida$251.85
- San Francisco-Oakland-Berkeley (San Francisco/San Mateo/Alameda/Contra Costa County)California$251.36
Lowest:
- Arkansas$207.09
- Iowa$208.30
- Nebraska$208.43
- Alabama$208.88
- Wisconsin$209.25
- Kansas$209.49
- Idaho$209.88
- Tennessee$210.34
Doctor's fee only, CPT 45385, facility setting, 20261. The national base rate before any local adjustment is $223.45.
The four codes on a colonoscopy bill
The code tells you what you are being charged for. Doctor's fee in the middle fee area, 20261:
- G0121 screeningaverage risk, nothing removed$164.59
- 45378 diagnosticsymptoms, nothing removed$164.41
- 45380 with biopsytissue sampled$177.74
- 45385 polyp removedsnare removal$223.60
If you went in for a screening and the bill lists a diagnostic code with a deductible or 20% share, call the billing office and ask them to check how the visit was coded.
What about anesthesia?
If an anesthesiologist or nurse anesthetist sedates you, they send their own bill. Medicare pays anesthesia as base units plus 15-minute time units, times a local anesthesia conversion factor: $20.44 per unit in the middle fee area and $20.88 in Riverside County for 20261. Ask before the procedure whether the anesthesia provider is in your plan's network.
Medicare colonoscopy rates, every state
CMS 2026 rates123. Where a state has more than one Medicare fee area, you see the low and high. “Screening” is the doctor's fee plus the facility fee; “polyp removed” adds the higher procedure fee and one pathology specimen.
| State | Doctor’s fee | Screening, surgery center | Screening, hospital | Polyp removed, surgery center |
|---|---|---|---|---|
| Alabama1 fee area | $153 | $664 | $1,103 | $930 |
| Alaska1 fee area | $215 | $725 | $1,165 | $1,036 |
| Arizona1 fee area | $162 | $672 | $1,112 | $945 |
| Arkansas1 fee area | $152 | $662 | $1,102 | $927 |
| California29 fee areas | $165–$190 | $675–$700 | $1,115–$1,140 | $955–$1,007 |
| Colorado1 fee area | $166 | $677 | $1,116 | $955 |
| Connecticut1 fee area | $174 | $684 | $1,124 | $965 |
| Delaware1 fee area | $164 | $674 | $1,114 | $948 |
| District of Columbia1 fee area | $180 | $691 | $1,130 | $980 |
| Florida3 fee areas | $170–$188 | $681–$699 | $1,120–$1,138 | $955–$982 |
| Georgia2 fee areas | $163–$169 | $673–$679 | $1,113–$1,119 | $943–$956 |
| Hawaii1 fee area | $165 | $676 | $1,115 | $957 |
| Idaho1 fee area | $154 | $665 | $1,104 | $933 |
| Illinois4 fee areas | $169–$184 | $679–$695 | $1,119–$1,134 | $951–$975 |
| Indiana1 fee area | $155 | $665 | $1,105 | $934 |
| Iowa1 fee area | $153 | $663 | $1,103 | $931 |
| Kansas1 fee area | $154 | $664 | $1,104 | $932 |
| Kentucky1 fee area | $159 | $669 | $1,109 | $937 |
| Louisiana2 fee areas | $159–$164 | $670–$675 | $1,109–$1,114 | $938–$947 |
| Maine2 fee areas | $156–$159 | $667–$670 | $1,106–$1,110 | $935–$943 |
| Maryland2 fee areas | $165–$173 | $676–$684 | $1,116–$1,123 | $952–$965 |
| Massachusetts2 fee areas | $166–$176 | $677–$687 | $1,116–$1,127 | $955–$975 |
| Michigan2 fee areas | $163–$173 | $673–$684 | $1,113–$1,123 | $944–$959 |
| Minnesota1 fee area | $156 | $667 | $1,107 | $941 |
| Mississippi1 fee area | $155 | $666 | $1,105 | $931 |
| Missouri3 fee areas | $158–$163 | $669–$673 | $1,109–$1,113 | $936–$945 |
| Montana1 fee area | $165 | $675 | $1,115 | $950 |
| Nebraska1 fee area | $153 | $663 | $1,103 | $931 |
| Nevada1 fee area | $163 | $673 | $1,113 | $947 |
| New Hampshire1 fee area | $165 | $676 | $1,115 | $952 |
| New Jersey2 fee areas | $175–$180 | $685–$690 | $1,125–$1,130 | $968–$979 |
| New Mexico1 fee area | $164 | $675 | $1,114 | $945 |
| New York5 fee areas | $159–$192 | $669–$703 | $1,109–$1,142 | $940–$996 |
| North Carolina1 fee area | $157 | $667 | $1,107 | $937 |
| North Dakota1 fee area | $157 | $667 | $1,107 | $940 |
| Ohio1 fee area | $161 | $672 | $1,111 | $942 |
| Oklahoma1 fee area | $157 | $668 | $1,107 | $935 |
| Oregon2 fee areas | $161–$168 | $671–$679 | $1,111–$1,118 | $945–$960 |
| Pennsylvania2 fee areas | $161–$171 | $671–$682 | $1,111–$1,122 | $941–$961 |
| Rhode Island1 fee area | $167 | $677 | $1,117 | $955 |
| South Carolina1 fee area | $159 | $670 | $1,110 | $940 |
| South Dakota1 fee area | $156 | $666 | $1,106 | $939 |
| Tennessee1 fee area | $154 | $665 | $1,105 | $933 |
| Texas8 fee areas | $160–$171 | $670–$681 | $1,110–$1,121 | $940–$958 |
| Utah1 fee area | $161 | $671 | $1,111 | $942 |
| Vermont1 fee area | $158 | $668 | $1,108 | $941 |
| Virginia1 fee area | $160 | $671 | $1,110 | $943 |
| Washington2 fee areas | $165–$178 | $676–$688 | $1,116–$1,128 | $954–$979 |
| West Virginia1 fee area | $165 | $676 | $1,115 | $945 |
| Wisconsin1 fee area | $153 | $664 | $1,104 | $934 |
| Wyoming1 fee area | $161 | $672 | $1,111 | $946 |
Puerto Rico and the Virgin Islands have their own fee areas and are left out. The Hawaii fee area also covers Guam. Facility fees are CMS's national rates.
How we got these numbers
We took the relative value units for each colonoscopy code from CMS's October 2026 physician fee schedule file and multiplied them by the geographic cost indexes for each of the 107 Medicare fee areas in the 50 states and DC, then by the 2026 conversion factor of $33.40091. Facility fees are CMS's October 2026 national rates for surgery centers2 and hospital outpatient departments3. “Middle” means the median across fee areas, not weighted by population. Nothing here is a price a hospital has quoted; it is what Medicare approves, and what most cash and commercial prices are measured against.
Receipt
Every number on this page, and where it came from.
- CMS Physician Fee Schedule, 2026 relative value file, October release RVU26D (PPRRVU2026_Oct_nonQPP, GPCI2026, 26LOCCO, ANES2026)source
- CMS: October 2026 ASC approved HCPCS codes and payment rates (Addendum AA)source
- CMS: October 2026 OPPS Addendum B, hospital outpatient payment by HCPCS codesource
- Medicare.gov: Colonoscopies (what you pay for a screening, and when a polyp is removed)source
- Medicare.gov: Medicare costs (2026 Part B deductible $283, then usually 20%)source
- HealthCare.gov: Preventive care benefits for adults (colorectal cancer screening, adults 45 to 75)source
Ratios such as rent share, tax rate and price differences are our math on the published figures above. ACS figures noisier than a 20% coefficient of variation are left out. How we count.