Code Reality Check
45378 reimbursement rate: Diagnostic colonoscopy
Diagnostic colonoscopy (CPT 45378) pays a median $489.69 in New Hampshire and $211.18 in Kentucky, against a Medicare anchor of $331.99. 50 of 51 states clear the publication floor.
spread 2.3x top to bottom
Medicare anchor $331.99
50/51 states published
The 50-state spread
as of 2026-07-15| State | Median | vs Medicare | Band | Rate points | Tier |
|---|---|---|---|---|---|
| New Hampshire | $489.69 | 1.48x | $312–$670 · P90 $1,021 | 20,498 | Benchmark |
| Wisconsin | $468.06 | 1.41x | $234–$920 · P90 $1,481 | 83,654 | Benchmark |
| Rhode Island | $454.05 | 1.37x | $250–$454 · P90 $636 | 5,612 | Benchmark |
| Massachusetts | $447.47 | 1.35x | $301–$599 · P90 $857 | 15,538 | Benchmark |
| South Carolina | $407.87 | 1.23x | $252–$708 · P90 $748 | 10,111 | Benchmark |
| Wyoming | $401.66 | 1.21x | $230–$520 · P90 $728 | 753 | Benchmark |
| California | $386.10 | 1.16x | $250–$822 · P90 $1,655 | 115,581 | Benchmark |
| Utah | $380.80 | 1.15x | $249–$698 · P90 $1,192 | 1,632 | Benchmark |
| Hawaii | $373.72 | 1.13x | $249–$562 · P90 $853 | 1,321 | Benchmark |
| New Jersey | $365.70 | 1.10x | $230–$549 · P90 $902 | 30,292 | Benchmark |
| Connecticut | $365.70 | 1.10x | $230–$609 · P90 $1,177 | 9,752 | Benchmark |
| Delaware | $365.70 | 1.10x | $230–$568 · P90 $941 | 1,153 | Benchmark |
| New York | $365.70 | 1.10x | $230–$549 · P90 $1,191 | 584,667 | Benchmark |
| Vermont | $365.70 | 1.10x | $230–$504 · P90 $599 | 3,372 | Benchmark |
| Georgia | $355.05 | 1.07x | $234–$520 · P90 $597 | 187,751 | Benchmark |
| Louisiana | $354.74 | 1.07x | $229–$549 · P90 $863 | 2,551 | Benchmark |
| Texas | $352.55 | 1.06x | $247–$495 · P90 $752 | 37,783 | Benchmark |
| Pennsylvania | $352.34 | 1.06x | $230–$527 · P90 $876 | 17,054 | Benchmark |
| Minnesota | $351.44 | 1.06x | $230–$553 · P90 $924 | 14,410 | Benchmark |
| Florida | $348.50 | 1.05x | $230–$522 · P90 $748 | 31,313 | Benchmark |
| Idaho | $345.26 | 1.04x | $232–$552 · P90 $807 | 1,019 | Benchmark |
| Oregon | $345.23 | 1.04x | $225–$585 · P90 $922 | 2,873 | Benchmark |
| North Dakota | $343.49 | 1.03x | $230–$516 · P90 $856 | 590 | Benchmark |
| Oklahoma | $338.69 | 1.02x | $230–$500 · P90 $742 | 2,106 | Benchmark |
| Arizona | $337.55 | 1.02x | $230–$548 · P90 $874 | 5,871 | Benchmark |
| Nevada | $332.85 | 1.00x | $237–$549 · P90 $922 | 2,420 | Benchmark |
| Washington | $332.56 | 1.00x | $218–$549 · P90 $961 | 5,557 | Benchmark |
| Nebraska | $332.45 | 1.00x | $228–$520 · P90 $774 | 1,070 | Benchmark |
| New Mexico | $329.91 | 0.99x | $227–$523 · P90 $750 | 1,740 | Benchmark |
| Mississippi | $328.48 | 0.99x | $214–$530 · P90 $748 | 1,260 | Benchmark |
| Illinois | $327.53 | 0.99x | $211–$498 · P90 $801 | 29,907 | Benchmark |
| Michigan | $327.53 | 0.99x | $207–$493 · P90 $899 | 11,614 | Benchmark |
| Indiana | $327.53 | 0.99x | $212–$447 · P90 $491 | 119,614 | Benchmark |
| South Dakota | $327.12 | 0.99x | $211–$545 · P90 $885 | 490 | Benchmark |
| Alaska | $326.75 | 0.98x | $206–$544 · P90 $748 | 619 | Benchmark |
| Alabama | $324.12 | 0.98x | $199–$501 · P90 $708 | 4,628 | Benchmark |
| Arkansas | $322.88 | 0.97x | $220–$482 · P90 $708 | 2,211 | Benchmark |
| Iowa | $320.86 | 0.97x | $207–$499 · P90 $794 | 2,938 | Benchmark |
| Colorado | $319.81 | 0.96x | $235–$634 · P90 $669 | 11,720 | Benchmark |
| Montana | $316.90 | 0.95x | $208–$520 · P90 $783 | 837 | Benchmark |
| Tennessee | $312.91 | 0.94x | $206–$486 · P90 $712 | 12,284 | Benchmark |
| Missouri | $309.11 | 0.93x | $210–$460 · P90 $661 | 141,102 | Benchmark |
| Maryland | $282.58 | 0.85x | $201–$469 · P90 $748 | 9,080 | Benchmark |
| Kansas | $277.41 | 0.84x | $203–$411 · P90 $566 | 3,844 | Benchmark |
| Ohio | $265.86 | 0.80x | $175–$395 · P90 $621 | 155,693 | Benchmark |
| Maine | $239.75 | 0.72x | $173–$359 · P90 $520 | 28,650 | Benchmark |
| Virginia | $235.14 | 0.71x | $171–$321 · P90 $473 | 54,435 | Benchmark |
| District of Columbia | $233.02 | 0.70x | $152–$421 · P90 $748 | 3,106 | Benchmark |
| West Virginia | $230.80 | 0.70x | $159–$342 · P90 $708 | 3,639 | Benchmark |
| Kentucky | $211.18 | 0.64x | $149–$312 · P90 $469 | 46,326 | Benchmark |
Payer-blind local peer percentiles per state, full verified distribution. Publication floor: 11 verified rate points and a non-degenerate spread; the P25–P75 band unlocks at 25 points, P90 at 100 (a smaller cell's P90 is one contract, not a statistic).
Documented reimbursement figures are modeled, not guaranteed. Derived from federally mandated Transparency in Coverage data (45 CFR 147.212). No PHI.
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Cite this page
Source: Reddenda Code Reality Check, CPT 45378. Reddenda. https://reddenda.health/code/45378/
Derivation federally mandated TiC MRFs, verified to provider identity1,842,041 verified rate points across 50 statesas of 2026-07-15 · methodology v1.0