Code Reality Check
45380 reimbursement rate: Colonoscopy w/ biopsy
Colonoscopy w/ biopsy (CPT 45380) pays a median $1,127.49 in Alaska and $276.38 in Kentucky, against a Medicare anchor of $389.66. 51 of 51 states clear the publication floor.
spread 4.1x top to bottom
Medicare anchor $389.66
51/51 states published
The 50-state spread
as of 2026-07-15| State | Median | vs Medicare | Band | Rate points | Tier |
|---|---|---|---|---|---|
| Alaska | $1,127.49 | 2.89x | $343–$2,187 · P90 $2,733 | 1,873 | Benchmark |
| South Dakota | $891.34 | 2.29x | $144–$1,198 · P90 $1,803 | 9,589 | Benchmark |
| Mississippi | $800.89 | 2.06x | $380–$1,166 · P90 $1,166 | 6,442 | Benchmark |
| Alabama | $791.43 | 2.03x | $358–$838 · P90 $1,101 | 11,444 | Benchmark |
| North Carolina | $747.97 | 1.92x | $321–$808 · P90 $1,196 | 180,504 | Benchmark |
| Iowa | $681.53 | 1.75x | $286–$1,465 · P90 $2,541 | 14,804 | Benchmark |
| North Dakota | $625.98 | 1.61x | $144–$1,193 · P90 $1,803 | 9,114 | Benchmark |
| Wisconsin | $615.02 | 1.58x | $279–$1,495 · P90 $2,839 | 137,423 | Benchmark |
| Connecticut | $599.13 | 1.54x | $177–$897 · P90 $1,276 | 30,180 | Benchmark |
| Hawaii | $544.20 | 1.40x | $473–$709 · P90 $995 | 7,116 | Benchmark |
| Michigan | $540.49 | 1.39x | $226–$568 · P90 $749 | 41,032 | Benchmark |
| New York | $518.22 | 1.33x | $296–$794 · P90 $1,695 | 588,428 | Benchmark |
| Maryland | $495.12 | 1.27x | $261–$698 · P90 $1,011 | 26,153 | Benchmark |
| Washington | $488.55 | 1.25x | $89–$750 · P90 $1,131 | 33,758 | Benchmark |
| New Hampshire | $478.83 | 1.23x | $339–$808 · P90 $999 | 27,461 | Benchmark |
| Utah | $475.52 | 1.22x | $52–$621 · P90 $932 | 18,151 | Benchmark |
| Wyoming | $475.48 | 1.22x | $350–$939 · P90 $1,900 | 1,485 | Benchmark |
| Louisiana | $474.63 | 1.22x | $48–$598 · P90 $736 | 14,888 | Benchmark |
| Nevada | $465.00 | 1.19x | $38–$466 · P90 $952 | 8,669 | Benchmark |
| California | $464.82 | 1.19x | $298–$998 · P90 $2,113 | 261,612 | Benchmark |
| Oregon | $458.08 | 1.18x | $53–$707 · P90 $1,205 | 18,472 | Benchmark |
| New Jersey | $453.33 | 1.16x | $238–$682 · P90 $1,120 | 54,390 | Benchmark |
| Idaho | $451.98 | 1.16x | $52–$857 · P90 $1,299 | 9,553 | Benchmark |
| Kansas | $450.18 | 1.16x | $232–$607 · P90 $731 | 11,416 | Benchmark |
| Minnesota | $444.03 | 1.14x | $393–$1,139 · P90 $2,214 | 40,567 | Benchmark |
| Colorado | $440.88 | 1.13x | $297–$689 · P90 $843 | 23,110 | Benchmark |
| Illinois | $434.47 | 1.11x | $259–$730 · P90 $1,064 | 73,806 | Benchmark |
| Delaware | $433.42 | 1.11x | $36–$505 · P90 $979 | 3,720 | Benchmark |
| Texas | $431.76 | 1.11x | $174–$537 · P90 $864 | 90,232 | Benchmark |
| Arkansas | $430.51 | 1.10x | $44–$523 · P90 $791 | 10,815 | Benchmark |
| Nebraska | $424.90 | 1.09x | $240–$731 · P90 $977 | 10,539 | Benchmark |
| Rhode Island | $423.64 | 1.09x | $225–$599 · P90 $750 | 10,996 | Benchmark |
| West Virginia | $421.40 | 1.08x | $50–$434 · P90 $677 | 15,880 | Benchmark |
| District of Columbia | $419.22 | 1.08x | $261–$631 · P90 $1,373 | 6,025 | Benchmark |
| Georgia | $409.89 | 1.05x | $258–$626 · P90 $896 | 197,636 | Benchmark |
| South Carolina | $408.74 | 1.05x | $275–$672 · P90 $1,058 | 35,824 | Benchmark |
| New Mexico | $406.08 | 1.04x | $48–$626 · P90 $845 | 6,535 | Benchmark |
| Tennessee | $403.72 | 1.04x | $183–$691 · P90 $835 | 34,053 | Benchmark |
| Vermont | $402.17 | 1.03x | $80–$620 · P90 $846 | 4,724 | Benchmark |
| Pennsylvania | $399.18 | 1.02x | $52–$578 · P90 $770 | 94,329 | Benchmark |
| Massachusetts | $395.15 | 1.01x | $62–$671 · P90 $856 | 82,344 | Benchmark |
| Arizona | $393.67 | 1.01x | $376–$809 · P90 $1,376 | 19,319 | Benchmark |
| Montana | $389.76 | 1.00x | $271–$981 · P90 $2,280 | 3,563 | Benchmark |
| Florida | $366.66 | 0.94x | $91–$557 · P90 $932 | 87,285 | Benchmark |
| Indiana | $358.77 | 0.92x | $229–$538 · P90 $590 | 130,983 | Benchmark |
| Missouri | $350.61 | 0.90x | $239–$525 · P90 $726 | 151,552 | Benchmark |
| Ohio | $321.22 | 0.82x | $205–$560 · P90 $989 | 189,881 | Benchmark |
| Virginia | $296.81 | 0.76x | $198–$461 · P90 $695 | 70,514 | Benchmark |
| Maine | $288.35 | 0.74x | $191–$466 · P90 $593 | 31,751 | Benchmark |
| Oklahoma | $288.10 | 0.74x | $40–$480 · P90 $672 | 9,713 | Benchmark |
| Kentucky | $276.38 | 0.71x | $184–$406 · P90 $609 | 57,678 | 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 45380. Reddenda. https://reddenda.health/code/45380/
Derivation federally mandated TiC MRFs, verified to provider identity3,017,331 verified rate points across 51 statesas of 2026-07-15 · methodology v1.0