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#364 of 11K

45378

Colonoscopy, diagnostic

Colonoscopy, diagnostic is the #364 most-billed Medicaid procedure code, with $337.4M in payments across 1.0M claims from 2018–2024. The national median cost per claim is $225.49. Costs vary widely — the 90th percentile is $622.13 per claim, 2.8× the median.

Total Paid

$337.4M

0.03% of all spending

Total Claims

1.0M

Providers

2K

Avg Cost/Claim

$335

National Cost Distribution

How much do providers bill per claim for 45378? Based on 2K providers billing this code nationally.

Median

$225.49

Average

$304.20

Std Dev

$275.59

Max

$2,521.00

Percentile Distribution (Cost per Claim)

p10
$80.92
p25
$131.88
Median
$225.49
p75
$377.47
p90
$622.13
p95
$839.14
p99
$1,477.18

50% of providers bill between $131.88 and $377.47 per claim for this code.

90% bill between $80.92 and $622.13.

Top 1% bill above $1,477.18.

About This Procedure

HCPCS code 45378 (Colonoscopy, diagnostic) was billed by 2K providers across 1.0M claims, totaling $337.4M in Medicaid payments from 2018–2024. This code was used for 958K unique beneficiaries.

Risk Assessment

Billing Statistics

Median Cost/Claim

$225.49

Providers Billing

2K

National Spending

$337.4M

Avg/Median Ratio

1.35×

Normal distribution

Top Providers Billing This Code

Ranked by total Medicaid payments for 45378

#ProviderTotal Paid
1Boston Medical Center Corporation

Boston, MA · General Acute Care Hospital

$5.3M
21205853041$3.5M
3Beth Israel Deaconess Medical Center, Inc.

Boston, MA · General Acute Care Hospital

$3.4M
4The Cooper Health System

Camden, NJ · General Acute Care Hospital

$3.1M
51588938682$2.9M
61043204316$2.8M
71619166097$2.6M
8Virginia Commonwealth University Health System Authority

Richmond, VA · General Acute Care Hospital

$2.6M
9Nyu Langone Hospitals

New York, NY · Clinic/Center, Oncology

$2.5M
101073699971$2.3M
111023551413$2.3M
12Montefiore Medical Center

Bronx, NY · General Acute Care Hospital

$2.2M
131932411493$2.1M
141487740957$2.1M
15Yale New Haven Hospital

New Haven, CT · General Acute Care Hospital

$2.0M
161609803204$2.0M
171336252402$2.0M
181013048461$1.9M
19Newark Beth Israel Medical Center Inc

Newark, NJ · General Acute Care Hospital

$1.9M
201659657856$1.9M

Showing top 20 of 2K providers billing this code