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#224 of 11K

45380

Colonoscopy with biopsy

Colonoscopy with biopsy is the #224 most-billed Medicaid procedure code, with $679.7M in payments across 2.1M claims from 2018–2024. The national median cost per claim is $200.68. Costs vary widely — the 90th percentile is $563.94 per claim, 2.8× the median.

Total Paid

$679.7M

0.06% of all spending

Total Claims

2.1M

Providers

4K

Avg Cost/Claim

$323

National Cost Distribution

How much do providers bill per claim for 45380? Based on 4K providers billing this code nationally.

Median

$200.68

Average

$274.81

Std Dev

$258.09

Max

$3,479.81

Percentile Distribution (Cost per Claim)

p10
$69.92
p25
$121.69
Median
$200.68
p75
$349.87
p90
$563.94
p95
$730.96
p99
$1,278.34

50% of providers bill between $121.69 and $349.87 per claim for this code.

90% bill between $69.92 and $563.94.

Top 1% bill above $1,278.34.

About This Procedure

HCPCS code 45380 (Colonoscopy with biopsy) was billed by 4K providers across 2.1M claims, totaling $679.7M in Medicaid payments from 2018–2024. This code was used for 2.0M unique beneficiaries.

Risk Assessment

Billing Statistics

Median Cost/Claim

$200.68

Providers Billing

4K

National Spending

$679.7M

Avg/Median Ratio

1.37×

Normal distribution

Top Providers Billing This Code

Ranked by total Medicaid payments for 45380

#ProviderTotal Paid
1Yale New Haven Hospital

New Haven, CT · General Acute Care Hospital

$6.1M
2Nyu Langone Hospitals

New York, NY · Clinic/Center, Oncology

$5.8M
31063457380$5.4M
4The Cooper Health System

Camden, NJ · General Acute Care Hospital

$5.1M
5Beth Israel Deaconess Medical Center, Inc.

Boston, MA · General Acute Care Hospital

$4.7M
6Boston Medical Center Corporation

Boston, MA · General Acute Care Hospital

$4.2M
71376774208$3.7M
81558612762$3.6M
9The New York And Presbyterian Hospital

New York, NY · General Acute Care Hospital

$3.5M
10Tufts Medical Center, Inc.

Boston, MA · General Acute Care Hospital

$3.3M
11The Cleveland Clinic Foundation

Cleveland, OH · General Acute Care Hospital

$3.2M
12The New York And Presbyterian Hospital

New York, NY · General Acute Care Hospital

$3.2M
13Umass Memorial Medical Center, Inc.

Worcester, MA · General Acute Care Hospital

$3.1M
14Jersey City Medical Center

Jersey City, NJ · General Acute Care Hospital

$3.1M
15Danbury Hospital

Danbury, CT · General Practice

$3.1M
16Bronxcare Health System

Bronx, NY · General Acute Care Hospital

$3.0M
17Yuma Regional Medical Center

Yuma, AZ · General Acute Care Hospital

$3.0M
18Cambridge Public Health Commission

Cambridge, MA · General Acute Care Hospital

$3.0M
19Rector & Visitors Of The University Of Virginia

Charlottesville, VA · General Acute Care Hospital

$3.0M
201093713091$2.9M

Showing top 20 of 4K providers billing this code