CMS released a procedure price lookup tool to provide consumers a view the average payment for common procedures in ASCs and hospital outpatient departments.
The tool includes the national average payments to HOPDs and ASCs, as well as the average copay Medicare beneficiaries without supplemental insurance would pay in both settings.
Here's the average total cost for 10 common gastroenterology procedures:
1. Colonoscopy, flexible; with biopsy, single or multiple (45380)
ASC: $488
HOPD: $936
2. Colonoscopy, flexible; with removal of tumor(s), polyp(s), or other lesion(s) by snare technique (45385)
ASC: $488
HOPD: $936
3. Colonoscopy, flexible; diagnostic, including collection of specimen(s) by brushing or washing, when performed (separate procedure) (45378)
ASC: $370
HOPD: $710
3. Cancer screening of the colon (large bowel) using an endoscope (colonoscopy) for high-risk individuals (G0105)
ASC: $370
HOPD: $710
4. Colonoscopy, flexible; with endoscopic mucosal resection (45390)
ASC: $488
HOPD: $936
5. Sigmoidoscopy, flexible; with biopsy, single or multiple (45331)
ASC: $370
HOPD: $710
6. Sigmoidoscopy, flexible; with removal of tumor(s), polyp(s), or other lesion(s) by snare technique (45338)
ASC: $488
HOPD: $936
7. Ultrasound examination of esophagus, stomach and/or upper small bowel using an endoscope (43259)
ASC: $627
HOPD: $1,427
8. Diagnostic examination of esophagus, stomach and/or upper small bowel using an endoscope (43235)
ASC: $387
HOPD: $743
9. Biopsy of the esophagus, stomach and/or upper small bowel using an endoscope (43239)
ASC: $387
HOPD: $743
10. Control of bleeding of esophagus, stomach and/or upper small bowel using an endoscope (43255)
ASC: $627
HOPD: $1,427
To access the procedure price lookup tool, click here.