Colonoscopy with biopsy
A colonoscopy where a tissue sample was taken for lab analysis.
Based on typical US negotiated and cash-pay rates. Hospital charges can run significantly higher — often 2–10x these numbers. If your bill is well above this range, it's worth questioning.
- Multiple biopsy codes billed when only one biopsy was performed.
- Screening colonoscopy converted to this code — often still covered as preventive.
Get the operative report. It will list exactly how many biopsies were taken. Match to the bill.
Frequently asked questions
What does CPT code 45380 mean?
A colonoscopy where a tissue sample was taken for lab analysis. In billing terms it's categorized as "Colonoscopy with biopsy" under Procedures.
How much should CPT 45380 cost?
Typical negotiated and cash-pay rates run about $1,000–$4,200. Hospital list prices are often 2–10× higher, but insurers rarely pay those. If your bill is well above the top of this range, ask for an itemized bill and compare.
Is CPT 45380 covered by insurance?
Most commercial plans and Medicare cover colonoscopy with biopsy when it's medically necessary and coded correctly. Denials usually come from missing prior authorization, incorrect modifiers, or the payer disputing medical necessity — all of which can be appealed.
What should I do if CPT 45380 looks wrong on my bill?
Get the operative report. It will list exactly how many biopsies were taken. Match to the bill.
Can I dispute a charge for CPT 45380?
Yes. You have the right to request an itemized bill, dispute the coding with the provider's billing office, and appeal the insurer's decision. Federal rules (including the No Surprises Act for emergency and out-of-network ancillary services) protect you from many surprise charges. BillCheck can generate the appeal or negotiation letter for you.
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BillCheck provides informational analysis only and is not legal, medical, or financial advice. Verify all details before submitting any correspondence to insurers or providers. Prices shown are typical ranges and vary by region, payer, and facility.