12 Statistics on Physician & ASC Reimbursement for Polypectomy Procedures

Here are 12 statistics on ambulatory surgery center and physician Medicare payments for gastroenterology/endoscopy procedures involving polypectomy, according to Boston Scientific’s 2014 Coding & Payment Quick Reference Select Polypectomy Procedures report.

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Procedure and CPT Code

Colonoscopy through stroma with removal of tumor(s), polyp(s) or other lesion(s) by hot biopsy forceps or bipolar cautery (44392)

Physician payment in facility: $226
ASC facility payment: $407

Colonoscopy, flexible, proximal to splenic flexure with removal of tumor(s), polyp(s) or other lesion(s) by hot biopsy forceps or bipolar cautery (45384)

Physician payment in facility: $277
ASC facility payment: $407

Sigmoidoscopy, flexible, with removal of tumor(s), polyp(s) or other lesion(s) by hot biopsy forceps or bipolar cautery (45333)

Physician payment in facility: $113
ASC facility payment: $255  

Colonoscopy through stroma with removal of tumor(s), polyp(s) or other lesion(s) by snare technique (44394)

Physician payment in facility: $263
ASC facility payment: $407

Colonoscopy, flexible, proximal to splenic flexure with removal of tumor(s), polyp(s) or other lesion(s) by snare technique (45385)

Physician payment in facility: $315
ASC facility payment: $407

Sigmoidoscopy, flexible, with removal of tumor(s), polyp(s) or other lesion(s) by snare technique (45338)

Physician payment in facility: $145
ASC facility payment: $431

CPT copyright 2014 American Medical Association. All rights reserved. CPT is a registered trademark of the American Medical Association.

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