Here are five notes on colonoscopy costs:
1. Unadjusted and adjusted average reimbursement for GI procedures dropped by 7% and 33%, respectively, from 2007 to 2022, according to a study published in the American Journal of Gastroenterology. Reimbursements for colonoscopy and biopsy decreased by 38% during that period.
2. The average cost to undergo a colonoscopy in the U.S. in 2024 is $1,608, according to data from startup insurance provider Sidecar Health.
3. U.S. hospitals’ facility fees for colonoscopy procedures covered by private health insurance are an average of 55% higher than facility fees billed by ASCs, according to a JAMA Health Forum study published Dec. 15.
4. Here is a look at how the cost of a diagnostic colonoscopy changed each year at ASCs compared to HOPDs from 2018 to 2022, according to a brief from Blue Cross Blue Shield affiliate Blue Health Intelligence’s “Rising Prices for Hospital Outpatient Care”:
2018
ASCs: $980 (+3.9% from previous year)
HOPDs: $1,472 (+5%)
2019
ASCs: $1,010 (+3.1%)
HOPDs: $1,520 (+3.3%)
2020
ASCs: $1,011 (+0.1%)
HOPDs: $1,557 (+2.4%)
2021
ASCs: $1,022 (+1.1%)
HOPDs: $1,601 (+2.8%)
2022
ASCs: $1,040 (+1.8%)
HOPDs: $1,646 (+2.8%)
5. Here is the breakdown of colonoscopy costs in the U.S., according to Sidecar:
- Facility fee: 59%
- Gastroenterologist: 23%
- Anesthesia: 16%
- Lab fees: 2%
At the Becker’s 32nd Annual Meeting: The Business and Operations of ASCs, taking place October 29-31 in Chicago, ASC leaders, surgeons and healthcare executives will explore strategies to drive growth, enhance operational performance, navigate reimbursement challenges and prepare for the future of ambulatory surgery. Apply for complimentary registration now.