Colonoscopy Price Variation in HOPDs vs. Community Settings: 4 Things to Know

The National Institute for Health Care Reform released a study of the price of common services performed in hospital outpatient departments in comparison to community settings, such as a physician office or freestanding ambulatory surgery center. Here are four things to know about the study's findings on colonoscopy price.

1. The study examined the price of colonoscopy based on the procedures most common CPT codes: 45378, 45380 and 45385. The nearly 45,000 of these procedures were performed in 2011 for the study population. The collective cost was approximately $23 million, excluding the cost of drugs, anesthesia and pathology.

2. The study bases its price comparisons on 16,566 colonoscopies with clear information on the site of service. Of this total number, 9,782 procedures were performed in HOPDs and 6,784 in community settings.

3. The average and median prices for colonoscopy were both at least twice as high when performed in an HOPD compared to community settings. The study found the costs of a basic colonoscopy, one with no polyps found, was an average of $1,383 in HOPDs, but $625 in community settings.

4. The average price for a colonoscopy with a biopsy was approximately $1,700 when performed in a HOPD. The price went down to average of approximately $800 in the community setting. For last of the most common CPT codes, a colonoscopy with polyp removal and biopsy, the average HOPD price rose to nearly $1,900. The average community-based setting price was approximately $900.

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