How colonoscopy reimbursement is expected to change for ASCs in 2023

Medicare ASC payments for colonoscopies with lesion removals and colonoscopies and biopsies are expected to increase in 2023, according to VMG Health’s “ASCs in 2022: A Year in Review” report released Jan. 26.

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Here is a summary of the estimated Medicare ASC payments for 2022 and 2023 for two colonoscopy procedures:

Colonoscopy and biopsy

CPT code: 45380

Estimated 2022 payments: 235

Percent of total Medicare: 4 percent

Estimated 2023 payments: 247

Percent total Medicare: 4 percent

Estimated 2023 change: 5 percent

Colonoscopy with lesion removal

CPT code: 45385

Estimated 2022 payments: 191

Percent of total Medicare: 3.3 percent

Estimated 2023 payments: 201

Percent total Medicare: 3.3 percent

Estimated 2023 change: 5 percent

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