What do doctors typically charge for Biopsy of Lower Large Bowel using a Flexible Endoscope?

The nationwide median physician charge for Biopsy of Lower Large Bowel using a Flexible Endoscope (CPT 45331) is $900.00. Doctor billed charges vary based on geographic region, setting, and overhead.

What is the standard insurance baseline for CPT 45331?

The standard insurance baseline reimbursement rate is $347.84. This represents the customary allowable amount established across standard fee schedules.

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CPT 45331Medical Service

Biopsy of Lower Large Bowel using a Flexible Endoscope

Q: What is Biopsy of Lower Large Bowel using a Flexible Endoscope (CPT 45331)?

Biopsy of lower large bowel using a flexible endoscope. This clinical code is utilized across practices and hospitals for diagnostic and therapeutic service documentation.

Biopsy of lower large bowel using a flexible endoscope. Clinical pricing breakdown and utilization metrics across 366 practicing doctors nationwide.

$900.00

Peer Median Charge

Gross billed rate

$347.84

Standard Baseline

Customary allowable

2.6x

National Markup

Charge vs baseline

366

Active Physicians

Billing this code

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Understanding This Medical Fee

Gross Charge vs Negotiated Payment: The median physician charge for this service is $900.00. However, insured patients almost never pay this full amount directly. Insurers negotiate rates down toward the $347.84 baseline.

Self-Pay & Uninsured Guidance: If you are paying without insurance or out-of-network, request a prompt-pay cash discount. Most medical practices are willing to settle self-pay bills near the customary baseline rate rather than the full gross charge.

Key Questions for Your Doctor's Billing Office:

"Does Dr. [Name] participate in my specific insurance plan network?"
"What is the total self-pay or cash rate for code 45331 if paid upfront?"
"Are there separate facility, anesthesia, or pathology fees associated with this procedure?"