Price Checker / CPT 45100
CPT 45100 — Biopsy of rectum
2026 Medicare Physician Fee Schedule rates and hospital pricing data
$302
What Medicare pays in a hospital/ASC setting
$302
What Medicare pays in a physician's office
$7,684
Based on 11 hospital(s) in our database
What do these numbers mean?
The Medicare rateis what the federal government determines is a fair payment for this procedure. It's based on the Relative Value Unit (RVU) system, which accounts for physician work, practice expense, and malpractice cost. Hospitals and providers often charge 3-20x this amount. If your bill is significantly higher than the Medicare rate, you may have grounds to negotiate.
Hospital Charges for CPT 45100
From hospital-published transparency (MRF) files. These are the hospitals in our database that list this procedure.
| Hospital | Gross Charge | Cash Rate | vs Medicare |
|---|---|---|---|
| Los Alamos Medical Center , NY | $27,583 | — | 9025% |
| Mena Hospital Commission dba Mena Regional Health System , AR | $9,570 | $5,742 | 3066% |
| HSHS Holy Family Hospital , IL | $9,478 | $6,824 | 3036% |
| Northern Itasca Hospital District , MN | $5,544 | $3,936 | 1734% |
| Dickenson Community Hospital , VA | $4,712 | $1,084 | 1459% |
| Hancock County Hospital , TN | $4,712 | $1,084 | 1459% |
| Johnson County Community Hospital , TN | $4,712 | $1,084 | 1459% |
| Lee County Community Hospital , VA | $4,712 | $1,084 | 1459% |
| Union County General Hospital , NM | $4,682 | $3,277 | 1449% |
| Stephens County Hospital , GA | $4,485 | $2,691 | 1384% |
| Aspire Behavioral Health Hospital Conroe, TX | $4,337 | — | 1335% |
Were you billed for this procedure?
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About CPT 45100
CPT code 45100 refers to “Biopsy of rectum”. Under the 2026 Medicare Physician Fee Schedule, this procedure is reimbursed at $302 in a facility (hospital or ambulatory surgery center) and $302in a non-facility (physician's office) setting.
These rates are set by CMS (Centers for Medicare & Medicaid Services) and represent what the government considers a fair payment for this service. While commercial insurance typically pays somewhat more than Medicare, many hospitals charge significantly higher amounts — sometimes 10-50x the Medicare rate.
What to do if you were overcharged
- Upload your bill— we'll identify this code and compare it against the rates shown above.
- Get a dispute letter— citing the Medicare rate and your hospital's own published pricing data.
- Negotiate or let us handle it — 25% of savings, no savings = no fee.