Cost of a Colonoscopy with and without Polypectomy
Another example is colorectal cancer screening by colonoscopy. According to the AHRQ report, the costs for colonoscopy without polypectomy can be calculated based on the following CPT codes
· 45378 (diagnostic colonoscopy),
· G0105 (colon screen in high risk individuals) and
· G0121 (colon cancer screening for non high risk individual).
Costs for colonoscopy with polypectomy or biopsy can be calculated based on the following CPT codes
· 45380 (colonoscopy and biopsy),
· 45381 (colonoscopy, submucous injection),
· 45382 (colonoscopy/control bleeding),
· 45383 (lesion removal colonoscopy – fulguration),
· 45384 (lesion removal colonoscopy-hot biopsy) and
· 45385 (lesion removal colonoscopy-snare polypectomy).
The total direct medical costs based on Medicare reimbursement for colonoscopy with and without polypectomy are $648.52 and $497.59, respectively. If you account for the indirect costs, the costs of colonoscopy with and without polypectomy are $794.94 and $979.98, respectively. Thus, polypectomy and/or biopsy adds $150-$180 to the cost of colonoscopy.
Other costs that are of interest in a cost-effectiness analysis are:
Opportunity cost, which represents the benefits of one or more interventions that we forgo, when we choose to spend the resources on other interventions. Opportunity cost underscores the fact that the resources are limited and we have to make choices.
- Incremental cost is the cost difference between two interventions.