Does Medicare cover it?
Does Medicare cover a colonoscopy?
Yes. A screening colonoscopy costs you nothing when the provider accepts assignment. If a polyp is removed during it, you owe a set share of the approved amount with no deductible. The estimator prices all three cases, screening, polyp removal and diagnostic, by facility.
What this service costs you
You pay
$0
| Doctor’s fee | $170 |
| Surgery center fee | $510 |
| Medicare-approved amount | $681 |
| Medicare pays | $681 |
Preventive service: $0 if the provider accepts assignment. If something is found and treated during the visit, a cost can apply.
How this is calculatedMedicare Part B covers screening colonoscopies with no minimum age, once every 120 months if you are not at high risk for colorectal cancer, or 48 months after a previous flexible sigmoidoscopy, and once every 24 months if you are at high risk. When the doctor accepts assignment you pay $0 for the screening, including a follow-up colonoscopy after a positive stool-based or blood-based screening test. The bill changes if the doctor finds and removes a polyp or other tissue during the screening: in 2026 you then pay 15% of the approved amount to the doctor and to the facility, and the Part B deductible does not apply. At national rates in an ambulatory surgery center that comes to $132 on an approved $880; in a hospital outpatient department, $217. Federal rules lower the share to 10% from 2027 to 2029, so the same surgery center case will cost $88, and to zero in 2030. A colonoscopy ordered because of symptoms is diagnostic, not screening: 20% after the deductible, or $135 in a surgery center once the deductible is met.
Screening, polyp removed or diagnostic
If a polyp is removed
$132
| Screening, nothing found | $0 |
| Share with a polyp | 15% |
| Diagnostic, deductible met | $135 |
Costs computed by Radif Partners · Editorial policy · How the costs are calculated
Three procedures that look the same on the day
From the patient's side, a colonoscopy is one appointment. On the claim, it can be one of three things, and each one is paid under a different rule. A screening colonoscopy is a preventive service. A screening during which a polyp is removed keeps its screening status but carries a reduced coinsurance. A diagnostic colonoscopy, ordered because of symptoms, follows the ordinary Part B rule.
| National rates, 2026 | Surgery center: approved | You pay | Hospital outpatient: approved | You pay |
|---|---|---|---|---|
| Screening, nothing removed | $675 | $0 | $1,115 | $0 |
| Screening with polyp removal (15%, no deductible) | $880 | $132 | $1,446 | $217 |
| Diagnostic, deductible met | $675 | $135 | $1,115 | $223 |
When a polyp is removed
Removing a polyp is the one event that turns a free screening into a bill. Medicare's rule is precise: you pay 15% of the approved amount for the provider's services, and in a hospital outpatient setting or an ambulatory surgical center you also pay the facility 15%. The Part B deductible does not apply, so the share is the same in January as in December.
The percentage is written into federal regulation, 42 CFR 410.152, and already scheduled to fall. Part B pays 85% through 2026, 90% from 2027 through 2029 and the full amount from 2030. Your share therefore drops to 10% in 2027, which turns the surgery center example into $88 and the hospital example into $145, before reaching zero in 2030. The 2027 approved amounts themselves are not published yet, so these examples use the 2026 rates with the 2027 percentage; the mini tool lets you switch the year.
Surgery center or hospital outpatient department
The doctor's fee is the same in both places. The facility fee is not: CMS pays a hospital outpatient department noticeably more than an ambulatory surgery center for the same procedure. For a plain screening this makes no difference to you, since you pay nothing either way. As soon as a polyp is removed, or the procedure is diagnostic, your share follows the facility rate, which is why the hospital column of the table is higher. If both options are available, asking where the procedure will be done is a fair question.
Your first bills of the year against the deductible
You pay for the three
$628
| Bill 1: deductible $95 | $95 |
| Bill 2: deductible $188 | $190 |
| Bill 3: deductible $0 | $344 |
| Deductible left | $0 |
2026 deductible $283; 2027 amount not yet published by CMS.
How often a screening is covered
- Every 24 months if you are at high risk for colorectal cancer.
- Every 120 months if you are not at high risk.
- 48 months after a previous flexible sigmoidoscopy, if you are not at high risk.
There is no minimum age. A screening colonoscopy can also follow a positive result from a Medicare-covered stool test, such as a fecal occult blood test or a multi-target stool DNA test, or from a blood-based biomarker test; that follow-up is covered as a screening too.
Diagnostic colonoscopies
When the colonoscopy is ordered because of symptoms, it is no longer preventive. You pay the Part B deductible if it is still due, then 20% of the approved amount, and in a hospital outpatient department a hospital copayment. With the deductible met, that is $135 in a surgery center and $223 in a hospital at national rates. Medigap Plan G pays that 20% in full; it also pays the share on a polyp removal, which is Part B coinsurance like any other.
Reading the bill afterwards
Expect at least two claims, the doctor's and the facility's, and compare each with the Medicare Summary Notice. A screening line marked as yours to pay, with nothing removed and a provider who accepts assignment, is worth questioning with the billing office.