CPT43235

How Much Does an Upper Endoscopy (EGD) Cost in Kansas?

Egd diagnostic brush wash

$1,037Hospital outpatient total2026 Medicare, physician + facility

Under 2026 Medicare rates, an upper endoscopy (EGD) costs about $1,037 in total at a hospital outpatient department or about $608 at an ambulatory surgery center, counting both the physician and the facility (national rates). The physician's own fee in Kansas averages $103.

Hospital payments are wage-adjusted by locality, so the ZIP changes the numbers.
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Kansas Medicare physician rate (2026)

-8.6% vs national

Single statewide locality.

Kansas (Hospital)
$103.28
Facility physician fee
Private plan est.
$384–$590
~130–200% of Medicare
Cash / self-pay est.
$236–$443
~80–150% of Medicare

What the whole procedure costs

The rate above is the physician’s fee on its own. The facility bills separately, and for most procedures the facility is the larger half of the bill. These are 2026 national Medicare amounts.

Surgery center, total
$608
$111 physician + $498 facility
Physician fee alone
$111
Only 11% of the hospital total

Choosing a surgery center over a hospital saves about $429 on the Medicare allowed amount for upper endoscopy (egd). Ask whether your procedure can be done at an ambulatory surgery center.

This is Medicare's separate payment to the facility on top of the physician's fee. Medicare allowed amounts are not what an uninsured patient is charged, and not a quote. Private plans typically allow more.

Your ZIP in Kansas

Enter a ZIP code for your part of Kansas, from Overland Park and the Kansas City suburbs to Wichita, Topeka, Lawrence, Salina, and the western High Plains.

What upper endoscopy (EGD) costs at hospitals near you

Everything above is a national average. The hospital you pick in Kansas moves the bill more than anything else you control.

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Rates for your ZIP, 5 named hospitals with CMS ratings, the add-on codes, and the scheduler script.

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What these numbers are

Every figure on this page is a 2026 Medicare allowed amount: the physician line comes from the Physician Fee Schedule adjusted by geographic practice-cost indices, and the facility totals come from the CMS hospital outpatient (OPPS) and ambulatory surgery center rates. None of them is a hospital chargemaster price, your insurer's contracted rate, or a quote. Anesthesia, pathology, imaging reads and follow-up care are billed under their own codes when they apply, and an inpatient stay is paid a different way again. In Kansas the office and hospital physician lines for this CPT differ by $191.73.

National vs Kansas

National office$322.65
National hospital (physician)$110.56
Kansas vs national9% below the national office rate of $322.65

Where Kansas ranks for this CPT

Rank (lowest physician fee first)#7 of 51
Lowest stateArkansas ($284.01)
Highest stateDistrict of Columbia ($371.11)

Upper Endoscopy (EGD) and how Kansas is priced

A single locality covers all of Kansas, with geographic indices in the lower national tier, so the published Medicare rates apply evenly from the Kansas City suburbs to the far western High Plains. Notably, the Kansas side of the Kansas City metro prices under the statewide Kansas locality while the Missouri side has its own metro locality, meaning the two halves of one city carry different approved amounts. Beyond that quirk, Kansas pricing is straightforwardly uniform. Wichita, Topeka, and rural Kansas all share the same adjustments.

The Kansas City metro and Wichita hold most of the state's specialists, with the academic medical center on the Kansas side of the metro serving as the top referral point. Western Kansas is genuinely frontier in places, with long distances to any hospital that performs advanced procedures, and some High Plains residents cross into Colorado or Nebraska for care. Critical access hospitals carry much of the rural load.

This procedure: An upper endoscopy, or EGD, passes a thin flexible camera through the mouth to examine the esophagus, stomach, and the first part of the small intestine. It investigates problems like persistent heartburn, swallowing difficulty, unexplained anemia, or upper abdominal pain. You receive sedation through an IV, the exam itself takes 10 to 20 minutes, and you go home the same day once the sedation wears off, needing a driver.

What Is Upper Endoscopy (EGD)?

An upper endoscopy, or EGD, passes a thin flexible camera through the mouth to examine the esophagus, stomach, and the first part of the small intestine. It investigates problems like persistent heartburn, swallowing difficulty, unexplained anemia, or upper abdominal pain. You receive sedation through an IV, the exam itself takes 10 to 20 minutes, and you go home the same day once the sedation wears off, needing a driver.

What Affects the Cost

  • –The choice between a hospital outpatient department and a freestanding endoscopy center is the single biggest price lever.
  • –Sedation billed by a separate anesthesia provider, especially propofol given by an anesthesiologist or CRNA, adds a significant independent charge.
  • –This code is the diagnostic-only exam; if the doctor takes even one biopsy the procedure is recoded to 43239 at a higher rate plus lab fees.
  • –Pre-procedure consultation visits with the gastroenterologist are billed separately from the endoscopy itself.
  • –Facility fees vary more than physician fees, so the same doctor can cost very different amounts at different locations.

Questions to Ask Before Booking

  • 1.Can this be scheduled at a freestanding endoscopy center rather than the hospital, and what is the facility fee at each?
  • 2.Who provides the sedation, what type is used, and are they in my network?
  • 3.If you take biopsies during the exam, how much does the procedure code and pathology add?
  • 4.Is prior authorization required and has it been obtained?
  • 5.What is the all-in estimate including physician, facility, anesthesia, and pathology?

Upper Endoscopy (EGD) in Kansas: questions

Under 2026 Medicare rates, an upper endoscopy (EGD) costs about $1,037 in total at a hospital outpatient department or about $608 at an ambulatory surgery center, counting both the physician and the facility (national rates). The physician's own fee in Kansas averages $103. Kansas is a single Medicare locality, so the physician rate is the same statewide.

Not on the physician fee schedule. Kansas uses one locality, so the Medicare physician rate is the same from one end of the state to the other. What still changes is site of service (office vs hospital) and any facility fee the hospital bills on its own claim.

After the Part B deductible, coinsurance is usually 20% of the allowed amount: about $59 for the office physician line or $21 for the hospital physician line in Kansas. Medigap may cover that 20%. This is not the hospital facility fee.

No. $103.28 is only the physician's share. Adding Medicare's facility payment brings the total to about $1,037 in a hospital outpatient department, or about $608 at an ambulatory surgery center. Anesthesia, pathology and other codes billed the same day are extra. Kansas ranks #7 of 51 states on the physician line (9% below the national office rate of $322.65).

Data source: 2026 Medicare Physician Fee Schedule (CMS PPRRVU26B, released March 2026). Conversion factor: $33.4009. Prices shown are Medicare allowed amounts for the physician service and may not match what you are billed. Private insurance and self-pay ranges, when shown, are labeled estimates (typical multiples of Medicare), not quotes. This site is an independent cost tool, not medical advice.