Upper Endoscopy (EGD) Cost in Kansas
Egd diagnostic brush wash
Kansas Medicare physician rate (2026)
-8.6% vs nationalSingle statewide locality.
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 this number is
The figures on this page are 2026 Medicare physician allowed amounts for a specific CPT code: the professional fee, adjusted by geographic practice-cost indices. They are not a hospital chargemaster price, not your insurer's contracted rate, and not a quote. Hospital facility fees, anesthesia, implants, imaging reads, and pathology are billed separately when they apply. In Kansas the office and hospital physician lines for this CPT differ by $191.73.
National vs Kansas
Where Kansas ranks for this CPT
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?
Other featured procedures in Kansas
Upper Endoscopy (EGD) in other states
Upper Endoscopy (EGD) in Kansas: questions
How much does upper endoscopy (egd) cost in Kansas?
Kansas is a single Medicare locality for this fee schedule. The 2026 physician rate for CPT 43235 is $295.01 in an office and $103.28 in a hospital, statewide. A ZIP lookup still confirms the locality mapping.
Does the rate change inside Kansas?
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.
What will a Medicare patient owe for the physician fee?
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.
Is this the full upper endoscopy (egd) bill in Kansas?
No. $295.01 is the Medicare physician allowed amount for CPT 43235. Anesthesia, facility fees, implants, and other CPT codes billed the same day are extra. Kansas ranks #7 of 51 states on this physician line (9% below the national office rate of $322.65).