How Much Does an Upper Endoscopy (EGD) With Biopsy Cost in Kansas?
Egd biopsy single/multiple
$1,050Hospital outpatient total2026 Medicare, physician + facilityUnder 2026 Medicare rates, an upper endoscopy (EGD) with biopsy costs about $1,050 in total at a hospital outpatient department or about $621 at an ambulatory surgery center, counting both the physician and the facility (national rates). The physician's own fee in Kansas averages $116.
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Kansas Medicare physician rate (2026)
-8.7% vs nationalSingle statewide locality.
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.
Choosing a surgery center over a hospital saves about $429 on the Medicare allowed amount for upper endoscopy (egd) with biopsy. 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) with biopsy 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.
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 $266.92.
National vs Kansas
Where Kansas ranks for this CPT
Upper Endoscopy (EGD) With Biopsy 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: This is the same upper endoscopy camera exam of the esophagus, stomach, and duodenum, but with the physician taking one or more small tissue samples through the scope using tiny forceps. Biopsies are painless and are taken to test for conditions such as H. pylori infection, celiac disease, Barrett's esophagus, or inflammation. The exam runs 10 to 20 minutes under IV sedation, and recovery is the same as a diagnostic EGD: home the same day with a driver.
What Is Upper Endoscopy (EGD) With Biopsy?
This is the same upper endoscopy camera exam of the esophagus, stomach, and duodenum, but with the physician taking one or more small tissue samples through the scope using tiny forceps. Biopsies are painless and are taken to test for conditions such as H. pylori infection, celiac disease, Barrett's esophagus, or inflammation. The exam runs 10 to 20 minutes under IV sedation, and recovery is the same as a diagnostic EGD: home the same day with a driver.
What Affects the Cost
- –Pathology is the defining extra cost of this code: each biopsy jar processed and read by the lab generates its own charge, and multiple sites mean multiple jars.
- –The facility fee difference between hospital outpatient departments and freestanding endoscopy centers dwarfs most other line items.
- –Separate anesthesia billing for propofol sedation adds an independent professional charge.
- –Testing biopsies for H. pylori or celiac disease may involve special stains that increase the lab bill.
- –The physician fee for 43239 is higher than the no-biopsy code 43235, reflecting the sampling work.
Questions to Ask Before Booking
- 1.How many biopsy specimens do you expect to take, and what does the lab charge per specimen?
- 2.Which pathology lab reads the samples and is it in my network?
- 3.What is the total estimate across physician, facility, anesthesia, and pathology bills?
- 4.Would a freestanding endoscopy center lower the facility portion of my cost?
- 5.If you find something needing treatment during the exam, how could the code and price change?
Other featured procedures in Kansas
Upper Endoscopy (EGD) With Biopsy in other states
Upper Endoscopy (EGD) With Biopsy in Kansas: questions
Under 2026 Medicare rates, an upper endoscopy (EGD) with biopsy costs about $1,050 in total at a hospital outpatient department or about $621 at an ambulatory surgery center, counting both the physician and the facility (national rates). The physician's own fee in Kansas averages $116. 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 $77 for the office physician line or $23 for the hospital physician line in Kansas. Medigap may cover that 20%. This is not the hospital facility fee.
No. $115.58 is only the physician's share. Adding Medicare's facility payment brings the total to about $1,050 in a hospital outpatient department, or about $621 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 $418.85).