Upper Endoscopy (EGD) With Biopsy Cost in Kansas
Egd biopsy single/multiple
Kansas Medicare physician rate (2026)
-8.7% 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 $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
How much does upper endoscopy (egd) with biopsy cost in Kansas?
Kansas is a single Medicare locality for this fee schedule. The 2026 physician rate for CPT 43239 is $382.50 in an office and $115.58 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 $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.
Is this the full upper endoscopy (egd) with biopsy bill in Kansas?
No. $382.50 is the Medicare physician allowed amount for CPT 43239. 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 $418.85).