Medical Procedure Costs in Kentucky

Kentucky Medicare physician rates are generally below the national average (-7.0%). One statewide locality — the ZIP tool still maps you onto that locality.

Look up any CPT in Kentucky

Featured table below is 59 procedures. Search covers 7,500+ fee-schedule codes.

Try
vs national (featured set)
-7.0%
Medicare localities
1
PE GPCI 0.889
On this page
59
featured procedures · rest via search

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 centre 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. These Kentucky averages are unweighted means of the state’s localities, not population-weighted.

How Medicare prices Kentucky

Kentucky's fee schedule runs on one statewide locality, with geographic indices below the national average, so Louisville, Lexington, and the Appalachian east all publish the same Medicare-approved amounts. The uniform locality smooths over a state with sharp internal contrasts, from urban river cities to some of the most rural counties in America. Because the adjustments are identical everywhere, the statewide figures here transfer cleanly to any Kentucky address. Setting of care, office versus hospital outpatient, remains the biggest driver of what a patient actually pays.

Louisville and Lexington host the state's two academic medical centers and absorb referrals from a wide rural hinterland, while northern Kentucky functions as part of the Cincinnati market across the river. Eastern Kentucky's mountain counties face persistent physician shortages and long travel for specialty procedures. For residents along the borders, comparing against Cincinnati, Nashville, or Huntington providers is often worthwhile.

Use a ZIP lookup for your area of Kentucky, whether Louisville, Lexington, the northern Kentucky suburbs of Cincinnati, Bowling Green, Owensboro, or the Appalachian east.

Featured physician rates in Kentucky

ProcedureKentucky
Incision & Drainage of Abscess10060$119
Skin Biopsy (Tangential)11102$87
Skin Biopsy (Punch)11104$111
Destruction of Skin Lesion17000$61
Partial Mastectomy19301$601
Total Hip Replacement27130$1,107
Total Knee Replacement27447$1,105
Knee Arthroscopy29881$485
Upper Endoscopy (EGD)43235$295
Upper Endoscopy (EGD) With Biopsy43239$381
Colonoscopy (Diagnostic)45378$348
Colonoscopy With Biopsy45380$440
Colonoscopy With Polyp Removal45385$461
Laparoscopic Cholecystectomy47562$602
Laparoscopic Inguinal Hernia Repair49650$402
Laparoscopic Removal of Ovarian Cyst58661$564
Vaginal Delivery (Global)59400$2,115
Cesarean Delivery (Global)59510$2,362
Lumbar Discectomy63030$845
Cataract Surgery66984$438
MRI Brain Without Contrast70551$179
MRI Brain With Contrast70552$246
MRI Brain70553$290
Chest X-Ray71046$30
CT Chest Without Contrast71250$122
CT Chest With Contrast71260$152
MRI Cervical Spine72141$175
MRI Lumbar Spine72148$176
Shoulder X-Ray73030$32
MRI Shoulder73221$187
Knee X-Ray73560$31
MRI Knee73721$187
CT Abdomen & Pelvis Without Contrast74176$169
CT Abdomen & Pelvis With Contrast74177$274
Ultrasound Abdomen76700$105
Ultrasound Transvaginal76830$107
Ultrasound Pelvis76856$96
Diagnostic Mammogram77066$143
Screening Mammogram77067$115
Nuclear Stress Test78452$386
Psychiatric Evaluation90791$168
Psychiatric Evaluation With Medical Services90792$195
Psychotherapy (45 min)90834$111
Psychotherapy (60 min)90837$163
ECG/EKG93000$14
Echocardiogram93306$180
Stress Echocardiogram93350$170
Carotid Ultrasound93880$171
Laser Treatment for Skin96920$126
Physical Therapy (Therapeutic Exercise)97110$28
Physical Therapy (Manual Therapy)97140$26
PT Evaluation (Low Complexity)97161$93
PT Evaluation (Moderate Complexity)97162$93
Office Visit (New, Low)99203$111
Office Visit (New, Moderate-High)99204$168
Office Visit (New, High)99205$224
Office Visit (Established, Moderate)99213$90
Office Visit (Established, Moderate-High)99214$128
Office Visit (Established, High)99215$182

Office (non-facility) physician rates. Open a row for the locality table and ZIP tool.

Medical costs in Kentucky: questions

Across the 59 featured procedures on this page, Kentucky sits below the national average by about 7%. Examples: incision & drainage of abscess $119, skin biopsy (tangential) $87, skin biopsy (punch) $111. Search any other CPT in the box above — those codes are in the tool, not as extra Kentucky articles.

Kentucky is one Medicare locality, so the physician fee schedule is statewide. Site of service (office vs hospital) and hospital facility fees still change what a patient is billed.

Medicare physician allowed amounts only — the professional fee after GPCI. They do not include hospital facility charges, anesthesia, or your plan’s contracted rate. Medicare patients typically owe 20% of the allowed amount after the Part B deductible, before Medigap.

Yes. The table is the featured set (59 procedures). The search box looks up 7,500+ payable codes from the 2026 fee schedule and applies Kentucky’s locality when you enter a ZIP.

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.