Medical Procedure Costs in Missouri
Missouri Medicare physician rates are generally below the national average (-5.0%). CMS uses 3 localities here, so a ZIP matters.
Look up any CPT in Missouri
Featured table below is 59 procedures. Search covers 7,500+ fee-schedule codes.
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. These Missouri averages are unweighted means of the state’s localities, not population-weighted.
How Medicare prices Missouri
Missouri is a three-locality state: metropolitan St. Louis and metropolitan Kansas City are each priced separately, and everywhere else falls into a rest-of-state locality with lower geographic adjustments. Both metro localities approve higher amounts than outstate Missouri, and the Kansas City locality applies only to the Missouri side of that metro, since the Kansas side prices under Kansas's statewide locality. Springfield, Columbia, and the rural counties all share rest-of-state factors. The metro-versus-outstate gap is the main pricing story here.
St. Louis and Kansas City hold the state's academic medical centers and most of its specialty depth, drawing patients from far beyond Missouri's borders, including southern Illinois and eastern Kansas. Outstate Missouri is served by regional hubs in Springfield, Columbia, and Cape Girardeau, with the Ozarks and Bootheel among the harder places to reach specialty care. Rural hospital viability has been a persistent concern across the state.
Enter a ZIP code to see which Missouri locality covers you: metro St. Louis, metro Kansas City, or rest-of-state areas like Springfield, Columbia, Joplin, and the Bootheel.
Missouri payment localities (GPCI)
| Locality | Work | PE |
|---|---|---|
| metropolitan kansas city | 1.000 | 0.939 |
| metropolitan st. louis | 1.000 | 0.952 |
| rest of missouri | 1.000 | 0.862 |
GPCI of 1.000 equals the national average. Higher PE GPCI raises office-based procedures more than hospital physician lines.
Featured physician rates in Missouri
Office (non-facility) physician rates. Open a row for the locality table and ZIP tool.
Other states
Medical costs in Missouri: questions
How do Medicare physician rates in Missouri compare nationally?
Across the 59 featured procedures on this page, Missouri sits below the national average by about 5%. Examples: incision & drainage of abscess $122, skin biopsy (tangential) $90, skin biopsy (punch) $114. Search any other CPT in the box above — those codes are in the tool, not as extra Missouri articles.
How many Medicare localities does Missouri have?
Missouri has 3 payment localities. Practice-expense GPCI runs from 0.862 to 0.952 (1.000 is the national average). Enter a ZIP code to see which Missouri locality covers you: metro St. Louis, metro Kansas City, or rest-of-state areas like Springfield, Columbia, Joplin, and the Bootheel.
What do these Missouri prices include?
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.
Can I look up a CPT that is not in the table?
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 Missouri’s locality when you enter a ZIP.