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 66 procedures. Search covers 7,500+ fee-schedule codes.
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. 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
Across the 66 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.
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.
The table shows Medicare physician allowed amounts in an office: the professional fee after GPCI, which for imaging and other tests done outside a hospital is the full global rate. It does not include hospital facility charges, anesthesia, or your plan’s contracted rate; each procedure page adds the full hospital or surgery center total where CMS pays one. Medicare patients typically owe 20% of the allowed amount after the Part B deductible, before Medigap.
Yes. The table is the featured set (66 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.