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Private endoscopic ultrasound (EUS) in London, a scope with ultrasound built in.

A scope with an ultrasound probe built in - the reference test for pancreatic and mediastinal lesions, with targeted FNA biopsy at the same session.

A stethoscope on a clinical desk

Indicative pricing

What a private EUS costs in London.

Indicative ranges across UK private providers.

In short

£2,000-£4,000, with findings on the day.

Procedure Indicative range
Diagnostic EUS £2,000–£4,000
EUS + FNA biopsy £2,800–£5,500
EUS + fine-needle biopsy (histology) £3,200–£6,500
Rectal EUS £1,800–£3,500
EUS + cyst drainage £4,500–£9,000
Repeat surveillance EUS £2,000–£4,000

Prices vary by unit, whether an FNA needle is used, and whether therapy (like cyst drainage) is performed.

The problem

A pancreatic lesion, a suspicious node - the wait feels endless.

When a CT or MRI raises a question about the pancreas, a lymph node or a submucosal lesion, EUS is usually the study that answers it.

  • Waiting for a tissue answer?

    FNA at the same session shortens weeks of uncertainty into one appointment plus cytology turnaround.

  • Small lesion no-one is sure about?

    EUS is often the study that finds it - the probe sits millimetres away from the pancreas.

  • Not sure you need one?

    Sometimes an MRI, MRCP or repeat CT is the better first step. A clinician can advise which is better.

What it shows

The questions EUS is the right test for.

EUS answers questions no other test can - and biopsies the answer at the same time. These are common reasons people have this test.

  • Pancreatic mass and cyst characterisation

    The reference test for small pancreatic lesions - often clearer than CT or MRI.

  • Submucosal lesions of the GI tract

    Layered ultrasound view of lesions sitting under the mucosa.

  • Tumour staging (oesophageal, pancreatic, rectal)

    Depth of invasion (T-stage) and local nodes in one study.

  • Mediastinal lymph nodes

    Sampled by EUS-guided FNA without a surgical procedure.

  • Bile duct assessment

    Small distal bile duct stones or strictures the CT missed.

  • Pancreatic cyst surveillance

    Periodic EUS to watch cysts with worrying features.

  • Rectal cancer staging

    Layered view of the rectal wall and perirectal nodes.

  • Red flag: acute pancreatitis with mass

    Urgent HPB referral - EUS is arranged in a specialist centre.

Procedure types

Not all EUS studies are the same.

What each option on your referral is actually for.

  • Diagnostic EUS

    Ultrasound imaging of the pancreas, bile duct, gastric wall and mediastinum through the scope, under sedation.

  • EUS + FNA biopsy

    A fine needle is passed through the scope under real-time ultrasound to sample a lesion for cytology.

  • EUS + fine-needle histology

    A dedicated core needle takes a small tissue cylinder for full histology - increasingly the first choice.

  • Rectal EUS

    Layered ultrasound view of the rectal wall and perirectal nodes for staging and fistula work-up.

  • EUS + cyst drainage

    Therapeutic drainage of a pancreatic pseudocyst or walled-off necrosis through a stent placed under EUS guidance.

  • Mediastinal EUS

    Sampling of subcarinal and paraoesophageal lymph nodes without a surgical mediastinoscopy.

  • Pancreatic cyst surveillance

    Structured repeat imaging of cysts with concerning features, on an agreed interval.

  • Repeat EUS

    A second study to reassess a lesion or confirm response after treatment.

Safety and eligibility

Very safe - but there is real planning to do.

EUS is very safe, but sedation, fasting, and blood-thinning medication all need planning.

  • Sedation or GA

    EUS is done under deep sedation or a short general anaesthetic - your consultant will discuss which is right for you.

  • Small bleeding risk if biopsy taken

    Bleeding after FNA is uncommon and usually settles on its own. Serious bleeding is rare.

  • Pancreatitis risk with pancreatic FNA

    A small (~1-2%) risk of a short episode of pancreatitis when sampling the pancreas. Usually mild.

  • Fast from midnight

    Nothing to eat after midnight. Small sips of water allowed up to 2 hours before your appointment.

  • Anticoagulation planned

    Warfarin, DOACs and clopidogrel are reviewed and paused where safe - always coordinated with your consultant, never on your own.

  • Overnight stay usually not needed

    Most diagnostic and FNA studies are day cases. Cyst drainage or complex therapy may require an overnight stay.

  • Pregnancy special case

    EUS is usually deferred in pregnancy unless essential.

  • Driving restriction 24 hrs

    No driving, alcohol or important decisions for 24 hours after sedation or GA. Have someone take you home.

  • Always share prior imaging

    Bring your CT or MRI images and reports - EUS is planned against them, and comparison makes the report far more useful.

Reading your report

An EUS report can look intimidating. It isn’t.

However much was examined, the report keeps to the same four parts.

A London consultant interventional gastroenterologist reviewing EUS images

A quiet reminder

You will be told the headline on the day - the cytology detail takes a little longer.

If anything is unclear, ask the clinician who arranged the test to talk you through it before your follow-up.

  1. 01 Header

    Your details, the indication and prior imaging

    Your details, the clinical question and the CT or MRI findings the EUS is answering.

  2. 02 Technique

    Routes examined and any FNA

    Which anatomy was scanned - pancreas, bile duct, gastric wall, mediastinum, rectum - and how many needle passes were taken from where.

  3. 03 Findings

    The lesion, lymph nodes and staging

    The target lesion measured in detail, local lymph nodes described, and TNM staging where relevant.

  4. 04 Impression

    The conclusion: read this first

    The bottom line - normal, benign findings, or an MDT recommendation. Cytology and histology follow separately in 5-7 days.

Recognised by major UK insurers

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Frequently asked

Common questions about EUS.

Quick answers on cost, sedation, biopsies, safety and results.

  • What does EUS show that CT or MRI can’t?

    EUS puts a high-frequency ultrasound probe right next to the pancreas, bile duct, oesophageal wall or rectum. It sees small pancreatic lesions, layered wall detail and small perirectal nodes better than CT or MRI, and it can biopsy any of them in the same session.

  • When is a fine-needle biopsy (FNA) done?

    FNA is added when a lesion needs a tissue diagnosis - a pancreatic mass, a suspicious lymph node, a submucosal tumour, or a worrying pancreatic cyst. It is decided by your consultant based on the ultrasound appearances during the study.

  • What are the risks?

    EUS itself is very safe. Sedation risk is small. Where an FNA is taken there is a small risk of bleeding, and pancreatic FNA carries a small (~1-2%) risk of a short episode of pancreatitis. Cyst drainage has additional risks that will be explained in detail before you consent.

  • How much does a private EUS cost in London?

    Adding an FNA biopsy takes it to £2,800-£5,500, fine-needle histology £3,200-£6,500, and EUS-guided cyst drainage £4,500-£9,000.

  • Do I need a referral?

    EUS is arranged after a short consultation with an interventional gastroenterologist so the right study is planned and any prior CT or MRI is reviewed.

  • What are the fasting rules?

    Nothing to eat after midnight. Small sips of water are allowed up to 2 hours before. Rectal EUS may need a small enema on the day - the unit will explain.

  • Is EUS safe in pregnancy?

    EUS is usually deferred in pregnancy unless essential. If it is essential, it is done in a specialist unit with obstetric input.

  • Can I drive home?

    No. Deep sedation and general anaesthetic both mean no driving, alcohol or important decisions for 24 hours. You need someone to take you home.

  • What is rectal EUS?

    Rectal EUS uses a slim ultrasound probe passed into the rectum to give a layered view of the rectal wall and the small nodes around it. It is used to stage rectal cancer and to work up complex fistulae.

  • When should I see a GP urgently?

    New jaundice, unexplained weight loss, ongoing upper-abdominal pain radiating to the back, or a pancreatic lesion found on a scan all need prompt specialist review.

Related content

Looking for something different?

In practice, in London

The London pathway for endoscopic ultrasound

With endoscopic ultrasound, the London question is usually about report turnaround and the radiologist reading it - not whether the scan is available. The NHS route for endoscopic ultrasound is thorough, but the queue is real. Many patients are told to expect anywhere from a handful of weeks to several months, depending on their local trust and how the referral is graded. Going private in London usually collapses that window to a matter of days - often the same week if the diary allows. It isn’t about jumping a queue so much as buying time back while you still have the flexibility to plan around it.

The mechanics are straightforward: a consultant appointment, any tests done at a nearby CQC-registered site, and a written report back within a few days. London’s density of private diagnostics - Marylebone, the City, Chelsea, Canary Wharf - means most patients can find something that fits around work without a cross-town trek. For endoscopic ultrasound specifically, the difference between a routine report and a sub-speciality read is where private care earns its keep.

There are a lot of consultants in London who can technically handle endoscopic ultrasound. Fewer who do it week in, week out for the exact question you’re bringing. It’s worth checking which is which - and being open to a different test or a different specialist if that would serve you better. UK-regulated providers work to CQC, GMC and Royal College standards; the choice is about fit, not floor.