Medical Procedure Costs in California
California Medicare physician rates are generally above the national average (+10.4%). CMS uses 29 localities here, so a ZIP matters.
Look up any CPT in California
Featured table below is 59 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 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 California averages are unweighted means of the state’s localities, not population-weighted.
How Medicare prices California
California is the most finely divided state in the Medicare fee schedule, with roughly thirty payment localities drawn around metropolitan statistical areas after CMS reformed the state's locality map. The San Francisco Bay Area carries some of the highest geographic adjustments in the nation, with San Francisco, San Jose, and the East Bay each priced separately, while Los Angeles, Orange County, San Diego, and Sacramento have their own localities at somewhat lower levels. Rural and inland counties fall into lower-cost localities, so the same procedure can carry meaningfully different Medicare-approved amounts within a single day's drive. No other state shows this much in-state variation on the fee schedule itself.
California's markets differ sharply: the Bay Area combines high wages with heavily consolidated hospital systems, Los Angeles offers enormous choice across a sprawling region, and the Central Valley and far north face genuine access shortages. Where you are treated within the state matters more here than almost anywhere else in the country. Academic medical centers in the Bay Area, Los Angeles, San Diego, and Sacramento handle much of the complex referral care.
A ZIP-level lookup matters more in California than in any other state; compare your area, whether that is the Bay Area, Los Angeles, San Diego, Sacramento, the Central Valley, or the rural north.
California payment localities (GPCI)
| Locality | Work | PE |
|---|---|---|
| bakersfield | 1.019 | 1.096 |
| chico | 1.017 | 1.096 |
| el centro | 1.017 | 1.096 |
| fresno | 1.017 | 1.096 |
| hanford-corcoran | 1.017 | 1.096 |
| los angeles-long beach-anaheim (los angeles/orange cnty) | 1.041 | 1.183 |
| madera | 1.017 | 1.096 |
| merced | 1.017 | 1.096 |
| modesto | 1.017 | 1.096 |
| napa | 1.063 | 1.318 |
| oxnard-thousand oaks-ventura | 1.028 | 1.182 |
| redding | 1.017 | 1.096 |
| riverside-san bernardino-ontario | 1.018 | 1.096 |
| sacramento-roseville-folsom | 1.036 | 1.163 |
| salinas | 1.031 | 1.159 |
| san diego-chula vista-carlsbad | 1.030 | 1.196 |
| san francisco-oakland-berkeley (san francisco/san mateo/alameda/contra costa cnty) | 1.095 | 1.410 |
| san francisco-oakland-berkeley (marin cnty) | 1.095 | 1.410 |
| san jose-sunnyvale-santa clara (san benito cnty) | 1.110 | 1.442 |
| san luis obispo-paso robles | 1.017 | 1.139 |
| san jose-sunnyvale-santa clara (santa clara cnty) | 1.110 | 1.442 |
| santa cruz-watsonville | 1.021 | 1.215 |
| santa maria-santa barbara | 1.028 | 1.166 |
| santa rosa-petaluma | 1.030 | 1.228 |
| stockton | 1.017 | 1.096 |
| vallejo | 1.063 | 1.318 |
| visalia | 1.017 | 1.096 |
| yuba city | 1.017 | 1.096 |
| rest of california | 1.017 | 1.096 |
GPCI of 1.000 equals the national average. Higher PE GPCI raises office-based procedures more than hospital physician lines.
Featured physician rates in California
Office (non-facility) physician rates. Open a row for the locality table and ZIP tool.
Other states
Medical costs in California: questions
Across the 59 featured procedures on this page, California sits above the national average by about 10%. Examples: incision & drainage of abscess $144, skin biopsy (tangential) $109, skin biopsy (punch) $138. Search any other CPT in the box above — those codes are in the tool, not as extra California articles.
California has 29 payment localities. Practice-expense GPCI runs from 1.096 to 1.442 (1.000 is the national average). A ZIP-level lookup matters more in California than in any other state; compare your area, whether that is the Bay Area, Los Angeles, San Diego, Sacramento, the Central Valley, or the rural north.
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 California’s locality when you enter a ZIP.