Medical Procedure Costs in California

California medical procedure costs are generally above the national average. Medicare divides California into 29 pricing localities, so costs can vary within the state.

Cost vs National Avg

+10.4%

Higher than average

Pricing Localities

Medicare pricing regions

Procedures Covered

7,500+

CPT codes with pricing

Pricing Regions in California

Locality	Work GPCI	PE GPCI	MP GPCI
bakersfield	1.019	1.096	0.609
chico	1.017	1.096	0.536
el centro	1.017	1.096	0.541
fresno	1.017	1.096	0.536
hanford-corcoran	1.017	1.096	0.536
los angeles-long beach-anaheim (los angeles/orange cnty)	1.041	1.183	0.664
madera	1.017	1.096	0.536
merced	1.017	1.096	0.536
modesto	1.017	1.096	0.536
napa	1.063	1.318	0.508
oxnard-thousand oaks-ventura	1.028	1.182	0.623
redding	1.017	1.096	0.536
riverside-san bernardino-ontario	1.018	1.096	0.853
sacramento-roseville-folsom	1.036	1.163	0.536
salinas	1.031	1.159	0.536
san diego-chula vista-carlsbad	1.030	1.196	0.542
san francisco-oakland-berkeley (san francisco/san mateo/alameda/contra costa cnty)	1.095	1.410	0.425
san francisco-oakland-berkeley (marin cnty)	1.095	1.410	0.459
san jose-sunnyvale-santa clara (san benito cnty)	1.110	1.442	0.536
san luis obispo-paso robles	1.017	1.139	0.536
san jose-sunnyvale-santa clara (santa clara cnty)	1.110	1.442	0.397
santa cruz-watsonville	1.021	1.215	0.536
santa maria-santa barbara	1.028	1.166	0.536
santa rosa-petaluma	1.030	1.228	0.536
stockton	1.017	1.096	0.536
vallejo	1.063	1.318	0.459
visalia	1.017	1.096	0.536
yuba city	1.017	1.096	0.536
rest of california	1.017	1.096	0.536

GPCI (Geographic Practice Cost Index) values adjust Medicare payments for regional cost differences. Higher values mean higher costs. A GPCI of 1.000 equals the national average.

Procedure Costs in California

Procedure	California	National Avg	Difference
Incision & Drainage of Abscess	$144	$129	+11.6%
Skin Biopsy (Tangential)	$109	$96	+13.7%
Skin Biopsy (Punch)	$138	$121	+13.4%
Destruction of Skin Lesion	$74	$66	+12.0%
Partial Mastectomy	$646	$633	+2.0%
Total Hip Replacement	$1,194	$1,162	+2.8%
Total Knee Replacement	$1,192	$1,159	+2.8%
Knee Arthroscopy	$547	$516	+6.0%
Upper Endoscopy (EGD)	$367	$323	+13.6%
Upper Endoscopy (EGD) With Biopsy	$478	$419	+14.2%
Colonoscopy (Diagnostic)	$423	$378	+11.9%
Colonoscopy With Biopsy	$542	$480	+12.9%
Colonoscopy With Polyp Removal	$559	$500	+11.8%
Laparoscopic Cholecystectomy	$640	$632	+1.3%
Laparoscopic Inguinal Hernia Repair	$437	$424	+2.9%
Laparoscopic Removal of Ovarian Cyst	$594	$586	+1.2%
Vaginal Delivery (Global)	$2,212	$2,214	-0.1%
Cesarean Delivery (Global)	$2,446	$2,473	-1.1%
Lumbar Discectomy	$923	$898	+2.8%
Cataract Surgery	$501	$463	+8.2%
MRI Brain Without Contrast	$222	$195	+13.6%
MRI Brain With Contrast	$307	$269	+14.2%
MRI Brain	$361	$317	+13.8%
Chest X-Ray	$38	$33	+13.9%
CT Chest Without Contrast	$150	$133	+13.3%
CT Chest With Contrast	$190	$167	+13.8%
MRI Cervical Spine	$216	$191	+13.5%
MRI Lumbar Spine	$218	$192	+13.5%
Shoulder X-Ray	$41	$36	+14.6%
MRI Shoulder	$234	$205	+14.2%
Knee X-Ray	$39	$34	+14.8%
MRI Knee	$233	$204	+14.2%
CT Abdomen & Pelvis Without Contrast	$206	$183	+12.5%
CT Abdomen & Pelvis With Contrast	$344	$300	+14.5%
Ultrasound Abdomen	$130	$114	+13.8%
Ultrasound Transvaginal	$135	$118	+14.4%
Ultrasound Pelvis	$120	$105	+14.2%
Diagnostic Mammogram	$179	$157	+14.2%
Screening Mammogram	$145	$126	+14.6%
Nuclear Stress Test	$496	$428	+15.9%
Psychiatric Evaluation	$186	$173	+7.2%
Psychiatric Evaluation With Medical Services	$215	$202	+6.4%
Psychotherapy (45 min)	$122	$114	+6.9%
Psychotherapy (60 min)	$179	$167	+6.9%
ECG/EKG	$17	$15	+10.2%
Echocardiogram	$224	$197	+13.9%
Stress Echocardiogram	$211	$185	+13.8%
Carotid Ultrasound	$218	$189	+15.2%
Laser Treatment for Skin	$158	$138	+14.8%
Physical Therapy (Therapeutic Exercise)	$32	$29	+9.9%
Physical Therapy (Manual Therapy)	$30	$28	+9.9%
PT Evaluation (Low Complexity)	$108	$98	+10.4%
PT Evaluation (Moderate Complexity)	$108	$98	+10.4%
Office Visit (New, Low)	$128	$118	+8.7%
Office Visit (New, Moderate-High)	$192	$177	+8.2%
Office Visit (New, High)	$255	$237	+7.8%
Office Visit (Established, Moderate)	$104	$95	+9.6%
Office Visit (Established, Moderate-High)	$148	$136	+9.1%
Office Visit (Established, High)	$209	$192	+8.8%

Prices shown are Medicare office (non-facility) rates. Click any procedure for full details including hospital rates and savings tips.

Understanding Medical Costs in California

Medical procedure costs in California are determined by Medicare's Geographic Practice Cost Indices (GPCIs), which account for differences in physician work, practice expenses, and malpractice insurance across regions. Because California has 29 different pricing localities, costs can vary significantly depending on where within the state the procedure is performed.

The prices listed above represent Medicare reimbursement rates, which serve as a baseline for what healthcare costs in California. Private insurance companies typically negotiate rates between 130% and 200% of these Medicare amounts. If you are paying out of pocket, many providers in California offer cash discounts of 20% to 40% off their standard charges.

For the most accurate pricing, enter your ZIP code on any procedure page to see costs adjusted for your specific locality within California.

Ways to Save on Medical Costs in California

Compare Insurance Plans

Comparing marketplace plans in California could save you thousands on procedures.

Compare plans on eHealth →

Try Telehealth First

Many consultations can be done virtually for $50-100, saving hundreds vs an in-person visit.

Book on Sesame Care →

Save on Prescriptions

If a procedure leads to a prescription, discount cards can save up to 80% at pharmacies.

Check prices on GoodRx →

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Medical Costs in California: Frequently Asked Questions

How much do medical procedures cost in California?

Medicare procedure costs in California are generally above the national average by about 10%. For example: incision & drainage of abscess around $144, skin biopsy (tangential) around $109, skin biopsy (punch) around $138. Private insurance typically pays 130-200% of these Medicare rates and self-pay cash prices vary by provider.

Why do procedure costs vary within California?

Medicare divides California into 29 pricing localities, each with its own geographic adjustment, so the same procedure can cost more in higher-cost metro areas than in rural ones. Enter your ZIP code for locality-specific pricing.

What do Medicare patients pay for procedures in California?

Medicare patients in California typically pay 20% of the Medicare-approved amount after meeting their Part B deductible, with Medicare covering the other 80%. Supplemental (Medigap) plans can cover most of that 20% coinsurance.

How can I save on medical procedures in California?

Ask each provider for a self-pay or cash price before scheduling, as many in California discount 20-40% for upfront payment. If you are uninsured, compare marketplace insurance plans, use telehealth for consultations, and check prescription discount cards.

Data source: 2026 Medicare Physician Fee Schedule (CMS PPRRVU26B, released March 2026). Conversion factor: $33.4009. Prices shown are Medicare allowed amounts and may not reflect actual charges. Private insurance and self-pay estimates are approximations.