Medicare's 109 payment localities for 2026
Medicare pays the same code differently depending on where the care was given. Each locality has three cost indices (work, practice expense, malpractice) that scale the national amount. Find yours by the state where you were treated.
| State | Locality | Work | Practice expense | Malpractice |
|---|---|---|---|---|
| Alabama | Alabama | 1.000 | 0.875 | 0.566 |
| Alaska | Alaska | 1.500 | 1.065 | 0.551 |
| Arizona | Arizona | 1.000 | 0.969 | 0.856 |
| Arkansas | Arkansas | 1.000 | 0.859 | 0.515 |
| California | Bakersfield | 1.019 | 1.096 | 0.609 |
| California | Chico | 1.017 | 1.096 | 0.536 |
| California | El Centro | 1.017 | 1.096 | 0.541 |
| California | Fresno | 1.017 | 1.096 | 0.536 |
| California | Hanford-Corcoran | 1.017 | 1.096 | 0.536 |
| California | Los Angeles-Long Beach-Anaheim (Los Angeles/Orange County) | 1.041 | 1.183 | 0.664 |
| California | Madera | 1.017 | 1.096 | 0.536 |
| California | Merced | 1.017 | 1.096 | 0.536 |
| California | Modesto | 1.017 | 1.096 | 0.536 |
| California | Napa | 1.063 | 1.318 | 0.508 |
| California | Oxnard-Thousand Oaks-Ventura | 1.028 | 1.182 | 0.623 |
| California | Redding | 1.017 | 1.096 | 0.536 |
| California | Rest of California | 1.017 | 1.096 | 0.536 |
| California | Riverside-San Bernardino-Ontario | 1.018 | 1.096 | 0.853 |
| California | Sacramento-Roseville-Folsom | 1.036 | 1.163 | 0.536 |
| California | Salinas | 1.031 | 1.159 | 0.536 |
| California | San Diego-Chula Vista-Carlsbad | 1.030 | 1.196 | 0.542 |
| California | San Francisco-Oakland-Berkeley (Marin County) | 1.095 | 1.410 | 0.459 |
| California | San Francisco-Oakland-Berkeley (San Francisco/San Mateo/Alameda/Contra Costa County) | 1.095 | 1.410 | 0.425 |
| California | San Jose-Sunnyvale-Santa Clara (San Benito County) | 1.110 | 1.442 | 0.536 |
| California | San Jose-Sunnyvale-Santa Clara (Santa Clara County) | 1.110 | 1.442 | 0.397 |
| California | San Luis Obispo-Paso Robles | 1.017 | 1.139 | 0.536 |
| California | Santa Cruz-Watsonville | 1.021 | 1.215 | 0.536 |
| California | Santa Maria-Santa Barbara | 1.028 | 1.166 | 0.536 |
| California | Santa Rosa-Petaluma | 1.030 | 1.228 | 0.536 |
| California | Stockton | 1.017 | 1.096 | 0.536 |
| California | Vallejo | 1.063 | 1.318 | 0.459 |
| California | Visalia | 1.017 | 1.096 | 0.536 |
| California | Yuba City | 1.017 | 1.096 | 0.536 |
| Colorado | Colorado | 1.012 | 1.064 | 0.781 |
| Connecticut | Connecticut | 1.020 | 1.077 | 1.210 |
| Delaware | Delaware | 1.005 | 0.988 | 0.899 |
| District of Columbia | DC + MD/VA Suburbs | 1.054 | 1.178 | 1.113 |
| Florida | Fort Lauderdale | 1.000 | 1.013 | 1.808 |
| Florida | Miami | 1.000 | 1.041 | 2.529 |
| Florida | Rest of Florida | 1.000 | 0.956 | 1.503 |
| Georgia | Atlanta | 1.003 | 1.016 | 1.201 |
| Georgia | Rest of Georgia | 1.000 | 0.892 | 1.192 |
| Hawaii | Hawaii, Guam | 1.000 | 1.137 | 0.579 |
| Idaho | Idaho | 1.000 | 0.920 | 0.473 |
| Illinois | Chicago | 1.007 | 1.005 | 2.295 |
| Illinois | East St. Louis | 1.000 | 0.920 | 2.014 |
| Illinois | Rest of Illinois | 1.000 | 0.913 | 1.563 |
| Illinois | Suburban Chicago | 1.007 | 1.027 | 1.772 |
| Indiana | Indiana | 1.000 | 0.927 | 0.486 |
| Iowa | Iowa | 1.000 | 0.915 | 0.397 |
| Kansas | Kansas | 1.000 | 0.904 | 0.504 |
| Kentucky | Kentucky | 1.000 | 0.889 | 0.915 |
| Louisiana | New Orleans | 1.000 | 0.941 | 1.136 |
| Louisiana | Rest of Louisiana | 1.000 | 0.885 | 0.958 |
| Maine | Rest of Maine | 1.000 | 0.920 | 0.622 |
| Maine | Southern Maine | 1.000 | 0.991 | 0.631 |
| Maryland | Baltimore/Surrounding Counties | 1.016 | 1.073 | 1.237 |
| Maryland | Rest of Maryland | 1.010 | 1.012 | 0.918 |
| Massachusetts | Metropolitan Boston | 1.041 | 1.194 | 0.890 |
| Massachusetts | Rest of Massachusetts | 1.016 | 1.053 | 0.797 |
| Michigan | Detroit | 1.000 | 0.965 | 1.686 |
| Michigan | Rest of Michigan | 1.000 | 0.913 | 1.129 |
| Minnesota | Minnesota | 1.000 | 1.029 | 0.296 |
| Mississippi | Mississippi | 1.000 | 0.861 | 0.739 |
| Missouri | Metropolitan Kansas City | 1.000 | 0.939 | 0.977 |
| Missouri | Metropolitan St. Louis | 1.000 | 0.952 | 1.002 |
| Missouri | Rest of Missouri | 1.000 | 0.862 | 0.974 |
| Montana | Montana | 1.000 | 1.000 | 0.998 |
| Nebraska | Nebraska | 1.000 | 0.923 | 0.378 |
| Nevada | Nevada | 1.000 | 1.001 | 0.833 |
| New Hampshire | New Hampshire | 1.000 | 1.041 | 0.875 |
| New Jersey | Northern NJ | 1.063 | 1.160 | 1.068 |
| New Jersey | Rest of New Jersey | 1.040 | 1.092 | 1.097 |
| New Mexico | New Mexico | 1.000 | 0.917 | 1.201 |
| New York | Manhattan | 1.064 | 1.162 | 1.586 |
| New York | NYC Suburbs/Long Island | 1.064 | 1.189 | 1.857 |
| New York | Poughkeepsie/Northern NYC Suburbs | 1.045 | 1.095 | 1.210 |
| New York | Queens | 1.064 | 1.182 | 1.442 |
| New York | Rest of New York | 1.000 | 0.950 | 0.703 |
| North Carolina | North Carolina | 1.000 | 0.933 | 0.639 |
| North Dakota | North Dakota | 1.000 | 1.000 | 0.406 |
| Ohio | Ohio | 1.000 | 0.913 | 1.008 |
| Oklahoma | Oklahoma | 1.000 | 0.893 | 0.777 |
| Oregon | Portland | 1.016 | 1.111 | 0.744 |
| Oregon | Rest of Oregon | 1.000 | 0.996 | 0.703 |
| Pennsylvania | Metropolitan Philadelphia | 1.018 | 1.041 | 1.193 |
| Pennsylvania | Rest of Pennsylvania | 1.000 | 0.918 | 0.945 |
| Puerto Rico | Puerto Rico | 1.000 | 1.011 | 0.985 |
| Rhode Island | Rhode Island | 1.019 | 1.033 | 0.892 |
| South Carolina | South Carolina | 1.000 | 0.924 | 0.850 |
| South Dakota | South Dakota | 1.000 | 1.000 | 0.336 |
| Tennessee | Tennessee | 1.000 | 0.909 | 0.537 |
| Texas | Austin | 1.002 | 1.058 | 0.886 |
| Texas | Beaumont | 1.000 | 0.910 | 0.929 |
| Texas | Brazoria | 1.008 | 0.991 | 0.780 |
| Texas | Dallas | 1.009 | 0.996 | 0.858 |
| Texas | Fort Worth | 1.009 | 0.986 | 0.871 |
| Texas | Galveston | 1.008 | 0.993 | 0.828 |
| Texas | Houston | 1.008 | 0.993 | 1.376 |
| Texas | Rest of Texas | 1.000 | 0.949 | 0.903 |
| U.S. Virgin Islands | Virgin Islands | 1.000 | 1.011 | 0.985 |
| Utah | Utah | 1.000 | 0.940 | 0.898 |
| Vermont | Vermont | 1.000 | 0.990 | 0.506 |
| Virginia | Virginia | 1.000 | 0.983 | 0.706 |
| Washington | Rest of Washington | 1.013 | 1.053 | 0.761 |
| Washington | Seattle (King County) | 1.050 | 1.227 | 0.817 |
| West Virginia | West Virginia | 1.000 | 0.869 | 1.431 |
| Wisconsin | Wisconsin | 1.000 | 0.958 | 0.308 |
| Wyoming | Wyoming | 1.000 | 1.000 | 0.740 |