Medicare's 2026 rates in Sacramento-Roseville-Folsom, California
Medicare payment locality 63, run by contractor 01112, covers these counties: Sacramento, Placer, Yolo, El Dorado. Its cost indices put code 99213, billed from an office, at $103.31, 8.5% above the national $95.19.
Cost indices for 2026
- Work (national = 1.000)
- 1.036
- Practice expense (national = 1.000)
- 1.163
- Malpractice (national = 1.000)
- 0.536
- ZIP codes CMS assigns to this locality
- 219
- Of those, split with another locality
- 9
30 common codes priced for Sacramento-Roseville-Folsom
Physician fee schedule amounts for 2026. Office is what Medicare allows when a doctor's office or clinic bills the code; facility is what it allows a doctor for the same work in a hospital or surgery center.
| Code | Category | Office here | Office national | Facility here |
|---|---|---|---|---|
| 99214 | Visit or care management | $146.64 | $135.61 | $87.20 |
| 99213 | Visit or care management | $103.31 | $95.19 | $59.41 |
| 97110 | Physical therapy or rehabilitation | $31.68 | $29.06 | none |
| 97530 | Physical therapy or rehabilitation | $38.71 | $35.07 | none |
| 97112 | Physical therapy or rehabilitation | $35.74 | $32.73 | none |
| 97140 | Physical therapy or rehabilitation | $30.21 | $27.72 | none |
| 17003 | Skin and soft tissue procedure | $7.21 | $6.35 | $1.77 |
| 88305 | Lab test or pathology | $78.06 | $70.14 | none |
| 93010 | Heart test or procedure | $8.78 | $8.35 | $8.78 |
| 99309 | Visit or care management | $122.16 | $114.57 | $103.52 |
| 99215 | Visit or care management | $207.47 | $192.39 | $129.78 |
| 98941 | Manipulation | $41.54 | $38.41 | $29.49 |
| 71045 | Imaging | $28.34 | $25.38 | none |
| 99204 | Visit or care management | $190.21 | $177.36 | $119.90 |
| 99308 | Visit or care management | $84.48 | $78.83 | $71.67 |
| 93000 | Heart test or procedure | $16.73 | $15.36 | none |
| 92014 | Eye exam or test | $141.14 | $127.26 | $65.39 |
| 99203 | Visit or care management | $126.60 | $117.57 | $72.99 |
| 95004 | Allergy testing or treatment | $4.02 | $3.67 | none |
| 92134 | Eye exam or test | $36.33 | $32.73 | none |
| 96372 | Infusion, injection or chemotherapy | $16.94 | $15.36 | none |
| 99490 | Visit or care management | $71.21 | $66.13 | $45.18 |
| 90837 | Mental health service | $177.77 | $167.00 | $140.87 |
| 93306 | Heart test or procedure | $221.10 | $196.73 | none |
| 99212 | Visit or care management | $64.92 | $59.45 | $31.90 |
| 71046 | Imaging | $37.15 | $33.07 | none |
| 17000 | Skin and soft tissue procedure | $73.54 | $66.47 | $51.79 |
| 77067 | Imaging | $142.65 | $126.26 | none |
| 95165 | Allergy testing or treatment | $19.74 | $17.37 | $2.64 |
| 77063 | Imaging | $56.30 | $51.10 | none |
Hospital outpatient rates and lab fee schedule amounts are national, so they are the same here as everywhere; each code page lists them.
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