Medicare's 2026 rates in San Francisco-Oakland-Berkeley (San Francisco/San Mateo/Alameda/Contra Costa County), California
Medicare payment locality 05, run by contractor 01112, covers these counties: San Francisco/Alameda/Contra Costa/San Mateo. Its cost indices put code 99213, billed from an office, at $117.58, 23.5% above the national $95.19.
Cost indices for 2026
- Work (national = 1.000)
- 1.095
- Practice expense (national = 1.000)
- 1.410
- Malpractice (national = 1.000)
- 0.425
- ZIP codes CMS assigns to this locality
- 254
- Of those, split with another locality
- 2
30 common codes priced for San Francisco-Oakland-Berkeley (San Francisco/San Mateo/Alameda/Contra Costa County)
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 | $166.40 | $135.61 | $94.34 |
| 99213 | Visit or care management | $117.58 | $95.19 | $64.37 |
| 97110 | Physical therapy or rehabilitation | $35.91 | $29.06 | none |
| 97530 | Physical therapy or rehabilitation | $44.49 | $35.07 | none |
| 97112 | Physical therapy or rehabilitation | $40.56 | $32.73 | none |
| 97140 | Physical therapy or rehabilitation | $34.24 | $27.72 | none |
| 17003 | Skin and soft tissue procedure | $8.53 | $6.35 | $1.93 |
| 88305 | Lab test or pathology | $90.56 | $70.14 | none |
| 93010 | Heart test or procedure | $9.66 | $8.35 | $9.66 |
| 99309 | Visit or care management | $136.73 | $114.57 | $114.12 |
| 99215 | Visit or care management | $234.90 | $192.39 | $140.71 |
| 98941 | Manipulation | $46.57 | $38.41 | $31.97 |
| 71045 | Imaging | $33.24 | $25.38 | none |
| 99204 | Visit or care management | $214.82 | $177.36 | $129.58 |
| 99308 | Visit or care management | $94.84 | $78.83 | $79.29 |
| 93000 | Heart test or procedure | $19.22 | $15.36 | none |
| 92014 | Eye exam or test | $163.18 | $127.26 | $71.34 |
| 99203 | Visit or care management | $143.68 | $117.57 | $78.69 |
| 95004 | Allergy testing or treatment | $4.75 | $3.67 | none |
| 92134 | Eye exam or test | $42.23 | $32.73 | none |
| 96372 | Infusion, injection or chemotherapy | $19.55 | $15.36 | none |
| 99490 | Visit or care management | $80.42 | $66.13 | $48.87 |
| 90837 | Mental health service | $195.05 | $167.00 | $150.31 |
| 93306 | Heart test or procedure | $259.82 | $196.73 | none |
| 99212 | Visit or care management | $74.49 | $59.45 | $34.46 |
| 71046 | Imaging | $43.76 | $33.07 | none |
| 17000 | Skin and soft tissue procedure | $85.54 | $66.47 | $59.16 |
| 77067 | Imaging | $168.59 | $126.26 | none |
| 95165 | Allergy testing or treatment | $23.53 | $17.37 | $2.81 |
| 77063 | Imaging | $64.86 | $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.
Other localities in California
- Bakersfield
- Chico
- El Centro
- Fresno
- Hanford-Corcoran
- Los Angeles-Long Beach-Anaheim (Los Angeles/Orange County)
- Madera
- Merced
- Modesto
- Napa
- Oxnard-Thousand Oaks-Ventura
- Redding
- Rest of California
- Riverside-San Bernardino-Ontario
- Sacramento-Roseville-Folsom
- Salinas
- San Diego-Chula Vista-Carlsbad
- San Francisco-Oakland-Berkeley (Marin County)
- San Jose-Sunnyvale-Santa Clara (San Benito County)
- San Jose-Sunnyvale-Santa Clara (Santa Clara County)
- San Luis Obispo-Paso Robles
- Santa Cruz-Watsonville
- Santa Maria-Santa Barbara
- Santa Rosa-Petaluma
- Stockton
- Vallejo
- Visalia
- Yuba City