Medicare's 2026 rates in San Jose-Sunnyvale-Santa Clara (San Benito County), California
Medicare payment locality 65, run by contractor 01112, covers these counties: San Benito. Its cost indices put code 99213, billed from an office, at $120.13, 26.2% above the national $95.19.
Cost indices for 2026
- Work (national = 1.000)
- 1.110
- Practice expense (national = 1.000)
- 1.442
- Malpractice (national = 1.000)
- 0.536
- ZIP codes CMS assigns to this locality
- 6
- Of those, split with another locality
- 1
30 common codes priced for San Jose-Sunnyvale-Santa Clara (San Benito 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 | $170.02 | $135.61 | $96.33 |
| 99213 | Visit or care management | $120.13 | $95.19 | $65.70 |
| 97110 | Physical therapy or rehabilitation | $36.61 | $29.06 | none |
| 97530 | Physical therapy or rehabilitation | $45.39 | $35.07 | none |
| 97112 | Physical therapy or rehabilitation | $41.35 | $32.73 | none |
| 97140 | Physical therapy or rehabilitation | $34.91 | $27.72 | none |
| 17003 | Skin and soft tissue procedure | $8.71 | $6.35 | $1.96 |
| 88305 | Lab test or pathology | $92.44 | $70.14 | none |
| 93010 | Heart test or procedure | $9.85 | $8.35 | $9.85 |
| 99309 | Visit or care management | $139.68 | $114.57 | $116.56 |
| 99215 | Visit or care management | $240.02 | $192.39 | $143.69 |
| 98941 | Manipulation | $47.43 | $38.41 | $32.50 |
| 71045 | Imaging | $34.00 | $25.38 | none |
| 99204 | Visit or care management | $219.66 | $177.36 | $132.48 |
| 99308 | Visit or care management | $96.83 | $78.83 | $80.94 |
| 93000 | Heart test or procedure | $19.67 | $15.36 | none |
| 92014 | Eye exam or test | $166.55 | $127.26 | $72.63 |
| 99203 | Visit or care management | $146.95 | $117.57 | $80.49 |
| 95004 | Allergy testing or treatment | $4.88 | $3.67 | none |
| 92134 | Eye exam or test | $43.16 | $32.73 | none |
| 96372 | Infusion, injection or chemotherapy | $19.97 | $15.36 | none |
| 99490 | Visit or care management | $82.16 | $66.13 | $49.89 |
| 90837 | Mental health service | $198.30 | $167.00 | $152.54 |
| 93306 | Heart test or procedure | $265.52 | $196.73 | none |
| 99212 | Visit or care management | $76.15 | $59.45 | $35.21 |
| 71046 | Imaging | $44.75 | $33.07 | none |
| 17000 | Skin and soft tissue procedure | $87.49 | $66.47 | $60.52 |
| 77067 | Imaging | $172.34 | $126.26 | none |
| 95165 | Allergy testing or treatment | $24.08 | $17.37 | $2.89 |
| 77063 | Imaging | $66.24 | $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
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