Medicare's 2026 rates in San Jose-Sunnyvale-Santa Clara (Santa Clara County), California
Medicare payment locality 09, run by contractor 01112, covers these counties: Santa Clara. Its cost indices put code 99213, billed from an office, at $119.71, 25.8% 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)
- 0.397
- ZIP codes CMS assigns to this locality
- 116
- Of those, split with another locality
- 2
30 common codes priced for San Jose-Sunnyvale-Santa Clara (Santa Clara 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 | $169.37 | $135.61 | $95.68 |
| 99213 | Visit or care management | $119.71 | $95.19 | $65.29 |
| 97110 | Physical therapy or rehabilitation | $36.56 | $29.06 | none |
| 97530 | Physical therapy or rehabilitation | $45.34 | $35.07 | none |
| 97112 | Physical therapy or rehabilitation | $41.31 | $32.73 | none |
| 97140 | Physical therapy or rehabilitation | $34.86 | $27.72 | none |
| 17003 | Skin and soft tissue procedure | $8.71 | $6.35 | $1.96 |
| 88305 | Lab test or pathology | $92.35 | $70.14 | none |
| 93010 | Heart test or procedure | $9.81 | $8.35 | $9.81 |
| 99309 | Visit or care management | $139.03 | $114.57 | $115.91 |
| 99215 | Visit or care management | $239.05 | $192.39 | $142.72 |
| 98941 | Manipulation | $47.39 | $38.41 | $32.46 |
| 71045 | Imaging | $33.91 | $25.38 | none |
| 99204 | Visit or care management | $218.54 | $177.36 | $131.37 |
| 99308 | Visit or care management | $96.46 | $78.83 | $80.56 |
| 93000 | Heart test or procedure | $19.57 | $15.36 | none |
| 92014 | Eye exam or test | $166.36 | $127.26 | $72.44 |
| 99203 | Visit or care management | $146.21 | $117.57 | $79.74 |
| 95004 | Allergy testing or treatment | $4.84 | $3.67 | none |
| 92134 | Eye exam or test | $43.07 | $32.73 | none |
| 96372 | Infusion, injection or chemotherapy | $19.92 | $15.36 | none |
| 99490 | Visit or care management | $81.83 | $66.13 | $49.56 |
| 90837 | Mental health service | $198.21 | $167.00 | $152.45 |
| 93306 | Heart test or procedure | $265.15 | $196.73 | none |
| 99212 | Visit or care management | $75.88 | $59.45 | $34.94 |
| 71046 | Imaging | $44.66 | $33.07 | none |
| 17000 | Skin and soft tissue procedure | $87.21 | $66.47 | $60.24 |
| 77067 | Imaging | $172.11 | $126.26 | none |
| 95165 | Allergy testing or treatment | $24.03 | $17.37 | $2.84 |
| 77063 | Imaging | $66.10 | $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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