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California Medicare fee schedule 2026: 29 payment localities

California is split into 29 Medicare payment localities, each with its own 2026 geographic practice cost indices. This page compares them, shows what the same codes pay in each, and lists the statewide DMEPOS amounts; every locality has its own page with its counties and full ZIP code list.

Compiled from CMS files by the QuickIntell RCM Editorial Team · Data effective · Method: reference methodology · Report a data correction

Data currency: PFS GPCIs, anesthesia conversion factors and localities: CY2026 Addendum E (RVU26D) (effective January 1, 2026); PFS relative value file: RVU26D, released August 26, 2026 (effective October 1, 2026); ZIP code to carrier locality file: ZIP5 October 2026 (file updated August 13, 2026) (effective October 1, 2026); DMEPOS fee schedule: DME26-D (October 2026) (effective October 1, 2026). Next CMS release: CY2027 PFS final rule (November 2026), effective January 1, 2027 for the PFS GPCIs, anesthesia conversion factors and localities; RVU27A with the CY2027 PFS final rule, effective January 1, 2027 for the PFS relative value file; January 1, 2027 (quarterly update) for the ZIP code to carrier locality file and DMEPOS fee schedule.

TL;DR

California has 29 Medicare payment localities for 2026: Bakersfield (01112-54), Chico (01112-55), El Centro (01182-71), Fresno (01112-56), Hanford-Corcoran (01112-57), Los Angeles-Long Beach-Anaheim (Los Angeles/Orange County) (01182-18), Madera (01112-58), Merced (01112-59), Modesto (01112-60), Napa (01112-51), Oxnard-Thousand Oaks-Ventura (01182-17), Redding (01112-61), Riverside-San Bernardino-Ontario (01112-62), Sacramento-Roseville-Folsom (01112-63), Salinas (01112-64), San Diego-Chula Vista-Carlsbad (01182-72), San Francisco-Oakland-Berkeley (Marin County) (01112-52), San Francisco-Oakland-Berkeley (San Francisco/San Mateo/Alameda/Contra Costa County) (01112-05), San Jose-Sunnyvale-Santa Clara (San Benito County) (01112-65), San Jose-Sunnyvale-Santa Clara (Santa Clara County) (01112-09), San Luis Obispo-Paso Robles (01182-73), Santa Cruz-Watsonville (01112-66), Santa Maria-Santa Barbara (01182-74), Santa Rosa-Petaluma (01112-67), Stockton (01112-68), Vallejo (01112-53), Visalia (01112-69), Yuba City (01112-70) and Rest of California (01112-75). The geographic adjustment factor runs from 1.032 in Rest of California to 1.234 in San Jose-Sunnyvale-Santa Clara (San Benito County), so 99213 in an office pays $99.22 in Rest of California and $120.13 in San Jose-Sunnyvale-Santa Clara (San Benito County). The localities cover 2,730 ZIP codes, 561 of them rural or super rural in the CMS ZIP file, and Noridian Healthcare Solutions, LLC processes the Part B claims.

California localities at a glance

Payment localities
29
Noridian Healthcare Solutions, LLC
GAF range
1.032 to 1.234
+19.6% from lowest to highest
ZIP codes
2,730
336 rural, 225 super rural
DMEPOS rural ZIP codes
359
on the quarter 4 2026 list

The 29 localities and their 2026 GPCIs

Medicare payment localities in California with 2026 GPCIs, GAF and counties
Locality and countiesWorkPEMPGAF
San Jose-Sunnyvale-Santa Clara (San Benito County) 01112-65San Benito · 6 ZIP codes1.1101.4420.5361.234
San Jose-Sunnyvale-Santa Clara (Santa Clara County) 01112-09Santa Clara · 116 ZIP codes1.1101.4420.3971.228
San Francisco-Oakland-Berkeley (Marin County) 01112-52Marin · 41 ZIP codes1.0951.4100.4591.209
San Francisco-Oakland-Berkeley (San Francisco/San Mateo/Alameda/Contra Costa County) 01112-05San Francisco/Alameda/Contra Costa/San Mateo · 254 ZIP codes1.0951.4100.4251.207
Napa 01112-51Napa · 12 ZIP codes1.0631.3180.5081.154
Vallejo 01112-53Solano · 16 ZIP codes1.0631.3180.4591.151
Santa Rosa-Petaluma 01112-67Sonoma · 51 ZIP codes1.0301.2280.5361.098
Los Angeles-Long Beach-Anaheim (Los Angeles/Orange County) 01182-18Los Angeles/Orange County · 691 ZIP codes1.0411.1830.6641.088
Santa Cruz-Watsonville 01112-66Santa Cruz · 21 ZIP codes1.0211.2150.5361.087
San Diego-Chula Vista-Carlsbad 01182-72San Diego · 190 ZIP codes1.0301.1960.5421.083
Oxnard-Thousand Oaks-Ventura 01182-17Ventura · 48 ZIP codes1.0281.1820.6231.080
Sacramento-Roseville-Folsom 01112-63Sacramento, Placer, Yolo, El Dorado · 219 ZIP codes1.0361.1630.5361.071
Santa Maria-Santa Barbara 01182-74Santa Barbara · 41 ZIP codes1.0281.1660.5361.069
Salinas 01112-64Monterey · 34 ZIP codes1.0311.1590.5361.067
San Luis Obispo-Paso Robles 01182-73San Luis Obispo · 36 ZIP codes1.0171.1390.5361.051
Riverside-San Bernardino-Ontario 01112-62San Bernardino, Riverside · 228 ZIP codes1.0181.0960.8531.046
Bakersfield 01112-54Kern · 70 ZIP codes1.0191.0960.6091.036
Chico 01112-55Butte · 24 ZIP codes1.0171.0960.5361.032
El Centro 01182-71Imperial · 17 ZIP codes1.0171.0960.5411.032
Fresno 01112-56Fresno · 105 ZIP codes1.0171.0960.5361.032
Hanford-Corcoran 01112-57Kings · 10 ZIP codes1.0171.0960.5361.032
Madera 01112-58Madera · 13 ZIP codes1.0171.0960.5361.032
Merced 01112-59Merced · 23 ZIP codes1.0171.0960.5361.032
Modesto 01112-60Stanislaus · 29 ZIP codes1.0171.0960.5361.032
Redding 01112-61Shasta · 33 ZIP codes1.0171.0960.5361.032
Stockton 01112-68San Joaquin · 46 ZIP codes1.0171.0960.5361.032
Visalia 01112-69Tulare · 41 ZIP codes1.0171.0960.5361.032
Yuba City 01112-70Sutter, Yuba · 22 ZIP codes1.0171.0960.5361.032
Rest of California 01112-75All Other Counties · 293 ZIP codes1.0171.0960.5361.032

A service is priced at the locality where it is furnished, which CMS resolves from the ZIP code of the service location, not from where the patient lives or where the practice is headquartered. A group with offices in several California localities is therefore paid different amounts for the same code; each locality page lists its ZIP codes.

The same codes across California

Non-facility amounts at the 2026 non-QP conversion factor for the global service; CPT numbers are shown without descriptors. The spread between the first and last row is the geographic adjustment alone, since the RVUs and the conversion factor are the same statewide.

2026 Medicare office payments for example codes in each California locality
Locality9921399214G2211G0439G040220610
San Jose-Sunnyvale-Santa Clara (San Benito County)$120.13$170.02$20.78$173.21$217.92$86.75
San Jose-Sunnyvale-Santa Clara (Santa Clara County)$119.71$169.37$20.69$172.61$217.13$86.14
San Francisco-Oakland-Berkeley (Marin County)$117.69$166.56$20.38$169.70$213.55$84.79
San Francisco-Oakland-Berkeley (San Francisco/San Mateo/Alameda/Contra Costa County)$117.58$166.40$20.36$169.55$213.36$84.64
Napa$111.96$158.59$19.54$161.50$203.49$80.61
Vallejo$111.81$158.36$19.51$161.29$203.21$80.40
Santa Rosa-Petaluma$106.22$150.59$18.68$153.28$193.39$76.40
Los Angeles-Long Beach-Anaheim (Los Angeles/Orange County)$104.89$148.89$18.64$151.43$191.38$75.49
Santa Cruz-Watsonville$105.19$149.15$18.51$151.81$191.54$75.66
San Diego-Chula Vista-Carlsbad$104.68$148.48$18.51$151.10$190.80$75.18
Oxnard-Thousand Oaks-Ventura$104.15$147.80$18.46$150.35$189.93$74.94
Sacramento-Roseville-Folsom$103.31$146.64$18.38$149.18$188.57$74.03
Santa Maria-Santa Barbara$103.11$146.32$18.31$148.87$188.12$73.94
Salinas$102.90$146.05$18.30$148.58$187.81$73.75
San Luis Obispo-Paso Robles$101.31$143.81$18.04$146.30$184.95$72.61
Riverside-San Bernardino-Ontario$100.21$142.49$18.01$144.77$183.30$72.35
Bakersfield$99.52$141.41$17.86$143.77$182.00$71.32
Chico$99.22$140.94$17.79$143.32$181.42$70.95
El Centro$99.23$140.96$17.79$143.35$181.44$70.97
Fresno$99.22$140.94$17.79$143.32$181.42$70.95
Hanford-Corcoran$99.22$140.94$17.79$143.32$181.42$70.95
Madera$99.22$140.94$17.79$143.32$181.42$70.95
Merced$99.22$140.94$17.79$143.32$181.42$70.95
Modesto$99.22$140.94$17.79$143.32$181.42$70.95
Redding$99.22$140.94$17.79$143.32$181.42$70.95
Stockton$99.22$140.94$17.79$143.32$181.42$70.95
Visalia$99.22$140.94$17.79$143.32$181.42$70.95
Yuba City$99.22$140.94$17.79$143.32$181.42$70.95
Rest of California$99.22$140.94$17.79$143.32$181.42$70.95

DMEPOS amounts in California

Durable medical equipment, prosthetics, orthotics and supplies are not priced by locality. The October 2026 DMEPOS fee schedule (DME26-D) sets one non-rural and one rural amount per code for the whole state, and the rural amount applies only in the ZIP codes on the quarterly DMEPOS rural list. The table shows the California amounts for common items next to the lowest and highest non-rural amount among the contiguous states; HCPCS Level II descriptors are CMS's.

DMEPOS fee schedule amounts in California, October 2026
CodeItemNon-ruralRuralContiguous states
E0601-RRContinuous positive airway pressure (cpap) devicecapped rental, monthly rental$50.44$93.04$50.04 to $52.65
E0260-RRHospital bed, semi-electric (head and foot adjustment), with any type side rails, with mattresscapped rental, monthly rental$74.66$128.14$72.80 to $78.16
K0001-RRStandard wheelchaircapped rental, monthly rental$27.96$53.64$25.23 to $31.07
E0143-NUWalker, folding, wheeled, adjustable or fixed heightinexpensive or routinely purchased, purchased new$59.18$101.17$55.55 to $60.89
E0114-NUCrutches underarm, other than wood, adjustable or fixed, pair, with pads, tips and handgripsinexpensive or routinely purchased, purchased new$67.26—$57.17 to $67.26
A4253-NUBlood glucose test or reagent strips for home blood glucose monitor, per 50 stripsinexpensive or routinely purchased, purchased new$8.32—$8.32 in every state
L1833Knee orthosis, adjustable knee joints (unicentric or polycentric), positional orthosis, rigid support, prefabricated, off-the shelfprosthetics and orthotics$455.16$695.27$455.16 to $556.31
E0784-RRExternal ambulatory infusion pump, insulincapped rental, monthly rental$557.75$576.36$557.75 in every state
Former competitive bidding areas use CMS's separate former CBA fee schedule for the items it lists; see the DMEPOS fee schedule page.

Contractor, coverage and other payment systems

Part B claims in California are processed by Noridian Healthcare Solutions, LLC, whose local coverage determinations decide which services are covered and with which diagnoses. The locality adjusts only physician fee schedule payments. Clinical laboratory tests are paid at one national amount from the Clinical Laboratory Fee Schedule, hospital outpatient services through APCs adjusted by each hospital's wage index rather than by these indices, and Part B drugs at the national ASP payment limits. QuickIntell's California page covers the state's payers and revenue-cycle requirements.

Where QuickIntell fits for California practices

Contract management in QuickRCM keeps payer contracts and fee schedules with their effective dates and compares expected reimbursement against allowed amounts, so a claim priced at the wrong locality, or with last year's indices, is reviewed before a dispute is opened.

See contract management in QuickRCMSee QuickRCMBook a meeting

Frequently asked questions

How many Medicare localities are in California?

29 for 2026: San Jose-Sunnyvale-Santa Clara (San Benito County) (locality 01112-65, GAF 1.234), San Jose-Sunnyvale-Santa Clara (Santa Clara County) (locality 01112-09, GAF 1.228), San Francisco-Oakland-Berkeley (Marin County) (locality 01112-52, GAF 1.209), San Francisco-Oakland-Berkeley (San Francisco/San Mateo/Alameda/Contra Costa County) (locality 01112-05, GAF 1.207), Napa (locality 01112-51, GAF 1.154), Vallejo (locality 01112-53, GAF 1.151), Santa Rosa-Petaluma (locality 01112-67, GAF 1.098), Los Angeles-Long Beach-Anaheim (Los Angeles/Orange County) (locality 01182-18, GAF 1.088), Santa Cruz-Watsonville (locality 01112-66, GAF 1.087), San Diego-Chula Vista-Carlsbad (locality 01182-72, GAF 1.083), Oxnard-Thousand Oaks-Ventura (locality 01182-17, GAF 1.080), Sacramento-Roseville-Folsom (locality 01112-63, GAF 1.071), Santa Maria-Santa Barbara (locality 01182-74, GAF 1.069), Salinas (locality 01112-64, GAF 1.067), San Luis Obispo-Paso Robles (locality 01182-73, GAF 1.051), Riverside-San Bernardino-Ontario (locality 01112-62, GAF 1.046), Bakersfield (locality 01112-54, GAF 1.036), Chico (locality 01112-55, GAF 1.032), El Centro (locality 01182-71, GAF 1.032), Fresno (locality 01112-56, GAF 1.032), Hanford-Corcoran (locality 01112-57, GAF 1.032), Madera (locality 01112-58, GAF 1.032), Merced (locality 01112-59, GAF 1.032), Modesto (locality 01112-60, GAF 1.032), Redding (locality 01112-61, GAF 1.032), Stockton (locality 01112-68, GAF 1.032), Visalia (locality 01112-69, GAF 1.032), Yuba City (locality 01112-70, GAF 1.032) and Rest of California (locality 01112-75, GAF 1.032). Rest of California covers every county not named for another locality.

Which California locality pays the most?

San Jose-Sunnyvale-Santa Clara (San Benito County), with a geographic adjustment factor of 1.234 (work 1.110, practice expense 1.442, malpractice 0.536). The lowest is Rest of California at 1.032, so the same service pays about 19.6% more in San Jose-Sunnyvale-Santa Clara (San Benito County).

Which counties are in each California locality?

San Jose-Sunnyvale-Santa Clara (San Benito County): San Benito. San Jose-Sunnyvale-Santa Clara (Santa Clara County): Santa Clara. San Francisco-Oakland-Berkeley (Marin County): Marin. San Francisco-Oakland-Berkeley (San Francisco/San Mateo/Alameda/Contra Costa County): San Francisco/Alameda/Contra Costa/San Mateo. Napa: Napa. Vallejo: Solano. Santa Rosa-Petaluma: Sonoma. Los Angeles-Long Beach-Anaheim (Los Angeles/Orange County): Los Angeles/Orange County. Santa Cruz-Watsonville: Santa Cruz. San Diego-Chula Vista-Carlsbad: San Diego. Oxnard-Thousand Oaks-Ventura: Ventura. Sacramento-Roseville-Folsom: Sacramento, Placer, Yolo, El Dorado. Santa Maria-Santa Barbara: Santa Barbara. Salinas: Monterey. San Luis Obispo-Paso Robles: San Luis Obispo. Riverside-San Bernardino-Ontario: San Bernardino, Riverside. Bakersfield: Kern. Chico: Butte. El Centro: Imperial. Fresno: Fresno. Hanford-Corcoran: Kings. Madera: Madera. Merced: Merced. Modesto: Stanislaus. Redding: Shasta. Stockton: San Joaquin. Visalia: Tulare. Yuba City: Sutter, Yuba. Rest of California: All Other Counties.

Does the DMEPOS fee schedule use the same California localities?

No. DMEPOS amounts are statewide, with a non-rural and a rural amount for each code; E0601-RR is $50.44 non-rural in California and $93.04 rural in October 2026, whichever physician fee schedule locality the beneficiary lives in.

More on Medicare localities

Every locality and the ZIP code finder are on the Medicare payment localities hub; the national GPCI table with anesthesia conversion factors is on the physician fee schedule page, and the fee schedules hub maps which CMS schedule pays which claim.

Sources

Every figure on this page is taken from the CMS publications below, as released by the Centers for Medicare & Medicaid Services. Projection built 2026-10-10. Verify against the primary file before billing or contracting decisions. The reference methodology explains how each figure is computed from these files.

Disclaimer

Operational reference compiled from CMS physician fee schedule and DMEPOS public use files. Amounts are Medicare fee schedule amounts before the deductible, coinsurance, sequestration and claim-level reductions; Medicare Advantage and commercial contracts set their own rates. CPT codes appear as bare numbers; CPT descriptors are copyright AMA. Not legal, coding or billing advice.

Found a figure that does not match the CMS file? Report a data correction with the CMS file and the value you expected; the request reaches the editorial team through the contact form.