FeeBase
Log inGet started
Menu
On this page

CMS RVU26D · Effective 2026-10-01

43249 in Modesto

Office / nonfacility

$1281.23

Base rate per service

Facility setting

$136.89

Base rate per service

Amounts below use the non-QP conversion factor for participating physicians. These are base physician payments before claim-level adjustments, not patient costs or total hospital charges.

The same code, a different location

How does Modesto compare?

In Bakersfield, the office rate for 43249 is $1282.14—$0.91 higher than the $1281.23 rate in Modesto. Both use the same code, release and participation basis.

43249 across payment areas

Same release and payment basis · bars start at $0

  1. Modesto · This locality

    $1281.23

  2. Bakersfield

    $1282.14

    $0.91 higher than Modesto

  3. Chico

    $1281.23

    The same base rate than Modesto

  4. El Centro

    $1281.28

    $0.05 higher than Modesto

  5. Fresno

    $1281.23

    The same base rate than Modesto

  6. Hanford-Corcoran

    $1281.23

    The same base rate than Modesto

  7. Los Angeles-Long Beach-Anaheim (Los Angeles/Orange Cnty)

    $1378.87

    $97.64 higher than Modesto

Other payment areas listed in California appear first, followed by selected cross-country examples. The chart compares amounts, not distance.

Across 109 of 109 CMS payment localities with a supported office rate, 43249 ranges from $1022.75 in Arkansas to $1664.21 in San Jose-Sunnyvale-Santa Clara (San Benito Cnty). This is a geographic range, not an average.

The code’s RVUs stay the same in these comparisons. Geographic adjustments to work, practice expense and malpractice change the dollar amount. A city name alone may not identify the payment area for a service address.

Compare all 108 other payment areas

  • Madera

    California · 43249

    Office

    $1281.23

    Facility

    $136.89

    The same base rate than Modesto for the office setting.

  • Merced

    California · 43249

    Office

    $1281.23

    Facility

    $136.89

    The same base rate than Modesto for the office setting.

  • Napa

    California · 43249

    Office

    $1525.49

    Facility

    $149.35

    $244.26 higher than Modesto for the office setting.

  • Oxnard-Thousand Oaks-Ventura

    California · 43249

    Office

    $1376.24

    Facility

    $142.10

    $95.01 higher than Modesto for the office setting.

  • Redding

    California · 43249

    Office

    $1281.23

    Facility

    $136.89

    The same base rate than Modesto for the office setting.

  • Rest Of California

    California · 43249

    Office

    $1281.23

    Facility

    $136.89

    The same base rate than Modesto for the office setting.

  • Riverside-San Bernardino-Ontario

    California · 43249

    Office

    $1284.50

    Facility

    $140.15

    $3.27 higher than Modesto for the office setting.

  • Sacramento-Roseville-Folsom

    California · 43249

    Office

    $1355.48

    Facility

    $141.18

    $74.25 higher than Modesto for the office setting.

  • Salinas

    California · 43249

    Office

    $1350.71

    Facility

    $140.59

    $69.48 higher than Modesto for the office setting.

  • San Diego-Chula Vista-Carlsbad

    California · 43249

    Office

    $1390.77

    Facility

    $142.02

    $109.54 higher than Modesto for the office setting.

  • San Francisco-Oakland-Berkeley (Marin Cnty)

    California · 43249

    Office

    $1627.46

    Facility

    $155.26

    $346.23 higher than Modesto for the office setting.

  • San Francisco-Oakland-Berkeley (San Francisco/San Mateo/Alameda/Contra Costa Cnty)

    California · 43249

    Office

    $1627.12

    Facility

    $154.92

    $345.89 higher than Modesto for the office setting.

  • San Jose-Sunnyvale-Santa Clara (San Benito Cnty)

    California · 43249

    Office

    $1664.21

    Facility

    $158.60

    $382.98 higher than Modesto for the office setting.

  • San Jose-Sunnyvale-Santa Clara (Santa Clara Cnty)

    California · 43249

    Office

    $1662.82

    Facility

    $157.21

    $381.59 higher than Modesto for the office setting.

  • San Luis Obispo-Paso Robles

    California · 43249

    Office

    $1327.82

    Facility

    $138.58

    $46.59 higher than Modesto for the office setting.

  • Santa Cruz-Watsonville

    California · 43249

    Office

    $1410.52

    Facility

    $141.92

    $129.29 higher than Modesto for the office setting.

  • Santa Maria-Santa Barbara

    California · 43249

    Office

    $1358.04

    Facility

    $140.60

    $76.81 higher than Modesto for the office setting.

  • Santa Rosa-Petaluma

    California · 43249

    Office

    $1425.39

    Facility

    $143.22

    $144.16 higher than Modesto for the office setting.

  • Stockton

    California · 43249

    Office

    $1281.23

    Facility

    $136.89

    The same base rate than Modesto for the office setting.

  • Vallejo

    California · 43249

    Office

    $1525.00

    Facility

    $148.86

    $243.77 higher than Modesto for the office setting.

  • Visalia

    California · 43249

    Office

    $1281.23

    Facility

    $136.89

    The same base rate than Modesto for the office setting.

  • Yuba City

    California · 43249

    Office

    $1281.23

    Facility

    $136.89

    The same base rate than Modesto for the office setting.

  • Dc + Md/Va Suburbs

    District of Columbia · 43249

    Office

    $1379.08

    Facility

    $149.11

    $97.85 higher than Modesto for the office setting.

  • Miami

    Florida · 43249

    Office

    $1240.13

    Facility

    $153.21

    $41.10 lower than Modesto for the office setting.

  • Chicago

    Illinois · 43249

    Office

    $1199.39

    Facility

    $150.06

    $81.84 lower than Modesto for the office setting.

  • Manhattan

    New York · 43249

    Office

    $1367.35

    Facility

    $154.09

    $86.12 higher than Modesto for the office setting.

  • Alaska*

    Alaska · 43249

    Office

    $1289.74

    Facility

    $177.76

    $8.51 higher than Modesto for the office setting.

  • Alabama

    Alabama · 43249

    Office

    $1040.60

    Facility

    $127.00

    $240.63 lower than Modesto for the office setting.

  • Arkansas

    Arkansas · 43249

    Office

    $1022.75

    Facility

    $125.86

    $258.48 lower than Modesto for the office setting.

  • Arizona

    Arizona · 43249

    Office

    $1145.36

    Facility

    $133.61

    $135.87 lower than Modesto for the office setting.

  • Colorado

    Colorado · 43249

    Office

    $1248.58

    Facility

    $137.65

    $32.65 lower than Modesto for the office setting.

  • Connecticut

    Connecticut · 43249

    Office

    $1267.66

    Facility

    $143.15

    $13.57 lower than Modesto for the office setting.

  • Delaware

    Delaware · 43249

    Office

    $1166.81

    Facility

    $135.22

    $114.42 lower than Modesto for the office setting.

  • Fort Lauderdale

    Florida · 43249

    Office

    $1202.57

    Facility

    $144.88

    $78.66 lower than Modesto for the office setting.

  • Rest Of Florida

    Florida · 43249

    Office

    $1137.75

    Facility

    $139.58

    $143.48 lower than Modesto for the office setting.

  • Atlanta

    Georgia · 43249

    Office

    $1200.00

    Facility

    $139.18

    $81.23 lower than Modesto for the office setting.

  • Rest Of Georgia

    Georgia · 43249

    Office

    $1065.29

    Facility

    $133.94

    $215.94 lower than Modesto for the office setting.

  • Hawaii, Guam

    Hawaii · 43249

    Office

    $1324.61

    Facility

    $137.46

    $43.38 higher than Modesto for the office setting.

  • Iowa

    Iowa · 43249

    Office

    $1082.25

    Facility

    $126.88

    $198.98 lower than Modesto for the office setting.

  • Idaho

    Idaho · 43249

    Office

    $1088.43

    Facility

    $127.84

    $192.80 lower than Modesto for the office setting.

  • East St. Louis

    Illinois · 43249

    Office

    $1103.87

    Facility

    $143.28

    $177.36 lower than Modesto for the office setting.

  • Rest Of Illinois

    Illinois · 43249

    Office

    $1091.76

    Facility

    $138.49

    $189.47 lower than Modesto for the office setting.

  • Suburban Chicago

    Illinois · 43249

    Office

    $1217.99

    Facility

    $145.68

    $63.24 lower than Modesto for the office setting.

  • Indiana

    Indiana · 43249

    Office

    $1096.14

    Facility

    $128.25

    $185.09 lower than Modesto for the office setting.

  • Kansas

    Kansas · 43249

    Office

    $1071.40

    Facility

    $127.52

    $209.83 lower than Modesto for the office setting.

  • Kentucky

    Kentucky · 43249

    Office

    $1059.26

    Facility

    $131.05

    $221.97 lower than Modesto for the office setting.

  • New Orleans

    Louisiana · 43249

    Office

    $1117.82

    Facility

    $135.31

    $163.41 lower than Modesto for the office setting.

  • Rest Of Louisiana

    Louisiana · 43249

    Office

    $1055.36

    Facility

    $131.32

    $225.87 lower than Modesto for the office setting.

  • Metropolitan Boston

    Massachusetts · 43249

    Office

    $1393.05

    Facility

    $146.38

    $111.82 higher than Modesto for the office setting.

  • Rest Of Massachusetts

    Massachusetts · 43249

    Office

    $1237.17

    Facility

    $137.72

    $44.06 lower than Modesto for the office setting.

  • Baltimore/Surr. Cntys

    Maryland · 43249

    Office

    $1263.25

    Facility

    $142.92

    $17.98 lower than Modesto for the office setting.

  • Rest Of Maryland

    Maryland · 43249

    Office

    $1193.44

    Facility

    $136.80

    $87.79 lower than Modesto for the office setting.

  • Rest Of Maine

    Maine · 43249

    Office

    $1089.92

    Facility

    $129.33

    $191.31 lower than Modesto for the office setting.

  • Southern Maine

    Maine · 43249

    Office

    $1166.94

    Facility

    $132.22

    $114.29 lower than Modesto for the office setting.

  • Detroit

    Michigan · 43249

    Office

    $1149.34

    Facility

    $141.77

    $131.89 lower than Modesto for the office setting.

  • Rest Of Michigan

    Michigan · 43249

    Office

    $1087.41

    Facility

    $134.14

    $193.82 lower than Modesto for the office setting.

  • Minnesota

    Minnesota · 43249

    Office

    $1204.76

    Facility

    $130.36

    $76.47 lower than Modesto for the office setting.

  • Metropolitan Kansas City

    Missouri · 43249

    Office

    $1114.06

    Facility

    $133.64

    $167.17 lower than Modesto for the office setting.

  • Metropolitan St. Louis

    Missouri · 43249

    Office

    $1128.40

    Facility

    $134.40

    $152.83 lower than Modesto for the office setting.

  • Rest Of Missouri

    Missouri · 43249

    Office

    $1030.60

    Facility

    $130.58

    $250.63 lower than Modesto for the office setting.

  • Mississippi

    Mississippi · 43249

    Office

    $1027.16

    Facility

    $128.18

    $254.07 lower than Modesto for the office setting.

  • Montana**

    Montana · 43249

    Office

    $1180.37

    Facility

    $136.26

    $100.86 lower than Modesto for the office setting.

  • North Carolina

    North Carolina · 43249

    Office

    $1104.17

    Facility

    $130.02

    $177.06 lower than Modesto for the office setting.

  • North Dakota**

    North Dakota · 43249

    Office

    $1174.44

    Facility

    $130.32

    $106.79 lower than Modesto for the office setting.

  • Nebraska

    Nebraska · 43249

    Office

    $1090.72

    Facility

    $127.01

    $190.51 lower than Modesto for the office setting.

  • New Hampshire

    New Hampshire · 43249

    Office

    $1223.56

    Facility

    $136.64

    $57.67 lower than Modesto for the office setting.

  • Northern Nj

    New Jersey · 43249

    Office

    $1359.90

    Facility

    $148.73

    $78.67 higher than Modesto for the office setting.

  • Rest Of New Jersey

    New Jersey · 43249

    Office

    $1284.52

    Facility

    $144.35

    $3.29 higher than Modesto for the office setting.

  • New Mexico

    New Mexico · 43249

    Office

    $1092.47

    Facility

    $135.02

    $188.76 lower than Modesto for the office setting.

  • Nevada**

    Nevada · 43249

    Office

    $1179.80

    Facility

    $134.64

    $101.43 lower than Modesto for the office setting.

  • Nyc Suburbs/Long Island

    New York · 43249

    Office

    $1399.32

    Facility

    $157.87

    $118.09 higher than Modesto for the office setting.

  • Poughkpsie/N Nyc Suburbs

    New York · 43249

    Office

    $1289.33

    Facility

    $146.03

    $8.10 higher than Modesto for the office setting.

  • Queens

    New York · 43249

    Office

    $1387.58

    Facility

    $153.44

    $106.35 higher than Modesto for the office setting.

  • Rest Of New York

    New York · 43249

    Office

    $1123.24

    Facility

    $131.33

    $157.99 lower than Modesto for the office setting.

  • Ohio

    Ohio · 43249

    Office

    $1086.20

    Facility

    $132.93

    $195.03 lower than Modesto for the office setting.

  • Oklahoma

    Oklahoma · 43249

    Office

    $1062.22

    Facility

    $129.82

    $219.01 lower than Modesto for the office setting.

  • Portland

    Oregon · 43249

    Office

    $1299.48

    Facility

    $139.47

    $18.25 higher than Modesto for the office setting.

  • Rest Of Oregon

    Oregon · 43249

    Office

    $1173.08

    Facility

    $133.14

    $108.15 lower than Modesto for the office setting.

  • Metropolitan Philadelphia

    Pennsylvania · 43249

    Office

    $1228.31

    Facility

    $141.39

    $52.92 lower than Modesto for the office setting.

  • Rest Of Pennsylvania

    Pennsylvania · 43249

    Office

    $1090.99

    Facility

    $132.49

    $190.24 lower than Modesto for the office setting.

  • Puerto Rico

    Puerto Rico · 43249

    Office

    $1192.16

    Facility

    $136.56

    $89.07 lower than Modesto for the office setting.

  • Rhode Island

    Rhode Island · 43249

    Office

    $1216.71

    Facility

    $138.14

    $64.52 lower than Modesto for the office setting.

  • South Carolina

    South Carolina · 43249

    Office

    $1096.54

    Facility

    $131.78

    $184.69 lower than Modesto for the office setting.

  • South Dakota**

    South Dakota · 43249

    Office

    $1173.73

    Facility

    $129.62

    $107.50 lower than Modesto for the office setting.

  • Tennessee

    Tennessee · 43249

    Office

    $1077.15

    Facility

    $128.05

    $204.08 lower than Modesto for the office setting.

  • Austin

    Texas · 43249

    Office

    $1242.26

    Facility

    $137.59

    $38.97 lower than Modesto for the office setting.

  • Beaumont

    Texas · 43249

    Office

    $1082.16

    Facility

    $132.02

    $199.07 lower than Modesto for the office setting.

  • Brazoria

    Texas · 43249

    Office

    $1169.13

    Facility

    $134.41

    $112.10 lower than Modesto for the office setting.

  • Dallas

    Texas · 43249

    Office

    $1175.41

    Facility

    $135.48

    $105.82 lower than Modesto for the office setting.

  • Fort Worth

    Texas · 43249

    Office

    $1164.71

    Facility

    $135.21

    $116.52 lower than Modesto for the office setting.

  • Galveston

    Texas · 43249

    Office

    $1171.77

    Facility

    $134.97

    $109.46 lower than Modesto for the office setting.

  • Houston

    Texas · 43249

    Office

    $1177.27

    Facility

    $140.46

    $103.96 lower than Modesto for the office setting.

  • Rest Of Texas

    Texas · 43249

    Office

    $1124.16

    Facility

    $133.29

    $157.07 lower than Modesto for the office setting.

  • Utah

    Utah · 43249

    Office

    $1114.35

    Facility

    $132.89

    $166.88 lower than Modesto for the office setting.

  • Virginia

    Virginia · 43249

    Office

    $1159.02

    Facility

    $132.66

    $122.21 lower than Modesto for the office setting.

  • Virgin Islands

    United States Virgin Islands · 43249

    Office

    $1192.16

    Facility

    $136.56

    $89.07 lower than Modesto for the office setting.

  • Vermont

    Vermont · 43249

    Office

    $1164.60

    Facility

    $130.93

    $116.63 lower than Modesto for the office setting.

  • Rest Of Washington

    Washington · 43249

    Office

    $1236.55

    Facility

    $137.10

    $44.68 lower than Modesto for the office setting.

  • Seattle (King Cnty)

    Washington · 43249

    Office

    $1428.86

    Facility

    $147.73

    $147.63 higher than Modesto for the office setting.

  • Wisconsin

    Wisconsin · 43249

    Office

    $1127.95

    Facility

    $127.69

    $153.28 lower than Modesto for the office setting.

  • West Virginia

    West Virginia · 43249

    Office

    $1042.76

    Facility

    $135.43

    $238.47 lower than Modesto for the office setting.

  • Wyoming**

    Wyoming · 43249

    Office

    $1177.78

    Facility

    $133.67

    $103.45 lower than Modesto for the office setting.

See how rates vary across the country

43249 · Office / nonfacility · Non-QP. Choose a state to explore its payment localities. A range means the amount varies within that state.

MEWIVTNHMTNDMNMINYMARIWAIDWYSDIAILINOHPANJCTORNVUTCONEMOKYWVVAMDDECAAZNMKSOKARTNNCSCDCTXLAMSALGAFLAKHI

Explore a state

Local rates. Clear comparisons.

Hover or focus a tile to see its rate range. Select it to open the state’s fee schedule.

$1,022.75

$1,472.72

Color shows the midpoint of each state’s locality range.

View all state and territory rates as a table
State / territoryRate rangeLocalities
AK$1,289.741
AL$1,040.601
AR$1,022.751
AZ$1,145.361
CA$1,281.23–$1,664.2129
CO$1,248.581
CT$1,267.661
DC$1,379.081
DE$1,166.811
FL$1,137.75–$1,240.133
GA$1,065.29–$1,200.002
GU$1,324.611
HI$1,324.611
IA$1,082.251
ID$1,088.431
IL$1,091.76–$1,217.994
IN$1,096.141
KS$1,071.401
KY$1,059.261
LA$1,055.36–$1,117.822
MA$1,237.17–$1,393.052
MD$1,193.44–$1,379.083
ME$1,089.92–$1,166.942
MI$1,087.41–$1,149.342
MN$1,204.761
MO$1,030.60–$1,128.403
MS$1,027.161
MT$1,180.371
NC$1,104.171
ND$1,174.441
NE$1,090.721
NH$1,223.561
NJ$1,284.52–$1,359.902
NM$1,092.471
NV$1,179.801
NY$1,123.24–$1,399.325
OH$1,086.201
OK$1,062.221
OR$1,173.08–$1,299.482
PA$1,090.99–$1,228.312
PR$1,192.161
RI$1,216.711
SC$1,096.541
SD$1,173.731
TN$1,077.151
TX$1,082.16–$1,242.268
UT$1,114.351
VA$1,159.02–$1,379.082
VI$1,192.161
VT$1,164.601
WA$1,236.55–$1,428.862
WI$1,127.951
WV$1,042.761
WY$1,177.781

Explore 43249 on the national rate map →

Where does this rate apply?

Modesto is a Medicare payment area. Our Census mapping connects it to 33 cities and communities in California, including the examples shown here.

Some communities span more than one payment area. Follow a city link to compare all of its mapped areas, or check the service-location ZIP above for an address-level starting point.

Browse all communities in California →

Why are the office and facility amounts different?

For 43249 in Modesto, the physician’s office rate is $1281.23 and the facility-setting rate is $136.89: a difference of $1144.34.

The calculation uses a different practice-expense RVU for each setting. Both amounts here are physician fee-schedule amounts. The facility figure does not include a hospital’s separate charges, so this comparison does not tell you the total cost of receiving care in each setting.

See the inputs behind this difference →

Use this rate

What is a percentage of Medicare worth?

Turn a percentage into dollars for 43249 in Modesto. This uses the base rate on this page, so the locality and release stay consistent.

Reference amount per service

$1409.35

$1281.23 × 110% = $1409.35

A contract may specify another Medicare year or additional adjustments. This is percentage arithmetic on the displayed base rate, not a claim adjudication.

Working with a whole code list?

Compare an offer across your annual code mix, including an older Medicare schedule or flat per-code rates.

Compare your contract offer →

How this local rate is calculated

Each RVU component is multiplied by its own geographic practice cost index (GPCI). The three adjusted components are added, then multiplied by the conversion factor. These are the inputs used for 43249 in Modesto.

PPRRVU2026_Oct_nonQPP.csv

5,177

Code
43249
Physician work
2.60
Practice expense
32.44
Malpractice
0.30

GPCI2026.csv

16

Locality
Modesto
Physician work
1.017
Practice expense
1.096
Malpractice
0.536
Office / nonfacility calculation for 43249 in Modesto
ComponentRVULocality factorAdjusted
Physician work2.60× 1.0172.6442
Practice expense32.44× 1.09635.5542
Malpractice0.30× 0.5360.1608
Total RVUs38.3592
Conversion factor× 33.4009

Office / nonfacility rate, Modesto$1281.23

Values as parsed from CMS release RVU26D, effective 2026-10-01. The amount is rounded to the nearest cent only at the end.

Open 43249 in the RVU calculator →

Explore RVUs, geographic factors and the full formula

Office / nonfacility

Office / nonfacility calculation inputs
ComponentRVULocal GPCI
Work2.61.017
Practice expense32.441.096
Malpractice0.30.536

(2.6 × 1.017 + 32.44 × 1.096 + 0.3 × 0.536) × $33.4009 = $1281.23

Facility

Facility calculation inputs
ComponentRVULocal GPCI
Work2.61.017
Practice expense1.181.096
Malpractice0.30.536

(2.6 × 1.017 + 1.18 × 1.096 + 0.3 × 0.536) × $33.4009 = $136.89

The office and facility calculations use their respective practice-expense RVUs. The facility amount here is the physician fee, not a separate hospital or facility bill.

How this rate has changed

43249 · Office / nonfacility

$1281.23

Effective 2026-10-01

The base rate is $210.65 higher than on 2025-10-01, moving from $1070.58 to $1281.23 (19.7%).

It is unchanged from the immediately preceding available release, effective 2026-07-01.

Base rate by release · bars start at $0 · select a bar to compare

One bar per available release, ordered by effective date. Missing rates remain gaps. These comparisons hold the code, setting and locality identifiers constant; they do not isolate which policy or input caused a change.

What changed, release by release

  1. January 1, 2026

    RVU26A

    $1070.58changed to$1281.23

    • Conversion factor 32.3465 changed to 33.4009
    • Work RVU 2.67 changed to 2.60
    • Practice expense RVU 27.63 changed to 32.44
    • Malpractice RVU 0.34 changed to 0.30
    • Work GPCI 1.014 changed to 1.017
    • Practice expense GPCI 1.093 changed to 1.096
    • Malpractice GPCI 0.560 changed to 0.536

    Held through RVU26B, RVU26C, RVU26D.

  2. January 1, 2025

    RVU25A

    Earliest loaded release: $1070.58

    Held through RVU25B, RVU25C, RVU25D.

Explore release dates and calculate this code in an earlier period →

Each row uses the accepted CMS release effective on that date and the same contractor and locality identifiers. Missing rates stay visible. Historical boundaries may differ; verify the service address for an older claim.

Inspect every release and its CMS source
Effective fromOffice / nonfacilityFacilityCMS release
2026-10-01$1281.23$136.89RVU26D
2026-07-01$1281.23$136.89RVU26C
2026-04-01$1281.23$136.89RVU26B
2026-01-01$1281.23$136.89RVU26A
2025-10-01$1070.58$148.18RVU25D
2025-07-01$1070.58$148.18RVU25C
2025-04-01$1070.58$148.18RVU25B
2025-01-01$1070.58$148.18RVU25A

Where these rates come from

FeeBase calculates base physician payments from CMS work, practice-expense, and malpractice RVUs, adjusted by each locality’s geographic indices and the applicable conversion factor. Unavailable or separately priced services are labeled rather than assigned a made-up amount.

Source: RVU26D. Effective 2026-10-01 through the day before 2027-01-01.

RVUs for 43249PPRRVU2026_Oct_nonQPP.csv, line 5,177 (RVU26D)
Geographic factors for ModestoGPCI2026.csv, line 16 (RVU26D)
Open CMS sourceHow this rate is calculatedBuild a fee sheet