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CMS RVU26D · Effective 2026-10-01
42226 Medicare reimbursement in Ballico, CA
Compare Medicare physician payments in Ballico, CA. Census city boundaries cover Merced County. Use the service ZIP to confirm the payment locality for a specific address.
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.
What does Medicare pay for 42226 in Ballico, California?
Ballico, California maps to 1 Medicare payment locality in our Census-to-CMS crosswalk. A city name alone does not confirm the service address’s payment area. These are the supported base rates for the payment area shown below, using the same CMS release.
Office / nonfacility
No supported rate
Facility setting
$860.70
1 of 1 localities have a supported rate.
Payment area: Merced
One mapped payment locality.
These are locality ranges, not averages or address-specific quotes. A facility-setting amount covers the physician service; it does not include a hospital’s separate bill. Choose a locality below to inspect its calculation, compare other payment areas, or price a percentage of Medicare.
Compare 42226 by payment locality
Find the payment area for your service address, then open its rate page for calculation inputs, release history and the percentage-of-Medicare tool. A city may cross payment-area boundaries; the ZIP lookup above helps resolve the location.
1 of 1 payment localities
Merced →
Office / nonfacility
Unavailable
Facility
$860.70
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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 42226 in Merced.
PPRRVU2026_Oct_nonQPP.csv
5,012
- Code
- 42226
- Physician work
- 10.09
- Practice expense
- 13.43
- Malpractice
- 1.47
GPCI2026.csv
15
- Locality
- Merced
- Physician work
- 1.017
- Practice expense
- 1.096
- Malpractice
- 0.536
| Component | RVU | Locality factor | Adjusted |
|---|---|---|---|
| Physician work | 10.09 | × 1.017 | 10.2615 |
| Practice expense | 13.43 | × 1.096 | 14.7193 |
| Malpractice | 1.47 | × 0.536 | 0.7879 |
| Total RVUs | 25.7687 | ||
| Conversion factor | × 33.4009 | ||
Facility rate, Merced$860.70
Explore RVUs, geographic factors and the full formula
Facility
| Component | RVU | Local GPCI |
|---|---|---|
| Work | 10.09 | 1.017 |
| Practice expense | 13.43 | 1.096 |
| Malpractice | 1.47 | 0.536 |
(10.09 × 1.017 + 13.43 × 1.096 + 1.47 × 0.536) × $33.4009 = $860.70
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 payment geography works in Ballico
City boundaries and Medicare payment boundaries are different. This page compares the payment areas covering the city’s counties. A mailing city name alone does not determine the rate; enter the service ZIP above to resolve the applicable locality.
- Merced: Merced County.
City boundaries: 2026 Census geography. Rates use the CMS release shown above.
CMS marks one payment locality as serviced by two MACs. This geography uses the published payment-locality GPCI identity, not a claim-routing determination; service ZIP lookup remains authoritative for address-level resolution.
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.