Medicare Physician Fee Schedule · Q4 2026 release
CPT 27447 in San Francisco, CA
Knee replacement in ZIPs including 94102, 94609, and 94704
01112-05
Status A
Medicare calculates a national payment amount for this code and pays it separately when the service is covered.
Full definition →
12.2% above the national baseline ($1,159.35)
( Work19.11 × 1.095 + Practice exp.11.58 × 1.410 + Malpractice4.02 × 0.425 ) × Conv. factor$33.4009 = $1,301.36
F Work RVU
19.11
G Non‑facility PE RVU
11.58
K MP RVU
4.02
Z Conversion factor
33.4009
E Work GPCI
1.095
F PE GPCI
1.410
G MP GPCI
0.425
CMS RVU26DOctober 1 – December 31, 2026revision 2
- Code
- 27447
- DOS
- Not selected; uses this release’s rates
- Locality
- SAN FRANCISCO-OAKLAND-BERKELEY (SAN FRANCISCO/SAN MATEO/ALAMEDA/CONTRA COSTA CNTY) (CA)
- Setting
- Office (non-facility)
- Participation
- Participating provider
- Modifiers
- None
- Units
- 1
- Release
- Q4 2026, revision 2
- Sequestration
- Shown separately from the allowed amount
Citations
Every input comes from a published CMS file. Open the same file at the row shown and the values match.
-
27447’s RVUs, PFS status and conversion factor
Physician relative value file (PPRRVU)CMS RVU26DOctober 1 – December 31, 2026revision 2
PPRRVU2026_Oct_nonQPP.csv row 2,899 in rvu26d-updated-08-26-2026.zip
- A HCPCS
- 27447
- B Modifier
- blank
- D Status code
- A
- F Work RVU
- 19.11
- G Non-facility PE RVU
- 11.58
- K MP RVU
- 4.02
- Z Conversion factor
- 33.4009
In the CMS file
Loading rows 2,897–2,901 of PPRRVU2026_Oct_nonQPP.csv…
Download rvu26d-updated-08-26-2026.zip from CMS File fingerprint
4d0d3f19bd954ffc0f5b8439169d267da023d4f6911f4539bb6e98723cb1a626 -
Locality 01112-05’s GPCIs
Geographic practice cost indices (GPCI)CMS RVU26DOctober 1 – December 31, 2026revision 2
GPCI2026.csv row 24 in rvu26d-updated-08-26-2026.zip
- A MAC
- 01112
- C Locality number
- 05
- E Work GPCI
- 1.095
- F PE GPCI
- 1.410
- G MP GPCI
- 0.425
In the CMS file
Loading rows 22–26 of GPCI2026.csv…
Download rvu26d-updated-08-26-2026.zip from CMS File fingerprint
7850e2987d12e46930e49033f96829b5ae11f60dd1f19965329b38cf08b05264
The Medicare allowed amount is $1,301.36 in the Office (non-facility) and Facility settings, under the Q4 2026 Physician Fee Schedule. This is the fee schedule amount before sequestration and before any deductible or coinsurance is applied—not necessarily what a specific claim pays.
Q4 2026 · Locality 01112-05 · Participating · Whole service · Sequestration excluded
What Medicare locality is San Francisco, CA in? Copy link
San Francisco, CA is in CMS payment locality San Francisco-Oakland-Berkeley (San Francisco/San Mateo/Alameda/Contra Costa County). The same amount applies across the whole locality, including Oakland and Berkeley.
CMS splits this metro across more than one payment locality
The amount above covers only the counties in San Francisco-Oakland-Berkeley (San Francisco/San Mateo/Alameda/Contra Costa County). CMS prices another part of the same metro area separately, with its own GPCIs and its own amount. Check the service-location ZIP before applying this figure.
- San Francisco-Oakland-Berkeley (Marin County) 01112-52 $1,305.92
Confirm the locality before using this amount. A split ZIP needs ZIP+4 for an exact match.
ZIP codes in this payment locality (254)
The CMS ZIP-to-locality crosswalk maps 254 ZIP codes to this payment locality. Use this amount only after you confirm the service location is in this locality. Of these, 2 span more than one locality and need ZIP+4 for an exact match.
154 more ZIP codes map to this locality. The San Francisco, CA locality page lists the full set.
Which ZIP codes does the San Francisco, CA rate for 27447 cover?
The CMS ZIP-to-locality crosswalk maps 254 ZIP codes to this payment locality, and 27447 has the same amount in every one of them. Examples include 94002, 94003, 94005, 94010, 94011, 94012. Of these, 2 span more than one payment locality and need ZIP+4 for an exact match.
Which cities does the San Francisco, CA rate for 27447 cover?
This payment locality also covers Oakland and Berkeley. 27447 has the same amount everywhere in it—the label names the largest metro, not a city-specific amount.
How locality affects the amount Copy link
Office (non-facility) · Q4 2026 · Participating · Whole service
Each of this locality's geographic practice cost indices (GPCIs) scales one RVU component before the conversion factor is applied. Together they put San Francisco, CA 12.2% above the national baseline.
CMS RVU26DOctober 1 – December 31, 2026revision 2 See citations
Why is the 27447 rate in San Francisco, CA different from the national amount?
The national figure is a GPCI 1.000 baseline, not an amount any provider is paid. This locality's geographic practice cost indices—work 1.095, practice expense 1.410, malpractice 0.425—scale each RVU component before the conversion factor is applied, which is why the San Francisco, CA amount is higher than the $1,159.35 baseline.
Formula and inputs Copy link
For the office (non-facility) amount, each of 27447's RVU components is multiplied by its San Francisco, CA GPCI; the products are summed and multiplied by the conversion factor.
- Code
- 27447
- DOS
- Not selected; uses this release’s rates
- Locality
- SAN FRANCISCO-OAKLAND-BERKELEY (SAN FRANCISCO/SAN MATEO/ALAMEDA/CONTRA COSTA CNTY) (CA)
- Setting
- Office (non-facility)
- Participation
- Participating provider
- Modifiers
- None
- Units
- 1
- Release
- Q4 2026, revision 2
- Sequestration
- Shown separately from the allowed amount
Formula
(work_rvu × work_gpci + pe_rvu × pe_gpci + mp_rvu × mp_gpci) × conversion_factor
Localis calculated this from CMS’s published inputs. Select an underlined value to see where it comes from.
| Component | RVU | × GPCI | = Adjusted |
|---|---|---|---|
| Work | 19.11 | × 1.095 | 20.9254 |
| Practice expense · Office (non-facility) | 11.58 | × 1.410 | 16.3278 |
| Malpractice | 4.02 | × 0.425 | 1.7085 |
| Sum of adjusted RVUs | 38.9617 | ||
| × 33.4009 conversion factor = formula amount | $1,301.36 | ||
Component subtotals show four decimals. The formula amount is rounded to cents before any later adjustment.
-
Locality-adjusted allowed amount $1,301.36
After applicable fee-schedule adjustments; sequestration excluded
Citations
Every input comes from a published CMS file. Open the same file at the row shown and the values match.
-
27447’s RVUs, PFS status and conversion factor
Physician relative value file (PPRRVU)CMS RVU26DOctober 1 – December 31, 2026revision 2
PPRRVU2026_Oct_nonQPP.csv row 2,899 in rvu26d-updated-08-26-2026.zip
- A HCPCS
- 27447
- B Modifier
- blank
- D Status code
- A
- F Work RVU
- 19.11
- G Non-facility PE RVU
- 11.58
- K MP RVU
- 4.02
- Z Conversion factor
- 33.4009
In the CMS file
Loading rows 2,897–2,901 of PPRRVU2026_Oct_nonQPP.csv…
Download rvu26d-updated-08-26-2026.zip from CMS File fingerprint
4d0d3f19bd954ffc0f5b8439169d267da023d4f6911f4539bb6e98723cb1a626 -
Locality 01112-05’s GPCIs
Geographic practice cost indices (GPCI)CMS RVU26DOctober 1 – December 31, 2026revision 2
GPCI2026.csv row 24 in rvu26d-updated-08-26-2026.zip
- A MAC
- 01112
- C Locality number
- 05
- E Work GPCI
- 1.095
- F PE GPCI
- 1.410
- G MP GPCI
- 0.425
In the CMS file
Loading rows 22–26 of GPCI2026.csv…
Download rvu26d-updated-08-26-2026.zip from CMS File fingerprint
7850e2987d12e46930e49033f96829b5ae11f60dd1f19965329b38cf08b05264
CMS RVU26DOctober 1 – December 31, 2026revision 2
Participating, non-participating and limiting charge Copy link
All figures are for the office (non-facility) setting in San Francisco, CA. Medicare pays part of the allowed amount and the patient pays the rest; the rows below show each figure. See how the limiting charge and sequestration are derived.
| Participating allowed amount The fee schedule amount a participating provider accepts as payment in full. | $1,301.36 |
|---|---|
| Non-participating allowed amount 95% of the participating amount. | $1,236.29 |
| Limiting charge Ceiling a non-participating provider may bill the patient on an unassigned claim—115% of the non-participating amount. | $1,421.73 |
| Medicare share 80% of the allowed amount, once the annual Part B deductible is met. | $1,041.09 |
| Patient coinsurance The remaining 20%. | $260.27 |
| Sequestration adjustment Reduces only Medicare's share—never the allowed amount or the patient's coinsurance. | $20.82 |
| Net Medicare payment Medicare's share after the sequestration reduction. | $1,020.27 |
What is the non-participating amount and limiting charge for 27447 in San Francisco, CA?
A non-participating provider is paid $1,236.29—95% of the $1,301.36 participating fee schedule amount. On an unassigned claim the limiting charge caps what the patient can be billed at $1,421.73, which is 115% of the non-participating amount.
How much of the San Francisco, CA 27447 rate does Medicare actually pay?
Medicare pays 80% of the allowed amount ($1,041.09) once the annual Part B deductible is met, and the beneficiary owes 20% ($260.27). Sequestration reduces Medicare's share by about 2% ($20.82), leaving $1,020.27. Sequestration never changes the allowed amount itself, which is why it is shown separately here.
Contracted rate: % of Medicare in San Francisco, CA Copy link
Commercial contracts are often written as a percentage of the Medicare fee schedule. The part that gets misread is which Medicare amount: a contract benchmarked to the fee schedule prices off this locality's allowed amount—$1,301.36 in the office (non-facility) setting—not the $1,159.35 national baseline.
Opens the calculator set to San Francisco, CA and your selected setting, where you can also compare what a payer paid against the expected amount. See how to find your contract's actual percentage.
Compare 27447 in nearby payment localities
Payment localities in the same region as San Francisco, CA, nearest first. Each amount is that locality's own GPCI-adjusted Office (non-facility) figure for 27447. Neighboring localities often differ.
| Metro | Allowed amount | vs. San Francisco, CA |
|---|---|---|
| San Jose, CA | $1,319.55 | +1.4% |
| Sacramento, CA | $1,183.07 | -9.1% |
| Fresno, CA | $1,145.03 | -12.0% |
| Bakersfield, CA | $1,156.10 | -11.2% |
| Ventura County, CA | $1,196.99 | -8.0% |
| Los Angeles, CA | $1,211.18 | -6.9% |
Every payment locality nationwide is on the CPT 27447 rate map.
Other codes priced in San Francisco, CA Copy link
Office (non-facility) allowed amounts in this same payment locality, Q4 2026.
| Code and service | Allowed | vs. national |
|---|---|---|
| 66984 Cataract Surgery | $559.07 | +20.9% |
| 66982 Complex Cataract Surgery With Lens Implant | $758.06 | +20.2% |
| 27130 Total Hip Arthroplasty | $1,304.14 | +12.2% |
| 29827 Arthroscopic Rotator Cuff Repair | $1,116.33 | +14.3% |
| 47562 Outpatient surgery | $695.78 | +10.1% |
| 64721 Open Carpal Tunnel Release | $596.93 | +23.7% |
| 29881 Outpatient surgery | $609.02 | +18.1% |
| 23472 Total Shoulder Arthroplasty | $1,462.93 | +12.5% |
| 49505 Outpatient surgery | $567.23 | +11.7% |
| 58571 Outpatient surgery | $916.79 | +10.6% |
| 19120 Outpatient surgery | $699.74 | +22.1% |
| 43775 Outpatient surgery | $1,027.92 | +2.8% |
Source & method Copy link
Computed from the CMS Medicare Physician Fee Schedule Q4 2026 release: this code's RVUs from the relative value file, multiplied by payment locality 01112-05's GPCIs, then by the 2026 conversion factor of $33.4009. ZIP coverage from the CMS ZIP-to-locality crosswalk, Q4 2026 release. Past releases are never edited, so an amount for an earlier quarter always matches what CMS published for it. Coverage and coding correctness are outside this calculation.
Working a claim with an earlier date of service? The calculator prices 27447 in San Francisco, CA against the release in effect on that date. Dates of service this quarter don't need an account; earlier dates need a free account.
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