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Medicare Physician Fee Schedule Effective Locality 01112-63 CMS RVU26D Updated

CPT 29827 Medicare rate in Sacramento, CA

Arthroscopic rotator cuff repair in ZIPs including 95814, 95661, and 95630

The Medicare allowed amount is $1,007.10 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.

29827 Q4 2026
Office (non-facility) Facility
Locality-adjusted allowed amount
$1,007.10
in a doctor’s own office or clinic

Sacramento, CA flag Sacramento, CA (Locality 01112-63)

3.2% above the national baseline ($976.31)

CMS RVU26DOctober 1 – December 31, 2026revision 2

( Work15.20 × 1.036 + Practice exp.10.98 × 1.163 + Malpractice3.05 × 0.536 ) × Conv. factor$33.4009 = $1,007.10

row 3,327

F Work RVU

15.20

G Non‑facility PE RVU

10.98

K MP RVU

3.05

Z Conversion factor

33.4009

row 21

E Work GPCI

1.036

F PE GPCI

1.163

G MP GPCI

0.536

The Medicare allowed amount is $1,007.10 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.

Assumes a participating provider, no modifiers, the whole service, before sequestration.

Customize service date, participation, and modifiers Check service-location ZIP CMS sources and method

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What Medicare locality is Sacramento, CA in? Copy link

Sacramento, CA is in CMS payment locality Sacramento-Roseville-Folsom. The same amount applies across the whole locality, including Roseville and Folsom.

Confirm the locality before using this amount. A split ZIP needs ZIP+4 for an exact match.

ZIP codes in this payment locality (219)

The CMS ZIP-to-locality crosswalk maps 219 ZIP codes to this payment locality. Use this amount only after you confirm the service location is in this locality. Of these, 9 span more than one locality and need ZIP+4 for an exact match.

94203 94204 94205 94206 94207 94208 94209 94211 94229 94230 94232 94234 94235 94236 94237 94239 94240 94243 94244 94245 94246 94247 94248 94249 94250 94252 94253 94254 94256 94257 94258 94259 94261 94262 94263 94267 94268 94269 94271 94273 94274 94277 94278 94279 94280 94282 94283 94284 94285 94286 94287 94288 94289 94290 94291 94293 94294 94295 94296 94297 94298 94299 95602 95603 95604 95605 95606 95607 95608 95609 95610 95611 95612 95613 95614 95615 95616 95617 95618 95619 95621 95623 95624 95626 95627 95628 95630 95631 95632 95633 95634 95635 95636 95637 95638 95639 95641 95645 95648 95650

119 more ZIP codes map to this locality. The Sacramento, CA locality page lists the full set.

Which ZIP codes does the Sacramento, CA rate for 29827 cover?

The CMS ZIP-to-locality crosswalk maps 219 ZIP codes to this payment locality, and 29827 has the same amount in every one of them. Examples include 94203, 94204, 94205, 94206, 94207, 94208. Of these, 9 span more than one payment locality and need ZIP+4 for an exact match.

Which cities does the Sacramento, CA rate for 29827 cover?

This payment locality also covers Roseville and Folsom. 29827 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

Sacramento, CA (this locality)
$1,007.10
National PFS baseline (GPCI 1.000)
$976.31

Each of this locality's geographic practice cost indices (GPCIs) scales one RVU component before the conversion factor is applied. Together they put Sacramento, CA 3.2% above the national baseline.

Sacramento, CA ranks #33 of 109 Medicare payment localities for 29827, where #1 has the highest allowed amount. Within California it's #12 of 29: $34.22 (3.5%) higher than Rest of California ($972.88).

Work GPCI
1.036
+$18.28 vs. national
Practice expense GPCI
1.163
+$59.78 vs. national
Malpractice GPCI
0.536
-$47.27 vs. national
2026 conversion factor
$33.4009

Each figure is that GPCI's share of the +$30.79 gap from the national baseline: its RVUs for 29827 × (GPCI − 1.000) × the conversion factor. Practice expense accounts for the most, +$59.78.

CMS RVU26DOctober 1 – December 31, 2026revision 2 See file rows

Why is the 29827 rate in Sacramento, 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 1.036, practice expense 1.163, malpractice 0.536—scale each RVU component before the conversion factor is applied, which is why the Sacramento, CA amount is higher than the $976.31 baseline.

29827 in Sacramento, CA since Q4 2025 Copy link

Office (non-facility) · Participating · Whole service

The allowed amount went from $1,094.20 in Q4 2025 to $1,007.10 in Q4 2026, -$87.10 (-8.0%). The national baseline moved -7.0% over the same period.

What changed 29827's allowed amount in Sacramento, CA between Q4 2025 and Q4 2026
Conversion factor National: the dollar multiplier CMS sets each year. +$35.67
29827's RVUs National: CMS revalued the code itself. -$123.91
Sacramento, CA's GPCIs Local: this payment locality's cost indices. +$1.14
Total change -$87.10

A derived breakdown of the two releases' formula inputs, applied in order: the conversion factor on Q4 2025's RVUs and GPCIs, then 29827's new RVUs, then this locality's new GPCIs. A different order moves a few cents between rows; the total is exact.

Formula and inputs Copy link

For the office (non-facility) amount, each of 29827's RVU components is multiplied by its Sacramento, CA GPCI; the products are summed and multiplied by the conversion factor.

Code
29827
DOS
Not selected; uses this release’s rates
Locality
SACRAMENTO-ROSEVILLE-FOLSOM (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.

RVU × GPCI components of Sacramento, CA allowed amount for 29827
Component RVU × GPCI = Adjusted
Work 15.20 × 1.036 15.7472
Practice expense · Office (non-facility) 10.98 × 1.163 12.7697
Malpractice 3.05 × 0.536 1.6348
Sum of adjusted RVUs 30.1517
× 33.4009 conversion factor = formula amount $1,007.10

Component subtotals show four decimals. The formula amount is rounded to cents before any later adjustment.

  1. Locality-adjusted allowed amount $1,007.10

    After applicable fee-schedule adjustments; sequestration excluded

Citations

  • 29827’s RVUs, PFS status and conversion factor

    Physician relative value file (PPRRVU)CMS RVU26DOctober 1 – December 31, 2026revision 2

    PPRRVU2026_Oct_nonQPP.csv row 3,327 in rvu26d-updated-08-26-2026.zip

    A HCPCS
    29827
    B Modifier
    blank
    D Status code
    A
    F Work RVU
    15.20
    G Non-facility PE RVU
    10.98
    K MP RVU
    3.05
    Z Conversion factor
    33.4009
    In the CMS file

    Loading rows 3,325–3,329 of PPRRVU2026_Oct_nonQPP.csv…

    Download rvu26d-updated-08-26-2026.zip from CMS File fingerprint 4d0d3f19bd954ffc0f5b8439169d267da023d4f6911f4539bb6e98723cb1a626

  • Locality 01112-63’s GPCIs

    Geographic practice cost indices (GPCI)CMS RVU26DOctober 1 – December 31, 2026revision 2

    GPCI2026.csv row 21 in rvu26d-updated-08-26-2026.zip

    A MAC
    01112
    C Locality number
    63
    E Work GPCI
    1.036
    F PE GPCI
    1.163
    G MP GPCI
    0.536
    In the CMS file

    Loading rows 19–23 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 Sacramento, 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.

Participation and payment-split amounts for 29827 in Sacramento, CA
Participating allowed amount The fee schedule amount a participating provider accepts as payment in full. $1,007.10
Non-participating allowed amount 95% of the participating amount. $956.75
Limiting charge Ceiling a non-participating provider may bill the patient on an unassigned claim—115% of the non-participating amount. $1,100.26
Medicare share 80% of the allowed amount, once the annual Part B deductible is met. $805.68
Patient coinsurance The remaining 20%. $201.42
Sequestration adjustment Reduces only Medicare's share—never the allowed amount or the patient's coinsurance. $16.11
Net Medicare payment Medicare's share after the sequestration reduction. $789.57
What is the non-participating amount and limiting charge for 29827 in Sacramento, CA?

A non-participating provider is paid $956.75—95% of the $1,007.10 participating fee schedule amount. On an unassigned claim the limiting charge caps what the patient can be billed at $1,100.26, which is 115% of the non-participating amount.

How much of the Sacramento, CA 29827 rate does Medicare actually pay?

Medicare pays 80% of the allowed amount ($805.68) once the annual Part B deductible is met, and the beneficiary owes 20% ($201.42). Sequestration reduces Medicare's share by about 2% ($16.11), leaving $789.57. Sequestration never changes the allowed amount itself, which is why it is shown separately here.

Contracted rate: % of Medicare in Sacramento, 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—$1,007.10 in the office (non-facility) setting—not the $976.31 national baseline.

Opens the calculator set to Sacramento, 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.

29827 in nearby payment localities Copy link

Payment localities in the same region as Sacramento, CA, nearest first. Each amount is that locality's own GPCI-adjusted Office (non-facility) figure for 29827. Neighboring localities often differ.

Percentages are against Sacramento, CA. Every payment locality nationwide is on the CPT 29827 rate map.

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 01112-63'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 29827 in Sacramento, 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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