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Medicare Physician Fee Schedule · Q3 2026 release

HCPCS G0121 in Ventura County, CA 01182-17

Colon ca scrn not hi rsk ind in ZIPs including 93030, 91360, and 93001

G0121 2026 C · Ventura County, CA flag01182-17 A Active
Allowed amount
$423.11
in a doctor’s own office or clinic

111.8% of the $378.43 national baseline

Medicare payment
$338.49
Patient / secondary
$84.62
Expected total to provider
$423.11

Patient / secondary and expected total to provider assume the Part B annual deductible is already met. If it isn't, the patient owes more than the amount shown here.

Locality-adjusted Physician Fee Schedule pricing

How much does Medicare allow for HCPCS G0121 in Ventura County, CA? Copy link

The Medicare allowed amount is $423.11 in the office (non-facility) setting and $170.83 in a facility, under the Q3 2026 Physician Fee Schedule. The office amount is 11.8% above the national baseline, and the facility amount is 3.5% above the national baseline. This is the fee schedule amount before sequestration and before any deductible or coinsurance is applied — not necessarily what a specific claim pays.

What Medicare locality is Ventura County, CA in? Copy link

CMS payment locality Oxnard-Thousand Oaks-Ventura. The same amount applies across the whole locality, including Oxnard, Thousand Oaks and Ventura.

Why Ventura County, CA differs from the national amount Copy link

Ventura County, CA (this locality)
$423.11
National PFS baseline (GPCI 1.000)
$378.43

The national figure is a baseline, not an amount any provider is paid. This locality's geographic practice cost indices scale each RVU component before the conversion factor is applied, which puts Ventura County, CA at 11.8% above the national baseline.

Work GPCI
1.028
Practice expense GPCI
1.182
Malpractice GPCI
0.623
2026 conversion factor
$33.4009

Formula and inputs Copy link

The office (non-facility) amount for G0121 in Ventura County, CA: each component's RVU times its GPCI, summed, then multiplied by the conversion factor.

RVU and GPCI components of the Ventura County, CA allowed amount for G0121
Component RVU × GPCI = Adjusted RVU
Work 3.18 1.028 3.2690
Practice expense 7.73 1.182 9.1369
Malpractice 0.42 0.623 0.2617
Sum of adjusted RVUs 12.6676
× $33.4009 2026 conversion factor $423.11

Facility vs. Office (non-facility) Copy link

In a facility (hospital outpatient or ASC), Ventura County, CA allows $170.83 for G0121, versus $423.11 in the office. Only the practice-expense RVU changes with the setting. In a facility, the hospital bills its own fee, so the professional payment is lower. Which setting applies to your place of service.

Participating, non-participating and limiting charge Copy link

All figures are for the office (non-facility) setting in Ventura County, CA. The allowed amount is not the program payment — the rows below separate them. See how the limiting charge and sequestration are derived.

Participation and payment-split amounts for G0121 in Ventura County, CA
Participating allowed amount The fee schedule amount a participating provider accepts as payment in full. $423.11
Non-participating allowed amount 95% of the participating amount. $401.95
Limiting charge Ceiling a non-participating provider may bill the patient on an unassigned claim — 115% of the non-participating amount. $462.24
Medicare program payment 80% of the allowed amount, once the annual Part B deductible is met. $338.49
Beneficiary coinsurance The remaining 20%. $84.62
Sequestration adjustment Reduces Medicare's share only — never the allowed amount, and never the patient's share. $6.77
Medicare pays after sequestration Program payment net of the sequestration reduction. $331.72

Contracted rate: % of Medicare in Ventura County, CA Copy link

Commercial contracts are usually written as a percentage of the Medicare fee schedule. Which Medicare amount they mean is the part that gets misread: a contract benchmarked to the fee schedule prices off this locality's allowed amount — $423.11 in the office (non-facility) setting — not the $378.43 national baseline.

Opens the calculator already set to Ventura County, CA and the office (non-facility) setting. It also compares what a payer actually paid against the expected amount. See how to find your contract's actual percentage.

ZIP codes this Ventura County, CA rate covers Copy link

The CMS ZIP-to-locality crosswalk maps 48 ZIP codes to this payment locality. G0121 prices identically in every one of them. 2 of them span more than one locality and need ZIP+4 for an exact match.

91319 91320 91358 91359 91360 91361 91362 91377 93001 93002 93003 93004 93005 93006 93007 93009 93010 93011 93012 93015 93016 93020 93021 93022 93023 93024 93030 93031 93032 93033 93034 93035 93036 93040 93041 93042 93043 93044 93060 93061 93062 93063 93064 93065 93066 93093 93094 93099

Resolves the ZIP to its payment locality, so you can confirm whether this amount applies.

G0121 in nearby payment localities Copy link

Payment localities in the same region as Ventura County, CA, nearest first. Each amount is that locality's own GPCI-adjusted office (non-facility) figure for G0121. Proximity doesn't imply similar pricing — neighbouring localities often differ.

G0121 allowed amount in payment localities near Ventura County, CA
Metro Allowed amount vs. Ventura County, CA
Los Angeles, CA $425.32 +0.5%
Bakersfield, CA $399.75 -5.5%
Riverside, CA $403.07 -4.7%
San Diego, CA $425.80 +0.6%
Fresno, CA $398.51 -5.8%
San Jose, CA $495.78 +17.2%

Every payment locality nationwide is on the HCPCS G0121 rate map.

Other codes priced in Ventura County, CA Copy link

Office (non-facility) allowed amounts in this same payment locality, Q3 2026.

Other curated codes and their allowed amounts in Ventura County, CA
Code Service Ventura County, CA vs. national
43239 Upper Gastrointestinal Endoscopy With Tissue Sampling $478.05 +14.1%
45385 Colonoscopy With Polyp Removal $558.55 +11.7%
45380 Colonoscopy With Tissue Sampling $541.64 +12.8%
45378 Diagnostic Colonoscopy $422.90 +11.8%
43235 Screening and endoscopy $366.40 +13.6%
45384 Screening and endoscopy $605.79 +12.3%
45381 Screening and endoscopy $553.87 +13.0%
G0105 Screening and endoscopy $422.90 +11.8%
99213 Routine Follow-Up Office Visit $104.15 +9.4%
99214 Long Follow-Up Office Visit $147.80 +9.0%
66984 Cataract Surgery $499.83 +8.0%
92014 Full Eye Exam, Returning Patient $142.37 +11.9%

Common questions Copy link

Which ZIP codes does the Ventura County, CA rate for G0121 cover?
The CMS ZIP-to-locality crosswalk maps 48 ZIP codes to this payment locality, and every one of them prices G0121 identically. Examples include 91319, 91320, 91358, 91359, 91360, 91361. 2 of them span more than one payment locality, so those need ZIP+4 for an exact match.
Why is the G0121 rate in Ventura County, 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 1.028, practice expense 1.182, malpractice 0.623 — scale each RVU component before the conversion factor is applied, which is why Ventura County, CA allows more than the $378.43 baseline.
Which cities does the Ventura County, CA rate for G0121 cover?
This payment locality also covers Oxnard, Thousand Oaks and Ventura. Every location in it prices G0121 identically — the label names the largest metro, not a city-specific amount.
What is the facility rate for G0121 in Ventura County, CA?
$170.83 in a facility, versus $423.11 in the office (non-facility) setting — a $252.28 difference. Only the practice-expense RVU changes with the setting: in an office the practice carries the overhead, so the professional payment is higher; in a hospital or ASC the facility bills its own fee.
What is the non-participating amount and limiting charge for G0121 in Ventura County, CA?
A non-participating provider is paid $401.95 — 95% of the $423.11 participating fee schedule amount. On an unassigned claim the limiting charge caps what the patient can be billed at $462.24, which is 115% of the non-participating amount.
How much of the Ventura County, CA G0121 rate does Medicare actually pay?
Medicare pays 80% of the allowed amount ($338.49) once the annual Part B deductible is met, and the beneficiary owes 20% ($84.62). Sequestration reduces Medicare's share by about 2% ($6.77), leaving $331.72. Sequestration never changes the allowed amount itself, which is why it is shown separately here.

Source & method Copy link

Computed from the CMS Medicare Physician Fee Schedule Q3 2026 release : this code's RVUs from the relative value file, multiplied by payment locality 01182-17's GPCIs, then by the 2026 conversion factor of $33.4009. ZIP coverage from the CMS ZIP-to-locality crosswalk, Q3 2026 release . Releases are immutable: an amount retrieved for a past quarter always reflects that PFS release. Coverage and coding correctness are outside this calculation.

Physician relative value file (Q3 2026) · rvu26c-updated-06-30-2026.zip (PPRRVU2026_Jul_nonQPP.csv row 15,024)
Geographic practice cost indices (Q3 2026) · rvu26c-updated-06-30-2026.zip (GPCI2026.csv row 18)
ZIP code to carrier locality crosswalk (Q3 2026) · zip-code-carrier-locality-file-updated-05-13-2026.zip (ZIP5_JUL2026.txt)

Working a claim with an earlier date of service? The calculator prices G0121 in Ventura County, CA against the release that governed that date. Past releases need a free account; today's rate does not.

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