Commercial rate index · metro cell
San Jose-Sunnyvale-Santa Clara healthcare rate index
Commercial contracted rates in San Jose-Sunnyvale-Santa Clara, CA run 1.66x the national Medicare fee schedule across the office-visit basket. Index 172.4, where 100 is the national standard.
Index 172.4
1.66x Medicare
98,989 verified rate points
8/8 basket codes
state index 95.3
The basket in San Jose-Sunnyvale-Santa Clara
as of 2026-07-15| CPT | Service | Metro median | vs Medicare | Rate points | Tier |
|---|---|---|---|---|---|
| 99202 | Office visit, new patient, 15-29 min | $145.57 | 2.05x | 13,521 | Benchmark |
| 99203 | Office visit, new patient, 30-44 min | $350.95 | 3.18x | 9,518 | Benchmark |
| 99204 | Office visit, new patient, 45-59 min | $522.63 | 3.13x | 12,856 | Benchmark |
| 99205 | Office visit, new patient, 60-74 min | $390.73 | 1.78x | 26,210 | Benchmark |
| 99212 | Office visit, established patient, 10-19 min | $87.31 | 1.54x | 10,644 | Benchmark |
| 99213 | Office visit, established patient, 20-29 min | $110.11 | 1.19x | 8,031 | Benchmark |
| 99214 | Office visit, established patient, 30-39 min | $168.88 | 1.28x | 9,303 | Benchmark |
| 99215 | Office visit, established patient, 40-54 min | $219.36 | 1.18x | 8,906 | Benchmark |
Medians across the full verified distribution of practice-level contracted rates in this CBSA (41940). Floor: 11 verified rate points per code, non-degenerate spread. Denominator: CMS PFS CY2026 national non-facility. Methodology v1.0.
Documented reimbursement figures are modeled, not guaranteed. Derived from federally mandated Transparency in Coverage data (45 CFR 147.212). No PHI.
The market around it.
San Jose-Sunnyvale-Santa Clara prints above its state cell (California at 95.3) and above the national standard of 100.
Cite this page
Source: Reddenda Commercial Rate Atlas, San Jose-Sunnyvale-Santa Clara, CA. Reddenda. https://reddenda.health/atlas/ca/san-jose-sunnyvale-santa-clara-41940/
Derivation federally mandated TiC MRFs, verified to provider identityCBSA 41940 · metro grainas of 2026-07-15 · methodology v1.0