California workers’ comp
Code 95913 — maximum allowable reimbursement
Maximum allowable (non-facility)
$518.55
Statewide range $489.17 – $601.36 across 29 localities
Show your work — how this rate is computed
Californiaprices workers’-comp physician services by the RBRVS formula (8 CCR §9789.12.5): each RVU component is scaled by its LOS ANGELES-LONG BEACH-ANAHEIM (LOS ANGELES/ORANGE CNTY) GPCI, summed, then multiplied by the conversion factor.
[ (Work 3.47 × PW GPCI 1.04)
+ (PE 5.35 × PE GPCI 1.18)
+ (MP 0.16 × MP GPCI 0.66) ]
= 10.04756 adjusted RVUs
× $51.6091 conversion factor
= $518.55
- RVUs: CMS National Physician Fee Schedule Relative Value File (PPRRVU2026_Jan_nonQPP.csv) — CMS ↗
- GPCIs: CMS Geographic Practice Cost Indices (GPCI2026.csv) — by payment locality
- Conversion factor $51.6091: Californiaworkers’ comp fee schedule (8 CCR §9789.12.5) — source ↗
- Methodology verified to the penny against the CMS Physician Fee Schedule Look-Up Tool (national) and the state’s Medicare contractor (locality).