California workers’ comp
Code 97163 — maximum allowable reimbursement
Maximum allowable (non-facility)
$167.33
Statewide range $159.16 – $191.20 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 1.54 × PW GPCI 1.04)
+ (PE 1.38 × PE GPCI 1.18)
+ (MP 0.01 × MP GPCI 0.66) ]
= 3.24232 adjusted RVUs
× $51.6091 conversion factor
= $167.33
- 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).