Medicare & Medicaid in California (CA)
2026 healthcare costs, coverage, and spending data for California.
$10,208
Spending/Capita
7,080,750
Medicare Enrollees
9,524,332
Medicaid Enrollees
7.9%
Uninsured Rate
Medicare Premiums in California
Part B Premium
$185/mo
Part D Premium (Avg)
$78/mo
Medigap Premium (Avg)
$132/mo
Medicaid Expansion: Yes - California expanded Medicaid under the ACA
Procedure Costs in California
Hospital
| Procedure | Avg Cost | Medicare Pays | You Pay |
|---|---|---|---|
| Kidney Transplant | $143,424 | $114,739 | $28,685 |
| Liver Transplant | $135,205 | $108,164 | $27,041 |
| Heart Valve Replacement | $89,317 | $71,454 | $17,863 |
| Coronary Artery Bypass Graft (CABG) | $81,579 | $65,263 | $16,316 |
| Spinal Fusion | $56,527 | $45,222 | $11,305 |
| Total Knee Replacement | $39,016 | $31,213 | $7,803 |
| Defibrillator Implantation (ICD) | $37,120 | $29,696 | $7,424 |
| Total Hip Replacement | $32,614 | $26,091 | $6,523 |
| Laminectomy | $28,474 | $22,779 | $5,695 |
| Colectomy | $27,781 | $22,225 | $5,556 |
| Cardiac Catheterization with Stent | $25,044 | $20,035 | $5,009 |
| Pacemaker Implantation | $24,701 | $19,760 | $4,940 |
| Lumbar Disc Surgery | $21,711 | $17,369 | $4,342 |
| Carotid Endarterectomy | $21,644 | $17,315 | $4,329 |
| Sepsis Treatment | $21,530 | $17,224 | $4,306 |
Outpatient
| Procedure | Avg Cost | Medicare Pays | You Pay |
|---|---|---|---|
| TURP (Prostate) | $8,314 | $6,651 | $1,663 |
| Endoscopic Sinus Surgery | $8,106 | $6,484 | $1,621 |
| Arthroscopic Knee Surgery | $6,846 | $5,477 | $1,369 |
| Dialysis Access Surgery | $6,831 | $5,465 | $1,366 |
| Lithotripsy (Kidney Stones) | $6,618 | $5,294 | $1,324 |
| Tonsillectomy | $6,198 | $4,958 | $1,240 |
| Hemorrhoid Surgery | $6,143 | $4,915 | $1,229 |
| Bunionectomy | $5,856 | $4,685 | $1,171 |
| Septoplasty | $5,719 | $4,576 | $1,144 |
| Nasal Polyp Removal | $5,109 | $4,087 | $1,022 |
| Pilonidal Cyst Surgery | $4,469 | $3,575 | $894 |
| Carpal Tunnel Release | $4,314 | $3,451 | $863 |
| Adenoidectomy | $4,267 | $3,413 | $853 |
| Ganglion Cyst Removal | $3,952 | $3,161 | $790 |
| Breast Biopsy | $3,687 | $2,950 | $737 |
Imaging
| Procedure | Avg Cost | Medicare Pays | You Pay |
|---|---|---|---|
| PET Scan | $3,508 | $2,807 | $702 |
| Nuclear Stress Test | $1,905 | $1,524 | $381 |
| CT Angiography | $1,789 | $1,431 | $358 |
| MRI Brain | $1,546 | $1,237 | $309 |
| MRI Spine (Lumbar) | $1,391 | $1,113 | $278 |
| MRI Knee | $1,323 | $1,058 | $265 |
| MRI Hip | $1,177 | $942 | $235 |
| MRI Shoulder | $1,176 | $941 | $235 |
| MRI Spine (Cervical) | $1,131 | $905 | $226 |
| CT Scan Abdomen/Pelvis | $1,038 | $830 | $208 |
| Bone Scan | $881 | $705 | $176 |
| CT Scan Head | $827 | $662 | $165 |
| CT Scan Chest | $825 | $660 | $165 |
| CT Colonography (Virtual) | $808 | $646 | $162 |
| Echocardiogram | $730 | $584 | $146 |
Physician/Office
| Procedure | Avg Cost | Medicare Pays | You Pay |
|---|---|---|---|
| Allergy Testing | $304 | $243 | $61 |
| Mammogram (Screening) | $304 | $304 | $0 |
| Sleep Study Consultation | $278 | $223 | $56 |
| Psychiatry Visit | $254 | $203 | $51 |
| Office Visit (New Patient) | $228 | $182 | $46 |
| Bone Density Test (DEXA Scan) | $228 | $182 | $46 |
| Shingles Vaccination | $221 | $221 | $0 |
| Annual Wellness Visit | $197 | $197 | $0 |
| Physical Therapy Session | $187 | $150 | $37 |
| Speech Therapy Session | $183 | $146 | $37 |
| Mental Health Counseling | $174 | $139 | $35 |
| Occupational Therapy Session | $171 | $137 | $34 |
| Office Visit (Established Patient) | $167 | $133 | $33 |
| Wound Care Visit | $159 | $127 | $32 |
| Skin Cancer Screening | $132 | $105 | $26 |
Laboratory
| Procedure | Avg Cost | Medicare Pays | You Pay |
|---|---|---|---|
| BNP (Heart Failure Marker) | $53 | $42 | $11 |
| Blood Type and Crossmatch | $48 | $39 | $10 |
| Troponin Level | $48 | $38 | $10 |
| Comprehensive Metabolic Panel | $45 | $36 | $9 |
| Blood Culture | $45 | $36 | $9 |
| Vitamin D Level | $45 | $36 | $9 |
| Liver Function Panel | $42 | $34 | $9 |
| PSA (Prostate-Specific Antigen) | $40 | $32 | $8 |
| Thyroid Panel (TSH) | $39 | $31 | $8 |
| Iron Studies (Ferritin) | $38 | $30 | $8 |
| B12 Level | $36 | $29 | $7 |
| Lipid Panel | $36 | $29 | $7 |
| Pap Smear Lab Processing | $33 | $26 | $7 |
| Glucose Tolerance Test | $31 | $25 | $6 |
| Stool Occult Blood Test | $31 | $31 | $0 |
Compare California With Other States
Frequently Asked Questions
How much does Medicare spend per person in California?
In 2026, the average Medicare spending per beneficiary in California is $10,208.
How many people are enrolled in Medicare in California?
California has approximately 7,080,750 Medicare beneficiaries.
Did California expand Medicaid?
Yes, California expanded Medicaid under the Affordable Care Act.
What is the uninsured rate in California?
The uninsured rate in California is 7.9%.
What is the average Medigap premium in California?
The average Medigap (Medicare Supplement) premium in California is $132 per month.