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GPCI-Adjusted Payment Calculator

Locality comparison workflow that recalculates the same CPT with Work, PE, and MP GPCI values.

For
Practices comparing Medicare locality variation
Inputs
CPT/HCPCS code
Output
Locality-ranked Work, PE, MP GPCI and payment

Locality payment comparison

Select a CPT and locality, then compare national high-payment localities for the same CPT and setting.

Inputs
01
Results
02
Selected locality payment

National: National Average, 4.06 total RVU.

$135.61
Work GPCI
1.000
PE GPCI
1.000
MP GPCI
1.000
Top-low spread
$46.40
Review
03
LocalityWorkPEMPPayment
California: San Jose-Sunnyvale-Santa Clara (San Benito Cnty)1.1101.4420.536$170.02
Alaska: Alaska1.5001.0650.551$169.92
California: San Jose-Sunnyvale-Santa Clara (Santa Clara Cnty)1.1101.4420.397$169.37
California: San Francisco-Oakland-Berkeley (Marin Cnty)1.0951.4100.459$166.56
California: San Francisco-Oakland-Berkeley (San Francisco/San Mateo/Alameda/Contra Costa Cnty)1.0951.4100.425$166.40
California: Napa1.0631.3180.508$158.59
California: Vallejo1.0631.3180.459$158.36
California: San Francisco1.0511.3080.642$157.78
New York: Nyc Suburbs/Long Island1.0641.1891.857$156.34
Alaska: State Average1.0801.2500.550$155.33
New York: Queens1.0641.1821.442$153.94
New York: Manhattan1.0641.1621.586$153.27
GPCI payment formula
Payment = ((work RVU x work GPCI) + (PE RVU x PE GPCI) + (MP RVU x MP GPCI)) x 2026 conversion factor.
Assumptions
CPT
99214
Setting
non-facility
Participant
Non-QPP
Rows shown
Top 12 by payment
CMS provenance
Source file and formula trace
Source file

2026/rvu26b

Release date

2026-03-10

Field mapping

CPT or HCPCS code, Work RVU, Practice expense RVU, Malpractice RVU, GPCI locality, Conversion factor

GPCI locality comparison provenance for CPT 99214. The calculation uses CMS April 2026 RVU records, GPCI localities, and conversion factors. Verify official CMS and payer rules before billing or contract decisions.

  • CPT or HCPCS code: CMS PFS Relative Value Files RVU record and descriptor fields
  • Work RVU: CMS PFS Relative Value Files work RVU component
  • Practice expense RVU: CMS PFS Relative Value Files facility and non-facility PE RVU fields
  • Malpractice RVU: CMS PFS Relative Value Files malpractice RVU component
Professional use
Keep constant before comparing markets

Keep constant CPT code, setting, and participant status. Change only the locality when judging geographic payment impact.

Next tool action
Core RVU calculatorGPCI map
CPT 99214 in National Average: $135.61 non-QPP payment; national locality comparison spread $46.40.

Related workflows

Use these tools when the current result needs payment, geography, compensation, or productivity context.

GpciOpen the related RVUinUSA workflow.ReferenceGPCI MapRank GPCI payment estimates for a selected CPT code.GeographyRVU CalculatorCore CPT payment calculator using 2026 CMS RVU and GPCI data.Payment
CMS 2026 data source

Uses the CMS April 2026 Physician Fee Schedule RVU files, GPCI localities, and 2026 conversion factors. Estimates should be verified against official CMS files for billing decisions.

For calculator workflows, calculator inputs are processed in the browser. Contact, lead forms and PDF download forms are separate submissions.

What does GPCI adjust?

GPCI adjusts work, practice expense, and malpractice RVU components separately before the conversion factor is applied.

Should I compare states or localities?

Use state pages for orientation, then use the exact CMS locality when modeling payment for a city, county, or practice market.

Does GPCI change the CPT work RVU?

No. GPCI adjusts payment calculation components; it does not change the base CPT work RVU value.