GPCI state page

District of Columbia GPCI Values & Physician Payment 2026

Representative work, practice expense, and malpractice GPCI values for District of Columbia.

State locality screening

select a locality, validate coverage context, compare payment with a fixed CPT, setting, and participant status, and avoid statewide-rate misuse.

Input
District of Columbia state, CMS locality, and representative CPT examples
Source basis
CMS 2026 GPCI records, state locality mapping, county coverage import, CPT examples, and GPCI calculator assumptions.
Result boundary
The page should not be used as a statewide payment rate when multiple CMS localities apply. This is not a statewide rate. Use the calculator with a fixed CPT, setting, and participant status before relying on a payment estimate.
Localities
1
City pages
1
Highest locality
Dc + Md/Va Suburbs
Highest factor
1.115

District of Columbia city GPCI localities

Open a city page for locality-specific CPT payment examples and calculator context.

District of Columbia CMS locality coverage

County and fee schedule area references from the imported 2026 CMS locality mapping file.

Fee schedule areaLocality #Counties / covered area
DC + Md/va Suburbs01DISTRICT OF COLUMBIA; ALEXANDRIA CITY, ARLINGTON, FAIRFAX, FAIRFAX CITY, FALLS CHURCH CITY IN VIRGINIA; MONTGOMERY AND PRINCE GEORGE'S IN MARYLAND

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

District of Columbia: Dc + Md/Va Suburbs, 4.54 total RVU.

$151.49
Work GPCI
1.054
PE GPCI
1.178
MP GPCI
1.113
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
CPT 99214 in Dc + Md/Va Suburbs: $151.49 non-QPP payment; national locality comparison spread $46.40.

District of Columbia locality values

Each RVU component is adjusted separately before the conversion factor is applied.

LocalityGPCI WorkGPCI PEGPCI MPAdjustment factor
Dc + Md/Va Suburbs1.0541.1781.1131.115

Common CPT payment examples in Dc + Md/Va Suburbs

Illustrative non-QPP estimates using Dc + Md/Va Suburbs GPCI values.

CPTDescriptionSettingTotal RVUPayment
99213Office o/p est low 20 minnon-facility3.19$106.56
99214Office o/p est mod 30 minnon-facility4.54$151.49
99215Office o/p est hi 40 minnon-facility6.42$214.58
99212Office o/p est sf 10 minnon-facility2.01$67.01
99204Office o/p new mod 45 minnon-facility5.92$197.64
93000Electrocardiogram completenon-facility0.52$17.35

Compare with nearby state pages

Use neighboring state pages to compare representative GPCI adjustment factors before evaluating location-specific offers.

StateAverage factorPage
Wyoming0.850View GPCI page
District of Columbia1.115View GPCI page
Puerto Rico0.999View GPCI page