GPCI state page

Massachusetts GPCI Values & Physician Payment 2026

Representative work, practice expense, and malpractice GPCI values for Massachusetts.

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: Massachusetts 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.

Run RVU calculatorUse the selected locality with a specific CPT code.Next action Compare GPCI localitiesHold code and setting constant while geography changes.Next action

Localities

City pages

Highest locality

Boston

Highest factor

1.068

Massachusetts city GPCI localities

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

BostonWork 1.044 · PE 1.190 · MP 0.970City locality Metropolitan BostonWork 1.041 · PE 1.194 · MP 0.890City locality Rest of MassachusettsWork 1.016 · PE 1.053 · MP 0.797City locality

Massachusetts CMS locality coverage

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

Fee schedule area	Locality #	Counties / covered area
Metropolitan Boston	01	MIDDLESEX, NORFOLK AND SUFFOLK

Inputs

CPT code

Selected locality

Results

Selected locality payment

Massachusetts: Boston, 4.52 total RVU.

$150.98

Work GPCI

1.044

PE GPCI

1.190

MP GPCI

0.970

Top-low spread

$46.40

Review

Locality	Work	PE	MP	Payment
California: San Jose-Sunnyvale-Santa Clara (San Benito Cnty)	1.110	1.442	0.536	$170.02
Alaska: Alaska	1.500	1.065	0.551	$169.92
California: San Jose-Sunnyvale-Santa Clara (Santa Clara Cnty)	1.110	1.442	0.397	$169.37
California: San Francisco-Oakland-Berkeley (Marin Cnty)	1.095	1.410	0.459	$166.56
California: San Francisco-Oakland-Berkeley (San Francisco/San Mateo/Alameda/Contra Costa Cnty)	1.095	1.410	0.425	$166.40
California: Napa	1.063	1.318	0.508	$158.59
California: Vallejo	1.063	1.318	0.459	$158.36
California: San Francisco	1.051	1.308	0.642	$157.78
New York: Nyc Suburbs/Long Island	1.064	1.189	1.857	$156.34
Alaska: State Average	1.080	1.250	0.550	$155.33
New York: Queens	1.064	1.182	1.442	$153.94
New York: Manhattan	1.064	1.162	1.586	$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 calculator GPCI map

CPT 99214 in Boston: $150.98 non-QPP payment; national locality comparison spread $46.40.

Massachusetts locality values

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

Locality	GPCI Work	GPCI PE	GPCI MP	Adjustment factor
State Average	1.040	1.180	0.960	1.060
Boston	1.044	1.190	0.970	1.068
Metropolitan Boston	1.041	1.194	0.890	1.042
Rest of Massachusetts	1.016	1.053	0.797	0.955

Common CPT payment examples in Boston

Illustrative non-QPP estimates using Boston GPCI values.

CPT	Description	Setting	Total RVU	Payment
99213	Office o/p est low 20 min	non-facility	3.18	$106.28
99214	Office o/p est mod 30 min	non-facility	4.52	$150.98
99215	Office o/p est hi 40 min	non-facility	6.40	$213.75
99212	Office o/p est sf 10 min	non-facility	2.00	$66.90
99204	Office o/p new mod 45 min	non-facility	5.89	$196.61
93000	Electrocardiogram complete	non-facility	0.52	$17.31

Compare with nearby state pages

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

State	Average factor	Page
Maryland	1.016	View GPCI page
Massachusetts	1.031	View GPCI page
Michigan	1.031	View GPCI page