Rhode Island GPCI Values & Physician Payment 2026
Representative work, practice expense, and malpractice GPCI values for Rhode Island.
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
- Rhode Island 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.
Rhode Island city GPCI localities
Open a city page for locality-specific CPT payment examples and calculator context.
Rhode Island CMS locality coverage
County and fee schedule area references from the imported 2026 CMS locality mapping file.
| Fee schedule area | Locality # | Counties / covered area |
|---|---|---|
| Statewide | 01 | ALL COUNTIES |
Locality payment comparison
Select a CPT and locality, then compare national high-payment localities for the same CPT and setting.
Rhode Island: Rhode Island, 4.15 total RVU.
| 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 |
- CPT
- 99214
- Setting
- non-facility
- Participant
- Non-QPP
- Rows shown
- Top 12 by payment
2026/rvu26b
2026-03-10
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
Keep constant CPT code, setting, and participant status. Change only the locality when judging geographic payment impact.
Rhode Island 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 | 1.020 | 1.080 | 0.780 | 0.960 |
| Rhode Island | 1.019 | 1.033 | 0.892 | 0.981 |
Common CPT payment examples in Rhode Island
Illustrative non-QPP estimates using Rhode Island GPCI values.
| CPT | Description | Setting | Total RVU | Payment |
|---|---|---|---|---|
| 99213 | Office o/p est low 20 min | non-facility | 2.91 | $97.30 |
| 99214 | Office o/p est mod 30 min | non-facility | 4.15 | $138.53 |
| 99215 | Office o/p est hi 40 min | non-facility | 5.88 | $196.44 |
| 99212 | Office o/p est sf 10 min | non-facility | 1.82 | $60.81 |
| 99204 | Office o/p new mod 45 min | non-facility | 5.41 | $180.87 |
| 93000 | Electrocardiogram complete | non-facility | 0.47 | $15.70 |
Compare with nearby state pages
Use neighboring state pages to compare representative GPCI adjustment factors before evaluating location-specific offers.
| State | Average factor | Page |
|---|---|---|
| Pennsylvania | 0.983 | View GPCI page |
| Rhode Island | 0.971 | View GPCI page |
| South Carolina | 0.879 | View GPCI page |