GPCI state page

Wisconsin GPCI Values & Physician Payment 2026

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

Localities

City pages

Highest locality

Milwaukee

Highest factor

0.827

Wisconsin GPCI interpretation

GPCI affects payment by adjusting each RVU component separately. The state page is a geography model, not a coding or contract conclusion by itself.

Geography: 3 CMS payment localities
Highest locality: Milwaukee
Adjustment method: Work, PE, and MP components adjusted separately

What this page can support

Comparing locality-adjusted Medicare estimates for the same CPT code and setting.
Selecting the correct geography before using the RVU calculator.
Explaining why the same CPT code can produce different estimates across localities.

What should stay separate

It does not change the base CPT work RVU assigned by CMS.
It should not be used as a statewide rate when multiple CMS localities apply.
It does not include payer-specific contracts, sequestration, or claim adjudication rules.

Wisconsin city GPCI localities

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

MilwaukeeWork 0.990 · PE 0.970 · MP 0.520City locality WisconsinWork 1.000 · PE 0.958 · MP 0.308City locality

Wisconsin 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	00	ALL COUNTIES

Locality payment comparison

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

Inputs

CPT code

Selected locality

Results

Selected locality payment

$130.72

Wisconsin: Milwaukee, 3.91 total RVU.

Work GPCI

0.990

PE GPCI

0.970

MP GPCI

0.520

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

CPT 99214 in Milwaukee: $130.72 non-QPP payment; national locality comparison spread $46.40.

Wisconsin 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	0.990	0.960	0.510	0.820
Milwaukee	0.990	0.970	0.520	0.827
Wisconsin	1.000	0.958	0.308	0.755

Common CPT payment examples in Milwaukee

Illustrative non-QPP estimates using Milwaukee GPCI values.

CPT	Description	Setting	Total RVU	Payment
99213	Office o/p est low 20 min	non-facility	2.75	$91.85
99214	Office o/p est mod 30 min	non-facility	3.91	$130.72
99215	Office o/p est hi 40 min	non-facility	5.55	$185.33
99212	Office o/p est sf 10 min	non-facility	1.71	$57.24
99204	Office o/p new mod 45 min	non-facility	5.09	$170.17
93000	Electrocardiogram complete	non-facility	0.44	$14.72

Compare with nearby state pages

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

State	Average factor	Page
West Virginia	0.972	View GPCI page
Wisconsin	0.801	View GPCI page
Wyoming	0.850	View GPCI page