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Guide

CMS Data Transparency Guide

Understand the CMS fields that power RVU and GPCI calculations.

Guide workflow boundary

Use the guide for method order, then move into the linked workflow for the live input, result, and export controls.

Use when
You need to apply CMS Data Transparency Guide to a CPT, GPCI, benchmark, or compensation scenario.
Source role
Reviewed guide content connects source assumptions to the related tool sequence.
Boundary
This guide explains workflow logic; it does not replace the tool result, CMS source table, or contract-specific review.
Open guide workflowContinue with the tool or directory linked from this guide.Next actionOpen guide workflowContinue with the tool or directory linked from this guide.Next action

CMS data transparency means users can see which RVU, GPCI, locality, and conversion factor assumptions power each calculator result and programmatic page.

RVU main file fields

The RVU main file supplies the CPT or HCPCS code, short descriptor, work RVU, facility and non-facility practice expense RVU, and malpractice RVU. These fields define the base components before geography and conversion factor assumptions are applied.

  • Track HCPCS/CPT code.
  • Separate facility and non-facility PE RVU.
  • Keep work, PE, and MP RVU visible.

Move from explanation to calculation

Use the article to understand the term, then run the calculator with explicit CPT, setting, locality, and QPP assumptions.

Core RVU payment formula
Total RVU = Work RVU + PE RVU + MP RVU, after applicable GPCI adjustment
Open RVU Calculator

GPCI locality fields

The GPCI data supplies locality-specific work, practice expense, and malpractice indexes. These values should be stored and displayed separately because collapsing them into one geography factor can hide why payment changes.

  • Store Work GPCI separately.
  • Store PE GPCI separately.
  • Store MP GPCI separately.

Conversion factor assumptions

The 2026 calculation uses separate non-QPP and QPP/APM conversion factors. The selected factor should be visible in calculators and copied results so users know whether a payment estimate assumes default non-QPP status or qualifying QPP/APM status.

  • Show non-QPP CF as $33.4009.
  • Show QPP/APM CF as $33.5675.
  • Document annual data refresh timing.

Guide workflows

Open the calculator or workflow connected to this reference topic.

Cms 2026 DataOpen the related RVUinUSA workflow.ReferenceRVU CalculatorCore CPT payment calculator using 2026 CMS RVU and GPCI data.Payment

FAQs

Why show data sources on the site?

Transparency lets users understand which CMS fields and assumptions produced each estimate.

What is the source of truth?

Official CMS Physician Fee Schedule files remain the source of truth.

Why keep QPP and non-QPP separate?

They use different conversion factors, so mixing them would make payment comparisons unclear.