Data transparency
CMS 2026 Data
Source files, field mappings, and conversion factors.
Data provenance
Use this page to verify the CMS source basis before interpreting calculator, CPT, GPCI, or specialty outputs.
- Use when
- You need the source files, conversion factors, row counts, or locality mapping behind the tools.
- Source role
- Imported CMS 2026 Physician Fee Schedule files, GPCI records, and conversion factor references.
- Boundary
- This page documents source data; it does not select CPT codes, adjudicate claims, or evaluate contract terms.
April 2026Generated CMS data
Release
April 2026
Released
2026-03-10
Generated at
2026-06-17T14:23:05.706Z
CPT/HCPCS records
7,790
GPCI localities
110
Use this data
- Source folder
- 2026/rvu26b
- Non-QPP rows
- 19,277
- QPP rows
- 11,839
- Non-QPP CF
- 33.4009
- QPP CF
- 33.5675
- County mappings
- 53
CMS 2026 data source
Uses the CMS April 2026 Physician Fee Schedule RVU files, GPCI localities, and 2026 conversion factors. Estimates should be verified against official CMS files for billing decisions.
For calculator workflows, calculator inputs are processed in the browser. Contact, lead forms and PDF download forms are separate submissions.
Calculation governance
Source-of-truth field map
These controls keep calculator output readable as a Medicare payment estimate with visible CPT, setting, locality, conversion factor, and workflow boundaries.
| Field | Source | Boundary |
|---|---|---|
| CPT or HCPCS code | CMS PFS Relative Value Files RVU record and descriptor fields | The site can look up economics after a code is selected; it does not choose the clinically correct code. |
| Work RVU | CMS PFS Relative Value Files work RVU component | Use for physician productivity context; do not treat work RVU alone as Medicare payment. |
| Practice expense RVU | CMS PFS Relative Value Files facility and non-facility PE RVU fields | The selected site of service controls which PE RVU enters the formula. |
| Malpractice RVU | CMS PFS Relative Value Files malpractice RVU component | MP RVU is adjusted only by MP GPCI, not by a blended geography factor. |
| GPCI locality | CMS GPCI locality records for Work, PE, and MP indexes | Locality is the payment assumption; state pages are navigation surfaces, not statewide payment guarantees. |
| Conversion factor | 2026 conversion factor assumptions used by the imported non-QPP and QPP/APM files | QPP/APM status changes the final multiplier only when participation status applies. |
| Formula step | Practitioner check |
|---|---|
| Confirm CPT/HCPCS record | Verify the CPT code and descriptor before using RVU values for payment, benchmark, or contract interpretation. |
| Select site of service | Choose facility or non-facility so the correct practice expense RVU enters the calculation. |
| Apply component GPCI | Calculate adjusted total RVU as work RVU x Work GPCI plus selected PE RVU x PE GPCI plus MP RVU x MP GPCI. |
| Select conversion factor status | Apply non-QPP or QPP/APM conversion factor only after adjusted total RVU is complete. |
| Read result boundary | Treat the result as a Medicare payment estimate, not a coding, legal, payer-contract, or employment-contract conclusion. |
Practitioner review checks
What must travel with a result
| Check | Requirement |
|---|---|
| Code assumption | Record CPT code and descriptor beside every exported estimate. |
| Setting assumption | Keep facility or non-facility visible whenever total RVU or payment is shown. |
| Locality assumption | Show Work, PE, and MP GPCI separately so users can explain why payment moved. |
| Participation assumption | Use QPP/APM only when the clinician or organization status is known for the reviewed period. |
| Compensation boundary | Separate Medicare payment estimates from salary, benchmark, contract, collections, and payer-rate analysis; the result is not a coding, legal, payer-contract, or employment-contract conclusion. |
| Export boundary | PDF or CSV exports should carry assumptions with the result and remain tool outputs, not login-gated products. |
| Dataset | Purpose | Fields |
|---|---|---|
| PPRRVU2026_Apr_nonQPP.csv | Non-QPP CPT work RVU, PE RVU, MP RVU, national payment values | HCPCS, DESCRIPTION, WORK RVU, PE RVU, MP RVU, TOTAL, PAYMENT AMOUNT |
| PPRRVU2026_Apr_QPP.csv | QPP CPT payment comparison and conversion factor validation | HCPCS, DESCRIPTION, CONV FACTOR, PAYMENT AMOUNT |
| GPCI2026.csv | Geographic adjustment factors by state and Medicare locality | State, Locality Name, PW GPCI, PE GPCI, MP GPCI |
| 26LOCCO.csv | County/locality mapping for geographic pages | MAC, Locality Number, State, Fee Schedule Area, Counties |
| Conversion factors | Medicare payment multiplier | $33.4009 non-QPP, $33.5675 QPP |