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2026 Geographic Practice Cost Indices (GPCI)
December 11, 2025
Our practice management systems and ARIA RCM Services make it easy use the GPCI and RVU values for each CPT® fee to calculate your Medicare fee schedule. This creates a simpler workflow for updating fees, modeling the impact of changes on practices, and automating charge entry.
The Medicare fee schedule can be replicated and modified for other agreements that utilize Medicare, including percentage or fixed adjustments for specific codes or ranges. We recommend visiting this page at the beginning of each quarter to check for any updates regarding the Conversion Factor or GPCIs. Depending on your system, the GPCI, charge, and RVU data may be automatically refreshed or conveniently downloaded to maintain up-to-date information. You can find guidance for updating CompuGroup Medical systems in your system's documentation.
New in 2026: There are two different Physician Fee Schedule Conversion Factors, depending on your clinic's status. CMS offers this participation lookup service for clinics that need to verify their status.
- Qualifying alternative payment model (APM) participants (QP): 33.5675
- Non qualified participants (Non-QP): 33.4009
Scroll down for the 2026 GPCI Value Table.
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2026 GPCI Value Table
ADDENDUM E. FINAL CY 2026 GEOGRAPHIC PRACTICE COST INDICES (GPCIs) BY STATE AND MEDICARE LOCALITY
(There is a left-right scroll bar at the bottom of the table, but you may also be able to click into the table and use the arrow keys on your keyboard.)
| Medicare Administrative Contractor (MAC) | State | Locality Number | Locality Name | 2026 PW GPCI (without 1.0 Floor) | 2026 PW GPCI (with 1.0 Floor) | 2026 PE GPCI | 2026 MP GPCI | Qualifying APM National Anes CF (with 2.5% statutory increase) of 20.599835 | Non-Qualifying APM National Anes CF (with 2.5% Statutory increase) of 20.49754 |
|---|---|---|---|---|---|---|---|---|---|
| 10112 | AL | 00 | ALABAMA | 0.988 | 1.000 | 0.875 | 0.566 | 19.63 | 19.53 |
| 02102 | AK | 01 | ALASKA* | 1.500 | 1.500 | 1.065 | 0.551 | 28.29 | 28.15 |
| 03102 | AZ | 00 | ARIZONA | 0.991 | 1.000 | 0.969 | 0.856 | 20.31 | 20.21 |
| 07102 | AR | 13 | ARKANSAS | 0.974 | 1.000 | 0.859 | 0.515 | 19.51 | 19.42 |
| 01112 | CA | 54 | BAKERSFIELD | 1.019 | 1.019 | 1.096 | 0.609 | 20.67 | 20.56 |
| 01112 | CA | 55 | CHICO | 1.017 | 1.017 | 1.096 | 0.536 | 20.54 | 20.43 |
| 01182 | CA | 71 | EL CENTRO | 1.017 | 1.017 | 1.096 | 0.541 | 20.54 | 20.44 |
| 01112 | CA | 56 | FRESNO | 1.017 | 1.017 | 1.096 | 0.536 | 20.54 | 20.43 |
| 01112 | CA | 57 | HANFORD-CORCORAN | 1.017 | 1.017 | 1.096 | 0.536 | 20.54 | 20.43 |
| 01182 | CA | 18 | LOS ANGELES-LONG BEACH-ANAHEIM (LOS ANGELES/ORANGE CNTY) | 1.041 | 1.041 | 1.183 | 0.664 | 21.36 | 21.26 |
| 01112 | CA | 58 | MADERA | 1.017 | 1.017 | 1.096 | 0.536 | 20.54 | 20.43 |
| 01112 | CA | 59 | MERCED | 1.017 | 1.017 | 1.096 | 0.536 | 20.54 | 20.43 |
| 01112 | CA | 60 | MODESTO | 1.017 | 1.017 | 1.096 | 0.536 | 20.54 | 20.43 |
| 01112 | CA | 51 | NAPA | 1.063 | 1.063 | 1.318 | 0.508 | 21.92 | 21.81 |
| 01182 | CA | 17 | OXNARD-THOUSAND OAKS-VENTURA | 1.028 | 1.028 | 1.182 | 0.623 | 21.09 | 20.99 |
| 01112 | CA | 61 | REDDING | 1.017 | 1.017 | 1.096 | 0.536 | 20.54 | 20.43 |
| 01112 | CA | 62 | RIVERSIDE-SAN BERNARDINO-ONTARIO | 1.018 | 1.018 | 1.096 | 0.853 | 20.98 | 20.88 |
| 01112 | CA | 63 | SACRAMENTO-ROSEVILLE-FOLSOM | 1.036 | 1.036 | 1.163 | 0.536 | 21.05 | 20.94 |
| 01112 | CA | 64 | SALINAS | 1.031 | 1.031 | 1.159 | 0.536 | 20.95 | 20.85 |
| 01182 | CA | 72 | SAN DIEGO-CHULA VISTA-CARLSBAD | 1.030 | 1.030 | 1.196 | 0.542 | 21.06 | 20.95 |
| 01112 | CA | 05 | SAN FRANCISCO-OAKLAND-BERKELEY (SAN FRANCISCO/SAN MATEO/ALAMEDA/CONTRA COSTA CNTY) | 1.095 | 1.095 | 1.410 | 0.425 | 22.60 | 22.49 |
| 01112 | CA | 52 | SAN FRANCISCO-OAKLAND-BERKELEY (MARIN CNTY) | 1.095 | 1.095 | 1.410 | 0.459 | 22.65 | 22.53 |
| 01112 | CA | 65 | SAN JOSE-SUNNYVALE-SANTA CLARA (SAN BENITO CNTY) | 1.110 | 1.110 | 1.442 | 0.536 | 23.09 | 22.98 |
| 01182 | CA | 73 | SAN LUIS OBISPO-PASO ROBLES | 1.017 | 1.017 | 1.139 | 0.536 | 20.67 | 20.56 |
| 01112 | CA | 09 | SAN JOSE-SUNNYVALE-SANTA CLARA (SANTA CLARA CNTY) | 1.110 | 1.110 | 1.442 | 0.397 | 22.90 | 22.79 |
| 01112 | CA | 66 | SANTA CRUZ-WATSONVILLE | 1.021 | 1.021 | 1.215 | 0.536 | 20.96 | 20.86 |
| 01182 | CA | 74 | SANTA MARIA-SANTA BARBARA | 1.028 | 1.028 | 1.166 | 0.536 | 20.93 | 20.82 |
| 01112 | CA | 67 | SANTA ROSA-PETALUMA | 1.030 | 1.030 | 1.228 | 0.536 | 21.15 | 21.04 |
| 01112 | CA | 68 | STOCKTON | 1.017 | 1.017 | 1.096 | 0.536 | 20.54 | 20.43 |
| 01112 | CA | 53 | VALLEJO | 1.063 | 1.063 | 1.318 | 0.459 | 21.85 | 21.74 |
| 01112 | CA | 69 | VISALIA | 1.017 | 1.017 | 1.096 | 0.536 | 20.54 | 20.43 |
| 01112 | CA | 70 | YUBA CITY | 1.017 | 1.017 | 1.096 | 0.536 | 20.54 | 20.43 |
| 01112 | CA | 75 | REST OF CALIFORNIA | 1.017 | 1.017 | 1.096 | 0.536 | 20.54 | 20.43 |
| 04112 | CO | 01 | COLORADO | 1.012 | 1.012 | 1.064 | 0.781 | 20.69 | 20.59 |
| 13102 | CT | 00 | CONNECTICUT | 1.020 | 1.020 | 1.077 | 1.210 | 21.44 | 21.34 |
| 12202 | DC | 01 | DC + MD/VA SUBURBS | 1.054 | 1.054 | 1.178 | 1.113 | 22.17 | 22.06 |
| 12102 | DE | 01 | DELAWARE | 1.005 | 1.005 | 0.988 | 0.899 | 20.51 | 20.41 |
| 09102 | FL | 03 | FORT LAUDERDALE | 0.993 | 1.000 | 1.013 | 1.808 | 21.74 | 21.63 |
| 09102 | FL | 04 | MIAMI | 0.994 | 1.000 | 1.041 | 2.529 | 22.80 | 22.69 |
| 09102 | FL | 99 | REST OF FLORIDA | 0.989 | 1.000 | 0.956 | 1.503 | 21.15 | 21.05 |
| 10212 | GA | 01 | ATLANTA | 1.003 | 1.003 | 1.016 | 1.201 | 20.97 | 20.87 |
| 10212 | GA | 99 | REST OF GEORGIA | 0.986 | 1.000 | 0.892 | 1.192 | 20.53 | 20.43 |
| 01212 | HI | 01 | HAWAII, GUAM | 0.998 | 1.000 | 1.137 | 0.579 | 20.44 | 20.34 |
| 02202 | ID | 00 | IDAHO | 0.980 | 1.000 | 0.920 | 0.473 | 19.64 | 19.54 |
| 06102 | IL | 16 | CHICAGO | 1.007 | 1.007 | 1.005 | 2.295 | 22.49 | 22.38 |
| 06102 | IL | 12 | EAST ST. LOUIS | 0.988 | 1.000 | 0.920 | 2.014 | 21.74 | 21.63 |
| 06102 | IL | 15 | SUBURBAN CHICAGO | 1.007 | 1.007 | 1.027 | 1.772 | 21.84 | 21.74 |
| 06102 | IL | 99 | REST OF ILLINOIS | 0.988 | 1.000 | 0.913 | 1.563 | 21.10 | 21.00 |
| 08102 | IN | 00 | INDIANA | 0.988 | 1.000 | 0.927 | 0.486 | 19.68 | 19.58 |
| 05102 | IA | 00 | IOWA | 0.984 | 1.000 | 0.915 | 0.397 | 19.52 | 19.43 |
| 05202 | KS | 00 | KANSAS | 0.984 | 1.000 | 0.904 | 0.504 | 19.63 | 19.54 |
| 15102 | KY | 00 | KENTUCKY | 0.981 | 1.000 | 0.889 | 0.915 | 20.15 | 20.05 |
| 07202 | LA | 01 | NEW ORLEANS | 0.989 | 1.000 | 0.941 | 1.136 | 20.61 | 20.50 |
| 07202 | LA | 99 | REST OF LOUISIANA | 0.985 | 1.000 | 0.885 | 0.958 | 20.19 | 20.09 |
| 14112 | ME | 03 | SOUTHERN MAINE | 0.990 | 1.000 | 0.991 | 0.631 | 20.07 | 19.97 |
| 14112 | ME | 99 | REST OF MAINE | 0.984 | 1.000 | 0.920 | 0.622 | 19.84 | 19.75 |
| 12302 | MD | 01 | BALTIMORE/SURR. CNTYS | 1.016 | 1.016 | 1.073 | 1.237 | 21.40 | 21.30 |
| 12302 | MD | 99 | REST OF MARYLAND | 1.010 | 1.010 | 1.012 | 0.918 | 20.69 | 20.58 |
| 14212 | MA | 01 | METROPOLITAN BOSTON | 1.041 | 1.041 | 1.194 | 0.890 | 21.70 | 21.59 |
| 14212 | MA | 99 | REST OF MASSACHUSETTS | 1.016 | 1.016 | 1.053 | 0.797 | 20.74 | 20.64 |
| 08202 | MI | 01 | DETROIT | 0.997 | 1.000 | 0.965 | 1.686 | 21.43 | 21.32 |
| 08202 | MI | 99 | REST OF MICHIGAN | 0.986 | 1.000 | 0.913 | 1.129 | 20.51 | 20.41 |
| 06202 | MN | 00 | MINNESOTA | 1.000 | 1.000 | 1.029 | 0.296 | 19.73 | 19.63 |
| 07302 | MS | 00 | MISSISSIPPI | 0.974 | 1.000 | 0.861 | 0.739 | 19.82 | 19.73 |
| 05302 | MO | 02 | METROPOLITAN KANSAS CITY | 0.989 | 1.000 | 0.939 | 0.977 | 20.38 | 20.28 |
| 05302 | MO | 01 | METROPOLITAN ST. LOUIS | 0.988 | 1.000 | 0.952 | 1.002 | 20.46 | 20.36 |
| 05302 | MO | 99 | REST OF MISSOURI | 0.976 | 1.000 | 0.862 | 0.974 | 20.15 | 20.05 |
| 03202 | MT | 01 | MONTANA** | 0.984 | 1.000 | 1.000 | 0.998 | 20.60 | 20.49 |
| 05402 | NE | 00 | NEBRASKA | 0.983 | 1.000 | 0.923 | 0.378 | 19.52 | 19.42 |
| 01312 | NV | 00 | NEVADA** | 0.989 | 1.000 | 1.001 | 0.833 | 20.38 | 20.27 |
| 14312 | NH | 40 | NEW HAMPSHIRE | 0.997 | 1.000 | 1.041 | 0.875 | 20.55 | 20.45 |
| 12402 | NJ | 01 | NORTHERN NJ | 1.063 | 1.063 | 1.160 | 1.068 | 22.20 | 22.09 |
| 12402 | NJ | 99 | REST OF NEW JERSEY | 1.040 | 1.040 | 1.092 | 1.097 | 21.66 | 21.55 |
| 04212 | NM | 05 | NEW MEXICO | 0.990 | 1.000 | 0.917 | 1.201 | 20.62 | 20.52 |
| 13202 | NY | 01 | MANHATTAN | 1.064 | 1.064 | 1.162 | 1.586 | 22.92 | 22.81 |
| 13202 | NY | 02 | NYC SUBURBS/LONG ISLAND | 1.064 | 1.064 | 1.189 | 1.857 | 23.37 | 23.26 |
| 13202 | NY | 03 | POUGHKPSIE/N NYC SUBURBS | 1.045 | 1.045 | 1.095 | 1.210 | 21.90 | 21.79 |
| 13292 | NY | 04 | QUEENS | 1.064 | 1.064 | 1.182 | 1.442 | 22.79 | 22.68 |
| 13282 | NY | 99 | REST OF NEW YORK | 0.995 | 1.000 | 0.950 | 0.703 | 20.04 | 19.95 |
| 11502 | NC | 00 | NORTH CAROLINA | 0.991 | 1.000 | 0.933 | 0.639 | 19.91 | 19.81 |
| 03302 | ND | 01 | NORTH DAKOTA** | 0.987 | 1.000 | 1.000 | 0.406 | 19.79 | 19.69 |
| 15202 | OH | 00 | OHIO | 0.990 | 1.000 | 0.913 | 1.008 | 20.35 | 20.25 |
| 04312 | OK | 00 | OKLAHOMA | 0.983 | 1.000 | 0.893 | 0.777 | 19.97 | 19.87 |
| 02302 | OR | 01 | PORTLAND | 1.016 | 1.016 | 1.111 | 0.744 | 20.85 | 20.74 |
| 02302 | OR | 99 | REST OF OREGON | 0.991 | 1.000 | 0.996 | 0.703 | 20.18 | 20.08 |
| 12502 | PA | 01 | METROPOLITAN PHILADELPHIA | 1.018 | 1.018 | 1.041 | 1.193 | 21.28 | 21.17 |
| 12502 | PA | 99 | REST OF PENNSYLVANIA | 0.990 | 1.000 | 0.918 | 0.945 | 20.28 | 20.18 |
| 09202 | PR | 20 | PUERTO RICO | 1.000 | 1.000 | 1.011 | 0.985 | 20.61 | 20.51 |
| 14412 | RI | 01 | RHODE ISLAND | 1.019 | 1.019 | 1.033 | 0.892 | 20.86 | 20.76 |
| 11202 | SC | 01 | SOUTH CAROLINA | 0.986 | 1.000 | 0.924 | 0.850 | 20.17 | 20.07 |
| 03402 | SD | 02 | SOUTH DAKOTA** | 0.990 | 1.000 | 1.000 | 0.336 | 19.70 | 19.60 |
| 10312 | TN | 35 | TENNESSEE | 0.984 | 1.000 | 0.909 | 0.537 | 19.69 | 19.60 |
| 04412 | TX | 31 | AUSTIN | 1.002 | 1.002 | 1.058 | 0.886 | 20.65 | 20.55 |
| 04412 | TX | 20 | BEAUMONT | 0.989 | 1.000 | 0.910 | 0.929 | 20.23 | 20.13 |
| 04412 | TX | 09 | BRAZORIA | 1.008 | 1.008 | 0.991 | 0.780 | 20.40 | 20.30 |
| 04412 | TX | 11 | DALLAS | 1.009 | 1.009 | 0.996 | 0.858 | 20.54 | 20.44 |
| 04412 | TX | 28 | FORT WORTH | 1.009 | 1.009 | 0.986 | 0.871 | 20.53 | 20.43 |
| 04412 | TX | 15 | GALVESTON | 1.008 | 1.008 | 0.993 | 0.828 | 20.47 | 20.37 |
| 04412 | TX | 18 | HOUSTON | 1.008 | 1.008 | 0.993 | 1.376 | 21.22 | 21.11 |
| 04412 | TX | 99 | REST OF TEXAS | 0.991 | 1.000 | 0.949 | 0.903 | 20.31 | 20.21 |
| 03502 | UT | 09 | UTAH | 0.985 | 1.000 | 0.940 | 0.898 | 20.28 | 20.18 |
| 14512 | VT | 50 | VERMONT | 0.988 | 1.000 | 0.990 | 0.506 | 19.90 | 19.80 |
| 11302 | VA | 00 | VIRGINIA | 1.000 | 1.000 | 0.983 | 0.706 | 20.15 | 20.05 |
| 09202 | VI | 50 | VIRGIN ISLANDS | 1.000 | 1.000 | 1.011 | 0.985 | 20.61 | 20.51 |
| 02402 | WA | 02 | SEATTLE (KING CNTY) | 1.050 | 1.050 | 1.227 | 0.817 | 21.85 | 21.74 |
| 02402 | WA | 99 | REST OF WASHINGTON | 1.013 | 1.013 | 1.053 | 0.761 | 20.65 | 20.54 |
| 11402 | WV | 16 | WEST VIRGINIA | 0.980 | 1.000 | 0.869 | 1.431 | 20.79 | 20.69 |
| 06302 | WI | 00 | WISCONSIN | 0.993 | 1.000 | 0.958 | 0.308 | 19.53 | 19.43 |
| 03602 | WY | 21 | WYOMING** | 0.991 | 1.000 | 1.000 | 0.740 | 20.25 | 20.15 |
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Integrated EHR and practice management
Instructions
MAC Assignments as of November 22, 2023
*Work GPCI reflects a 1.5 floor in Alaska established by the MIPPA
**PE GPCI reflects a 1.0 floor for frontier states established by the ACA
Note:
- The work GPCI floor of 1.0 that was applied in previous updates was extended through January 31, 2026 by Section 6207 of Continuing Appropriations, Agriculture, Legislative Branch, Military Construction and Veterans Affairs, and Extensions Act, 2026 (H.R.5371).
Therefore, the work GPCIs for 2025 reflect the 1.0 work GPCI floor, and work GPCIs for 2026 are shown both with and without a 1.0 floor, and work GPCIs for 2027 do not reflect a 1.0 floor. - For CY 2024 and on, Addendum E will reflect the retirement of 3 California localities, as finalized in the CY 2023 PFS final rule.
