2016 GPCI Value Table

The following table shows the GPCI values, by Medicare Carrier and Locality, CPT® Conversion Factor and Anesthesia Conversion Factor by Locality for 2016. eMDs Bill uses these in conjunction with the RVU values for each CPT® fee to automatically calculate your Medicare fee schedule. This fee schedule can also be copied and adjusted for other contracts based on Medicare. We advise that you check this page at the start of each quarter to see if there have been changes to the conversion factor or GPCIs. You should also check the for updated RVU conversion files.

Instructions

  • » Ensure you have the 2016 CPT® & HCPCS content update.
  • » Ensure you have the 2016 RVU update against the CPT® and HCPCS codes.
  • » Look up your Medicare locality in the Locality Name column. Make sure you distinguish between urban areas and rest of state areas.
  • » In eMDs Bill, click File >> Setup Options and type the GPCI values into the fields provided. Don't forget to use the decimal point. Note that the options are facility-specific, so be sure to set these based on the facility in which you are calculating fees. There is no Budget Neutrality Adjuster (BNA) for 2016 so leave the Data 1 field blank or set to 1.
  • » Enter the CPT® and Anesthesia Conversion Factors. The 2016 Physician Fee Schedule Conversion Factor is $35.8043 . The anesthesia CF for your locality can be found in the GPCI table. Click Save.
  • » Refer to Fee Schedules in the eMDs Bill User Guide for assistance with creating the Medicare and other fee schedules.

Addendum E Final 2016 Geographic Practice Cost Indices (GPCIs)

Locality Locality name Work GPCI  PE GPCI  MP GPCI  Anesthesia CF
00 Alabama 1.000 0.886 0.611 21.08
01 Alaska** 1.500 1.107 0.712 30.58
00 Arizona 1.000 1.000 0.877 21.83
13 Arkansas 1.000 0.867 0.534 20.91
26 Anaheim/Santa Ana, CA 1.035 1.216 0.908 23.20
18 Los Angeles, CA 1.047 1.161 0.908 23.22
03 Marin/Napa/Solano, CA 1.059 1.286 0.496 23.29
07 Oakland/Berkeley, CA 1.061 1.260 0.457 23.19
05 San Francisco, CA 1.079 1.388 0.457 23.93
06 San Mateo, CA 1.079 1.372 0.416 23.82
09 Santa Clara, CA 1.088 1.347 0.416 23.89
17 Ventura, CA 1.030 1.180 0.834 22.89
99 Rest of California 1.027 1.083 0.658 22.27
01 Colorado 1.000 1.011 1.090 22.15
00 Connecticut 1.024 1.121 1.232 23.13
01 DC + MD/VA Suburbs 1.051 1.205 1.280 23.95
01 Delaware 1.012 1.031 1.083 22.42
03 Fort Lauderdale, FL 1.000 1.030 1.715 23.07
04 Miami, FL 1.000 1.033 2.490 24.14
99 Rest of Florida 1.000 0.960 1.315 22.29
01 Atlanta, GA 1.000 1.005 0.943 21.93
99 Rest of Georgia 1.000 0.899 0.904 21.52
01 Hawaii/Guam 1.003 1.162 0.618 22.07
00 Idaho 1.000 0.898 0.508 20.98
16 Chicago, IL 1.016 1.037 2.019 23.78
12 East St. Louis, IL 1.000 0.934 1.885 22.98
15 Suburban Chicago, IL 1.012 1.057 1.636 23.26
99 Rest of Illinois 1.000 0.909 1.253 22.03
00 Indiana 1.000 0.921 0.617 21.20
00 Iowa 1.000 0.896 0.493 20.95
00 Kansas 1.000 0.903 0.662 21.20
00 Kentucky 1.000 0.872 0.795 21.28
01 New Orleans, LA 1.000 0.983 1.390 22.47
99 Rest of Louisiana 1.000 0.887 1.205 21.89
03 Southern Maine 1.000 1.007 0.642 21.53
99 Rest of Maine 1.000 0.918 0.642 21.23
01 Baltimore/Surr. Cntys, MD 1.023 1.097 1.181 22.97
99 Rest of Maryland 1.015 1.036 0.971 22.33
01 Metropolitan Boston 1.017 1.163 0.617 22.32
99 Rest of Massachusetts 1.017 1.066 0.617 21.99
01 Detroit, MI 1.000 0.994 1.328 22.42
99 Rest of Michigan 1.000 0.920 0.954 21.66
00 Minnesota 1.000 1.020 0.319 21.13
00 Mississippi 1.000 0.864 0.613 21.01
02 Metropolitan Kansas City, MO 1.000 0.952 1.025 21.87
01 Metropolitan St Louis, MO 1.000 0.955 1.025 21.88
99 Rest of Missouri 1.000 0.848 0.946 21.41
01 Montana *** 1.000 1.000 1.226 22.30
00 Nebraska 1.000 0.908 0.362 20.81
00 Nevada *** 1.005 1.051 0.982 22.23
40 New Hampshire 1.000 1.058 0.873 22.02
01 Northern NJ 1.040 1.182 1.090 23.42
99 Rest of New Jersey 1.025 1.125 1.090 22.97
05 New Mexico 1.000 0.919 1.161 21.94
01 Manhattan, NY 1.052 1.168 1.764 24.50
02 NYC Suburbs/Long I., NY 1.046 1.209 2.215 25.15
03 Poughkpsie/N NYC Suburbs, NY 1.010 1.074 1.484 23.08
04 Queens, NY 1.052 1.199 2.181 25.17
99 Rest of New York 1.000 0.945 0.760 21.48
00 North Carolina 1.000 0.930 0.768 21.44
01 North Dakota *** 1.000 1.000 0.554 21.39
00 Ohio 1.000 0.918 0.993 21.71
00 Oklahoma 1.000 0.872 0.845 21.35
01 Portland, OR 1.005 1.049 0.708 21.85
99 Rest of Oregon 1.000 0.967 0.708 21.48
01 Metropolitan Philadelphia, PA 1.021 1.087 1.264 23.01
99 Rest of Pennsylvania 1.000 0.929 0.987 21.74
20 Puerto Rico 1.000 0.705 0.293 20.03
01 Rhode Island 1.022 1.053 0.759 22.22
01 South Carolina 1.000 0.912 0.715 21.31
02 South Dakota*** 1.000 1.000 0.400 21.18
35 Tennessee 1.000 0.898 0.524 21.00
31 Austin, TX 1.000 1.019 0.766 21.74
20 Beaumont, TX 1.000 0.902 0.955 21.60
09 Brazoria, TX 1.019 0.990 0.955 22.23
11 Dallas, TX 1.018 1.009 0.772 22.02
28 Fort Worth, TX 1.005 0.995 0.772 21.75
15 Galveston, TX 1.019 1.013 0.955 22.30
18 Houston, TX 1.019 1.006 0.955 22.28
99 Rest of Texas 1.000 0.920 0.822 21.48
09 Utah 1.000 0.922 1.169 21.96
50 Vermont 1.000 1.004 0.682 21.57
00 Virginia 1.000 0.983 0.824 21.70
50 Virgin Islands 1.000 0.960 0.996 21.85
02 Seattle (King Cnty), WA 1.025 1.155 0.495 22.26
99 Rest of Washington 1.000 1.015 0.475 21.33
16 West Virginia 1.000 0.836 1.282 21.82
00 Wisconsin 1.000 0.955 0.566 21.25
21 Wyoming *** 1.000 1.000 1.219 22.29