GPCI

GPCI

2015 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 2015. e-MDs 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:

  1. Ensure you have the 2015 CPT® & HCPCS content update.
  2. Ensure you have the 2015 RVU update against the CPT® and HCPCS codes.
  3. Look up your Medicare locality in the Locality Name column. Make sure you distinguish between urban areas and rest of state areas.
  4. In e-MDs 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 2015 so leave the Data 1 field blank or set to 1.
  5. Enter the CPT® and Anesthesia Conversion Factors. The 2015 Physician Fee Schedule Conversion Factor is $35.7547. The anesthesia CF for your locality can be found in the GPCI table. Click Save.
  6. Refer to Fee Schedules in the e-MDs Bill User Guide for assistance with creating the Medicare and other fee schedules.

 

 

ADDENDUM E FINAL 2014 GEOGRAPHIC PRACTICE COST INDICES (GPCIs)
Locality State/County Work RVU PE RVU MP RVU 2015 Anes CF
00 Alabama 1.000 0.886 0.611 21.43
01 Alaska** 1.500 1.107 0.712 31.00
00 Arizona 1.000 1.000 0.877 22.32
13 Arkansas 1.000 0.867 0.534 21.21
26 Anaheim/Santa Ana, CA 1.035 1.216 0.908 23.71
18 Los Angeles, CA 1.047 1.161 0.908 23.73
03 Marin/Napa/Solano, CA 1.059 1.286 0.496 23.57
07 Oakland/Berkeley, CA 1.061 1.260 0.457 23.44
05 San Francisco, CA 1.079 1.388 0.457 24.18
06 San Mateo, CA 1.079 1.372 0.416 24.05
09 Santa Clara, CA 1.088 1.347 0.416 24.12
17 Ventura, CA 1.030 1.180 0.834 23.36
99 Rest of California 1.027 1.083 0.658 22.64
01 Colorado 1.000 1.011 1.090 22.76
00 Connecticut 1.024 1.121 1.232 23.82
01 DC + MD/VA Suburbs 1.051 1.205 1.280 24.66
01 Delaware 1.012 1.031 1.083 23.03
03 Fort Lauderdale, FL 1.000 1.030 1.715 24.03
04 Miami, FL 1.000 1.033 2.490 25.52
99 Rest of Florida 1.000 0.960 1.315 23.02
01 Atlanta, GA 1.000 1.005 0.943 22.46
99 Rest of Georgia 1.000 0.899 0.904 22.03
01 Hawaii/Guam 1.003 1.162 0.618 22.42
00 Idaho 1.000 0.898 0.508 21.27
16 Chicago, IL 1.016 1.037 2.019 24.91
12 East St. Louis, IL 1.000 0.934 1.885 24.03
15 Suburban Chicago, IL 1.012 1.057 1.636 24.17
99 Rest of Illinois 1.000 0.909 1.253 22.73
00 Indiana 1.000 0.921 0.617 21.56
00 Iowa 1.000 0.896 0.493 21.23
00 Kansas 1.000 0.903 0.662 21.58
00 Kentucky 1.000 0.872 0.795 21.73
01 New Orleans, LA 1.000 0.983 1.390 23.25
99 Rest of Louisiana 1.000 0.887 1.205 22.57
03 Southern Maine 1.000 1.007 0.642 21.89
99 Rest of Maine 1.000 0.918 0.642 21.59
01 Baltimore/Surr. Cntys, MD 1.023 1.097 1.181 23.63
99 Rest of Maryland 1.015 1.036 0.971 22.88
01 Metropolitan Boston 1.017 1.163 0.617 22.66
99 Rest of Massachusetts 1.017 1.066 0.617 22.34
01 Detroit, MI 1.000 0.994 1.328 23.16
99 Rest of Michigan 1.000 0.920 0.954 22.20
00 Minnesota 1.000 1.020 0.319 21.32
00 Mississippi 1.000 0.864 0.613 21.36
02 Metropolitan Kansas City, MO 1.000 0.952 1.025 22.44
01 Metropolitan St Louis, MO 1.000 0.955 1.025 22.45
99 Rest of Missouri 1.000 0.848 0.946 21.94
01 Montana *** 1.000 1.000 1.226 22.99
00 Nebraska 1.000 0.908 0.362 21.02
00 Nevada *** 1.005 1.051 0.982 22.78
40 New Hampshire 1.000 1.058 0.873 22.51
01 Northern NJ 1.040 1.182 1.090 24.03
99 Rest of New Jersey 1.025 1.125 1.090 23.58
05 New Mexico 1.000 0.919 1.161 22.59
01 Manhattan, NY 1.052 1.168 1.764 25.48
02 NYC Suburbs/Long I., NY 1.046 1.209 2.215 26.38
03 Poughkpsie/N NYC Suburbs, NY 1.010 1.074 1.484 23.90
04 Queens, NY 1.052 1.199 2.181 26.39
99 Rest of New York 1.000 0.945 0.760 21.91
00 North Carolina 1.000 0.930 0.768 21.87
01 North Dakota *** 1.000 1.000 0.554 21.70
00 Ohio 1.000 0.918 0.993 22.27
00 Oklahoma 1.000 0.872 0.845 21.83
01 Portland, OR 1.005 1.049 0.708 22.25
99 Rest of Oregon 1.000 0.967 0.708 21.88
01 Metropolitan Philadelphia, PA 1.021 1.087 1.264 23.72
99 Rest of Pennsylvania 1.000 0.929 0.987 22.29
20 Puerto Rico 1.000 0.705 0.293 20.21
01 Rhode Island 1.022 1.053 0.759 22.65
01 South Carolina 1.000 0.912 0.715 21.71
02 South Dakota*** 1.000 1.000 0.400 21.40
35 Tennessee 1.000 0.898 0.524 21.30
31 Austin, TX 1.000 1.019 0.766 22.17
20 Beaumont, TX 1.000 0.902 0.955 22.14
09 Brazoria, TX 1.019 0.990 0.955 22.76
11 Dallas, TX 1.018 1.009 0.772 22.46
28 Fort Worth, TX 1.005 0.995 0.772 22.19
15 Galveston, TX 1.019 1.013 0.955 22.84
18 Houston, TX 1.019 1.006 0.955 22.82
99 Rest of Texas 1.000 0.920 0.822 21.94
09 Utah 1.000 0.922 1.169 22.62
50 Vermont 1.000 1.004 0.682 21.96
00 Virginia 1.000 0.983 0.824 22.16
50 Virgin Islands 1.000 0.960 0.996 22.41
02 Seattle (King Cnty), WA 1.025 1.155 0.495 22.54
99 Rest of Washington 1.000 1.015 0.475 21.60
16 West Virginia 1.000 0.836 1.282 22.54
00 Wisconsin 1.000 0.955 0.566 21.57
21 Wyoming *** 1.000 1.000 1.219 22.97

2015 GPCIs reflect the second year of the two year update transition.

 

* January 1, 2015 through March 31, 2015, the Work GPCIs reflect a 1.0 floor as required by the Protecting Access to Medicare Act (PAMA) of 2014.

** Work GPCI reflects a 1.5 floor for Alaska established by the MIPPA.

 

*** PE GPCI reflects a 1.0 floor for frontier states established by the ACA.