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Geographic Practice Cost Indices (GPCIs) are CMS-published adjustment factors that account for geographic differences in the cost of practicing medicine. They adjust the three RVU components so Medicare payment reflects local costs.

The three GPCIs

How GPCIs affect payment

A GPCI of 1.000 means the area is at the national average. Values above 1.0 increase payment; values below 1.0 decrease it.

Example comparison

Manhattan pays ~34% more than rural Mississippi for the same service, reflecting higher local costs.

Work GPCI floor

CMS sets a floor of 1.000 for the Work GPCI. This means no area has its Work RVU reduced below the national average, even if local physician compensation is lower.

RCI and GPCIs

The L1 (Physical Location) layer in RCI’s knowledge graph resolves GPCI values from the facility’s CCN. These values flow into L6 (Service) for payment calculation.
Response includes: