The Geographic Practice Cost Index (GPCI) is the set of factors that adjust each RVU component for the cost of practicing in a specific locality. It's why the same code, with the same RVUs, produces a different Medicare allowed amount in different regions.
What it adjusts
- There is a GPCI for each RVU component — work, practice expense, and malpractice.
- Each locality has its own set of GPCI values, applied before the conversion factor.
- Higher-cost areas have higher GPCIs, raising the allowed amount.
Frequently asked
Why does the same CPT code pay more in one city?
Because of GPCI — the geographic adjustment applied to the RVUs for that locality before the conversion factor.
Does GPCI affect commercial payers?
Commercial fee schedules are often set as a percentage of Medicare, so the geographic variation can carry through, depending on the contract.
Primary sources: CMS — Medicare Physician Fee Schedule. General information, not legal or medical advice — confirm against the governing rule for the plan type.
Related guides
When the appeal has to be written, and cited
Upload the denied EOB and Merits returns a complete, citation-verified appeal letter — the clinical argument, the payer's own coverage criteria, and your federal appeal rights — in about a minute.