New York GPCI Values

Geographic Practice Cost Index (GPCI) values for New York (NY). GPCIs adjust Medicare physician payments to reflect local cost differences.

Based on CMS Physician Fee Schedule GPCI data

Work GPCI
1.035
3.5% above national
Practice Expense GPCI
1.101
10.1% above national
Malpractice GPCI
0.827
17.3% below national

New York GPCI by Locality

LocalityWork GPCIPE GPCIMP GPCI
Manhattan1.0941.3761.190
Queens/Brooklyn1.0581.2161.190
Long Island/Westchester1.0581.2470.940
Rest of New York1.0000.8890.594

Example: How New York GPCIs Affect Payment

Here is an example calculation for CPT 99214 (Established Patient Office Visit, Level 4) in New York using statewide average GPCIs:

ComponentNational RVUNY GPCIAdjusted RVU
Work RVU1.921.0351.9872
Practice Expense RVU1.561.1011.7176
Malpractice RVU0.290.8270.2398
Total3.77--3.9446

Estimated New York Medicare Payment for 99214: 3.9446 x $32.74 (conversion factor) = $129.15(+4.6% vs. national average of $123.43)

What Are GPCIs?

The Geographic Practice Cost Index (GPCI) is a set of three adjustment factors used by CMS to modify Medicare physician payments based on geographic differences in the cost of practicing medicine. Every Medicare locality has its own set of GPCI values.

Work GPCI

Adjusts the work RVU based on local physician earnings. Most states have a floor of 1.000.

PE GPCI

Adjusts the practice expense RVU based on local rents, wages, equipment, and supply costs.

MP GPCI

Adjusts the malpractice RVU based on local professional liability insurance premiums.

About New York: New York City has the widest GPCI variation of any metro area. Manhattan has one of the highest practice expense GPCIs nationally.

Medicare Payment Formula

CMS calculates Medicare physician payment using this formula:

Payment = [(Work RVU x Work GPCI) + (PE RVU x PE GPCI) + (MP RVU x MP GPCI)] x Conversion Factor

The 2026 Medicare conversion factor is $32.74. This single dollar amount is multiplied by the GPCI-adjusted total RVU to determine the Medicare Allowed Amount for each service.

GPCI values shown are representative averages based on CMS data. Actual values vary by specific Medicare locality. Always verify with the official CMS Physician Fee Schedule for billing purposes. wRVU Tracker is for reference only.