What is GPCI?

Geographic Practice Cost Indices and how they adjust Medicare payment

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

GPCI	Adjusts	Reflects
Work GPCI (PW)	Work RVU	Physician compensation variations by area
PE GPCI	Practice Expense RVU	Rent, staff wages, supply costs by area
MP GPCI	Malpractice RVU	Malpractice insurance premiums by area

How GPCIs affect payment

Payment = (Work RVU × PW_GPCI + PE RVU × PE_GPCI + MP RVU × MP_GPCI) × CF

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

Area	PW GPCI	PE GPCI	MP GPCI	Payment (99213)
Manhattan, NY	1.058	1.281	1.554	$91.43
Kansas	1.000	0.891	0.407	$71.91
Rural Mississippi	1.000	0.799	0.382	$68.12

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.

# Get GPCI values for a facility
curl https://api-dev.rcintell.com/v1/knowledge/layers/170001/l1 \
  -H "X-API-Key: kp_test_..."

Response includes:

{
  "layer": "l1_location",
  "state": "KS",
  "gpci": {
    "pw_gpci": 1.000,
    "pe_gpci": 0.891,
    "mp_gpci": 0.407
  },
  "mac": "Jurisdiction 5"
}