> ## Documentation Index
> Fetch the complete documentation index at: https://docs.rcintell.com/llms.txt
> Use this file to discover all available pages before exploring further.

# 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.

```bash theme={null}
# 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:

```json theme={null}
{
  "layer": "l1_location",
  "state": "KS",
  "gpci": {
    "pw_gpci": 1.000,
    "pe_gpci": 0.891,
    "mp_gpci": 0.407
  },
  "mac": "Jurisdiction 5"
}
```