Glossary · Updated Jul 6, 2026
GPCI (Geographic Practice Cost Index)
A GPCI is a geographic adjustment factor that scales each RVU component up or down to reflect local cost differences. Medicare publishes three GPCIs per locality — one each for work, practice expense, and malpractice.
Why it exists
The cost of employing staff, renting space, and buying malpractice coverage varies widely across the country. The GPCIs adjust the national RVUs so that payment reflects what it actually costs to deliver care in a given locality. A GPCI above 1.000 raises that component; below 1.000 lowers it.
Three indexes, three components
The work GPCI adjusts the work RVU, the practice expense GPCI adjusts the PE RVU, and the malpractice GPCI adjusts the MP RVU. Each locality has its own set of three, so two localities with the same code can arrive at different payment amounts.
The national baseline
A GPCI of 1.000 represents the national average. National rate figures — like the ones shown on our code pages by default — apply 1.000 for all three GPCIs, which isolates the pure RVU-and-conversion-factor result before any locality adjustment. Every locality's three GPCIs are listed in the locality directory.
Frequently asked
How many GPCIs are there per code?
Three per locality: work, practice expense, and malpractice. They apply to the matching RVU component.
What does a GPCI of 1.000 mean?
It is the national average — no upward or downward local adjustment. National amounts use 1.000 for all three indexes.
Related
Sources
Written from primary CMS sources — see how we source, compute, and verify everything on this site.