Medicare fee schedule by locality · Q3 2026 release
New York
New York has 5 Medicare payment localities, each with its own GPCIs — the work GPCI alone ranges from 1.000 to 1.064 across the state. National amounts use GPCI 1.000; every row below shows what a common code actually pays once each locality's real GPCIs apply.
Localities in New York
99213 non-facility amount by locality, Q3 2026 (before sequestration) — national baseline $95.19 .
| Locality | Work GPCI | PE GPCI | MP GPCI | 99213 amount |
|---|---|---|---|---|
| Manhattan | 1.064 | 1.162 | 1.586 | $107.63 (+13.1%) |
| NYC Suburbs/Long Island | 1.064 | 1.189 | 1.857 | $109.76 (+15.3%) |
| Poughkpsie/N NYC Suburbs | 1.045 | 1.095 | 1.210 | $102.41 (+7.6%) |
| Queens | 1.064 | 1.182 | 1.442 | $108.18 (+13.6%) |
| Rest of New York | 1.000 | 0.950 | 0.703 | $91.86 (-3.5%) |
Need a different code or the facility rate? Use the rate calculator with any locality above selected.
Common questions
How many Medicare payment localities are in New York?
New York has 5 Medicare payment localities, each with its own work, practice-expense, and malpractice GPCIs.
Do Medicare rates vary within New York?
Yes. New York's 5 localities have different GPCIs — the work GPCI alone ranges from 1.000 to 1.064 , so the same code can pay a different amount depending on where in the state it's billed.
Source & method
GPCIs and example rates computed from the CMS Medicare Physician Fee Schedule Q3 2026 release. Example amounts are national non-facility figures rescaled by each locality's GPCIs, before the ~2% sequestration cut. Releases are immutable; a rate retrieved for a past quarter always reflects that release.