Medicare fee schedule by locality · Q3 2026 release
Pennsylvania
Pennsylvania has 2 Medicare payment localities, each with its own GPCIs — the work GPCI alone ranges from 1.000 to 1.018 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 Pennsylvania
99213 non-facility amount by locality, Q3 2026 (before sequestration) — national baseline $95.19 .
| Locality | Work GPCI | PE GPCI | MP GPCI | 99213 amount |
|---|---|---|---|---|
| Metropolitan Philadelphia | 1.018 | 1.041 | 1.193 | $98.55 (+3.5%) |
| Rest of Pennsylvania | 1.000 | 0.918 | 0.945 | $91.03 (-4.4%) |
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 Pennsylvania?
Pennsylvania has 2 Medicare payment localities, each with its own work, practice-expense, and malpractice GPCIs.
Do Medicare rates vary within Pennsylvania?
Yes. Pennsylvania's 2 localities have different GPCIs — the work GPCI alone ranges from 1.000 to 1.018 , 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.