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Medicare payment locality · Q3 2026 release

Rest of Washington WA

MAC 02402 · Locality 99

This locality's GPCIs lift Medicare payments above the national average for the Q3 2026 Physician Fee Schedule. Every code below is the national amount rescaled by the three local indexes.

Work GPCI
1.013
Adjusts payment for local physician wages and cost of living
Practice expense GPCI
1.053
Adjusts payment for local office costs like rent and staff
Malpractice GPCI
0.761
Adjusts payment for local malpractice insurance premiums

1.000 is the national baseline. Above raises that component; below lowers it.

Example rates in Rest of Washington

National vs. Rest of Washington non-facility amounts for common codes, Q3 2026 (before sequestration).

Code National Rest of Washington Difference
0446T $6,320.12 $6,652.72 +5.3%
0447T $100.87 $103.69 +2.8%
0448T $6,219.58 $6,545.08 +5.2%
0509T $77.82 $81.23 +4.4%
0583T $1,505.04 $1,579.74 +5.0%
0596T $2,019.08 $2,121.47 +5.1%
0597T $596.54 $626.21 +5.0%
0605T $758.53 $798.05 +5.2%
10004 $53.11 $53.61 +0.9%
10005 $132.27 $135.72 +2.6%

Need a specific code or a facility rate? Use the rate calculator with this locality selected.

ZIP codes in this locality

Rest of Washington covers 614 ZIP codes across WA, per the CMS ZIP-to-locality crosswalk (Q3 2026). 4 of them span more than one locality and need ZIP+4 for an exact match.

98012 98020 98021 98026 98036 98037 98043 98046 98061 98068 98082 98087 +602 more

Not sure which locality your ZIP is in? Look it up by ZIP code.

Common questions

Why do Medicare rates in Rest of Washington differ from the national amount?

Medicare scales each code's work, practice-expense, and malpractice RVUs by this locality's three GPCIs before applying the conversion factor, so local labor, rent, and liability costs move the final amount up or down. Rest of Washington currently pays above the national average for the Q3 2026 release.

How do I know if my address is in this locality?

Medicare assigns localities by ZIP code, not city or county lines, so neighboring addresses can fall in different localities. Look up your ZIP to find your locality. About 4 ZIP codes in Rest of Washington span more than one locality and need the ZIP+4 to resolve exactly.

Do commercial insurers or Medicare Advantage plans use this locality?

No. Medicare payment localities are specific to Original Medicare's Physician Fee Schedule. Medicare Advantage plans and commercial insurers set their own geographic adjustments and negotiated network rates — they aren't required to follow CMS locality boundaries, even though many benchmark off the Medicare amount.

Does my locality affect what I owe as a patient?

Yes. Your 20% coinsurance under Original Medicare is calculated on the locality-adjusted amount, not the national one, so the same code can leave you owing more or less depending on where you're treated. Rest of Washington pays above the national average, so patients here typically owe a bit more in coinsurance than the national amount would suggest.

Why did my Medicare payment change even though I didn't change what I billed?

GPCIs and the conversion factor update with each quarterly CMS release (January, April, July, October), so the same code in the same locality can pay a different amount quarter to quarter with nothing else changing — see what changed each release.

Source & method

GPCIs and rates computed from the CMS Medicare Physician Fee Schedule Q3 2026 release (effective July 2026). ZIP coverage from the CMS ZIP-to-locality crosswalk, Q3 2026 release. Example amounts are national non-facility figures rescaled by this locality's GPCIs, before the ~2% sequestration cut. Releases are immutable; a rate retrieved for a past quarter always reflects that release.

Geographic practice cost indices (Q3 2026) · rvu26c-updated-06-30-2026.zip (GPCI2026.csv row 109)
ZIP code to carrier locality crosswalk (Q3 2026) · zip-code-carrier-locality-file-updated-05-13-2026.zip (ZIP5_JUL2026.txt)

Spot an inaccuracy?

We work hard to keep every rate and citation accurate, but CMS source data is messy and mistakes happen. If something here looks wrong, we'd appreciate you letting us know.

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