Medicare payment locality · Q3 2026 release

Connecticut CT Medicare Locality 00

MAC 13102 · Locality 00

This locality's GPCIs are all at or above the national baseline, so normally RVU-priced services tend to price above the national amount for the Q3 2026 Physician Fee Schedule. For nationally priced services, Medicare adjusts each code's work, practice-expense, and malpractice RVUs using these indexes.

Work GPCI

1.020

Adjusts the physician-work component for professional labor costs

Practice expense GPCI

1.077

Adjusts practice-expense inputs such as staff, rent, and services

Malpractice GPCI

1.210

Adjusts the malpractice component using liability-cost data

1.000 is the national baseline. Above raises that component; below lowers it. GPCIs are Medicare payment factors, not general cost-of-living or physician-compensation indexes.

Example rates in Connecticut Copy link

National vs. Connecticut office (non-facility) amounts for frequently reviewed codes, Q3 2026 (before sequestration). Conversion factor: 2026 standard (non-QP) physician conversion factor · $33.4009.

Code	National	Connecticut	Difference
99214	$135.61	$143.02	+5.5%
99213	$95.19	$100.45	+5.5%
99215	$192.39	$202.81	+5.4%
66984	$462.60	$486.97	+5.3%
99204	$177.36	$187.13	+5.5%
92014	$127.26	$134.53	+5.7%
97110	$29.06	$30.48	+4.9%
88305	$70.14	$74.24	+5.8%
97530	$35.07	$36.98	+5.4%
99203	$117.57	$124.29	+5.7%

Need a specific code or a facility rate? Use the rate calculator with this locality selected. Or start from your field's usual procedure mix on the specialty fee schedules.

ZIP codes in this locality Copy link

Connecticut covers 421 ZIP codes across CT, per the CMS ZIP-to-locality crosswalk (Q3 2026).

06001 06002 06006 06010 06011 06013 06016 06018 06019 06020 06021 06022 06023 06024 06025 06026 06027 06028 06029 06030 06031 06032 06033 06034 06035 06037 06039 06040 06041 06042 06043 06045 06050 06051 06052 06053 06057 06058 06059 06060 06061 06062 06063 06064 06065 06066 06067 06068 06069 06070 06071 06072 06073 06074 06075 06076 06077 06078 06079 06080 06081 06082 06083 06084 06085 06088 06089 06090 06091 06092 06093 06094 06095 06096 06098 06101 06102 06103 06104 06105 06106 06107 06108 06109 06110 06111 06112 06114 06115 06117 06118 06119 06120 06123 06126 06127 06128 06129 06131 06132 06133 06134 06137 06138 06140 06141 06142 06143 06144 06145 06146 06147 06150 06151 06152 06153 06154 06155 06156 06160 06161 06167 06176 06180 06183 06199 06226 06230 06231 06232 06233 06234 06235 06237 06238 06239 06241 06242 06243 06244 06245 06246 06247 06248 06249 06250 06251 06254 06255 06256 06258 06259 06260 06262 06263 06264 06265 06266 06267 06268 06269 06277 06278 06279 06280 06281 06282 06320 06330 06331 06332 06333 06334 06335 06336 06338 06339 06340 06349 06350 06351 06353 06354 06355 06357 06359 06360 06365 06370 06371 06372 06373 06374 06375 06376 06377 06378 06379 06380 06382 06383 06384 06385 06387 06388 06389 06401 06403 06404 06405 06408 06409 06410 06411 06412 06413 06414 06415 06416 06417 06418 06419 06420 06422 06423 06424 06426 06437 06438 06439 06440 06441 06442 06443 06444 06447 06450 06451 06455 06456 06457 06459 06460 06461 06467 06468 06469 06470 06471 06472 06473 06474 06475 06477 06478 06479 06480 06481 06482 06483 06484 06487 06488 06489 06491 06492 06493 06494 06495 06498 06501 06502 06503 06504 06505 06506 06507 06508 06509 06510 06511 06512 06513 06514 06515 06516 06517 06518 06519 06520 06521 06524 06525 06530 06531 06532 06533 06534 06535 06536 06537 06538 06540 06601 06602 06604 06605 06606 06607 06608 06610 06611 06612 06614 06615 06673 06699 06701 06702 06703 06704 06705 06706 06708 06710 06712 06716 06720 06721 06722 06723 06724 06725 06726 06750 06751 06752 06753 06754 06755 06756 06757 06758 06759 06762 06763 06770 06776 06777 06778 06779 06781 06782 06783 06784 06785 06786 06787 06790 06791 06792 06793 06794 06795 06796 06798 06801 06804 06807 06810 06811 06812 06813 06820 06824 06825 06828 06829 06830 06831 06836 06838 06840 06850 06851 06852 06853 06854 06855 06856 06857 06858 06860 06870 06875 06876 06877 06878 06879 06880 06881 06883 06888 06889 06890 06896 06897 06901 06902 06903 06904 06905 06906 06907 06910 06911 06912 06913 06914 06926 06927

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

Common questions Copy link

Why do Medicare rates in Connecticut differ from the national amount?

For nationally priced Physician Fee Schedule services, Medicare adjusts each code's work, practice-expense, and malpractice RVUs by this locality's three GPCIs before applying the conversion factor. Local professional labor, office-input, and liability costs therefore move the final amount up or down. Connecticut currently has all three GPCI components at or above the national baseline, so normally RVU-priced services tend to price above the national amount for the Q3 2026 release.

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

Medicare payment localities are geographic fee-schedule areas, commonly defined with county boundaries. CMS uses the service-location ZIP code to map a claim to the applicable carrier and locality. Look up your ZIP to find your locality. A few ZIPs nationally span multiple localities and need ZIP+4 to resolve exactly.

Do commercial insurers or Medicare Advantage plans use this locality?

Original Medicare uses these PFS localities directly. Commercial and Medicare Advantage plans are not required to use the same locality structure. A contract may benchmark payment to Medicare, but its language controls the Medicare release, percentage, geographic basis, and other adjustments.

Does my locality affect what I owe as a patient?

For a particular covered service, a higher locality-adjusted allowed amount generally produces a higher percentage-based coinsurance amount. The effect depends on the code, the beneficiary's deductible, supplemental coverage, and other claim circumstances.

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

CMS publishes updated PFS files during the year. A code's amount can change because of conversion-factor, RVU, policy, or correction updates. GPCI policy values are generally established through annual rulemaking, although later files can contain corrections. See what changed each release.

Source & method Copy link

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 use the standard (non-QP) physician conversion factor ($33.4009) and apply this locality's GPCIs to nationally priced non-facility RVUs, before the ~2% sequestration cut. Releases are immutable: a rate retrieved for a past quarter always reflects that PFS release.

Geographic practice cost indices (Q3 2026) · rvu26c-updated-06-30-2026.zip (GPCI2026.csv row 38)

ZIP code to carrier locality crosswalk (Q3 2026) · zip-code-carrier-locality-file-updated-05-13-2026.zip (ZIP5_JUL2026.txt)

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