Medicare payment locality · Q2 2025 release

Atlanta, Ga GA Medicare Locality 01

MAC 10212 · Locality 01

This locality's GPCIs are mixed, so the net payment effect varies by code for the Q2 2025 Physician Fee Schedule. For nationally priced services, Medicare adjusts each code's work, practice-expense, and malpractice RVUs using these indexes.

Work GPCI

1.000

Adjusts the physician-work component for professional labor costs

Practice expense GPCI

0.997

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

Malpractice GPCI

1.128

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 Atlanta, Ga Copy link

National vs. Atlanta, Ga office (non-facility) amounts for frequently reviewed codes, Q2 2025 (before sequestration). Conversion factor: 2025 standard (non-QP) physician conversion factor · $32.3465.

Code	National	Atlanta, Ga	Difference
99214	$125.18	$125.63	+0.4%
99213	$88.95	$89.24	+0.3%
99215	$175.64	$176.28	+0.4%
66984	$521.75	$523.23	+0.3%
99204	$163.35	$164.13	+0.5%
92014	$120.98	$120.92	0.0%
97110	$28.79	$28.79	0.0%
88305	$69.54	$69.49	-0.1%
97530	$34.61	$34.59	-0.1%
99203	$109.01	$109.51	+0.5%

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

Atlanta, Ga covers 275 ZIP codes across GA, per the CMS ZIP-to-locality crosswalk (Q2 2025). 20 of them span more than one locality and need ZIP+4 for an exact match.

30002 30003 30004 30005 30006 30007 30008 30009 30010 30012 30013 30014 30015 30016 30017 30018 30019 30021 30022 30023 30024 30025 30026 30028 30029 30030 30031 30032 30033 30034 30035 30036 30037 30038 30039 30040 30041 30042 30043 30044 30045 30046 30047 30048 30049 30052 30054 30055 30056 30058 30060 30061 30062 30063 30064 30065 30066 30067 30068 30069 30070 30071 30072 30073 30074 30075 30076 30077 30078 30079 30080 30081 30082 30083 30084 30085 30086 30087 30088 30090 30091 30092 30093 30094 30095 30096 30097 30098 30099 30101 30102 30106 30107 30111 30114 30115 30122 30126 30127 30132 30133 30134 30135 30141 30142 30144 30146 30151 30152 30154 30156 30157 30160 30168 30169 30183 30187 30188 30189 30205 30213 30214 30215 30216 30228 30232 30233 30234 30236 30237 30238 30248 30250 30252 30253 30260 30268 30269 30270 30272 30273 30274 30281 30287 30288 30290 30291 30294 30296 30297 30298 30300 30301 30302 30303 30304 30305 30306 30307 30308 30309 30310 30311 30312 30313 30314 30315 30316 30317 30318 30319 30320 30321 30322 30323 30324 30325 30326 30327 30328 30329 30330 30331 30332 30333 30334 30335 30336 30337 30338 30339 30340 30341 30342 30343 30344 30345 30346 30347 30348 30349 30350 30351 30352 30353 30354 30355 30356 30357 30358 30359 30360 30361 30362 30363 30364 30365 30366 30367 30368 30369 30370 30371 30374 30375 30376 30377 30378 30379 30380 30381 30383 30384 30385 30386 30387 30388 30389 30390 30392 30394 30396 30398 30399 30515 30518 30519 30641 30655 30656 31106 31107 31119 31120 31126 31131 31132 31136 31139 31141 31144 31145 31146 31150 31156 31169 31191 31192 31193 31195 31196 31197 31198 31199 39901

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

Common questions Copy link

Why do Medicare rates in Atlanta, Ga 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. Atlanta, Ga currently has mixed GPCI components, so the net payment effect varies by code for the Q2 2025 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. About 20 ZIP codes in Atlanta, Ga span more than one locality and need the 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 Q2 2025 release (effective April 2025). ZIP coverage from the CMS ZIP-to-locality crosswalk, Q2 2025 release . Example amounts use the standard (non-QP) physician conversion factor ($32.3465) 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 (Q2 2025) · rvu25b-updated-06-05-2025.zip (GPCI2025.csv row 44)

ZIP code to carrier locality crosswalk (Q2 2025) · 2025.zip (ZIP5_APR2025.txt)

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