Iowa (IA) Medicare rates & GPCIs—Q2 2024

ZIP codes in this locality Copy link

Iowa covers 1,080 ZIP codes across IA, per the CMS ZIP-to-locality crosswalk (Q2 2024). 5 of them, outlined with a dashed border below, span more than one locality: CMS places those by ZIP+4, so this locality holds for only part of each.

The Q2 2024 ZIP-to-locality crosswalk file is not a captured CMS release; each reconstructed field has high confidence from bracketing CMS files and documented effective-quarter changes, but the original CMS artifact has not been recovered.

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Show all 1,080 ZIP codes

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Have a service address? Look up its ZIP and date of service to confirm the locality.

GPCI history Copy link

This locality's GPCIs in each release on file, newest first. Releases with unchanged GPCIs share a row.

Release	Work	PE	MP
January 2026 to October 2026	1.000	0.915	0.397
January 2024 to October 2025 (this page)	1.000	0.913	0.457
January 2023 to October 2023	1.000	0.910	0.441
January 2021 to October 2022	1.000	0.907	0.425
January 2020 to October 2020	1.000	0.907	0.424
January 2018 to October 2019	1.000	0.907	0.423
January 2017 to October 2017	1.000	0.902	0.458
January 2015 to October 2016	1.000	0.896	0.493
April 2014 to October 2014	1.000	0.892	0.475
January 2013 to April 2013	1.000	0.887	0.456

Example rates in Iowa Copy link

National and local Office (non-facility) amounts for frequently reviewed codes in the Q2 2024 release, before sequestration. Conversion factor: 2024 standard (non-QP) physician conversion factor, $33.2875.

Code	National	Local	Difference
99214	$128.16	$120.44	-6.0%
99213	$90.87	$85.22	-6.2%
99215	$180.42	$169.49	-6.1%
66984	$537.26	$503.46	-6.3%
99204	$167.10	$156.45	-6.4%
92014	$125.49	$118.08	-5.9%
97110	$29.29	$27.90	-4.7%
88305	$71.57	$67.21	-6.1%
97530	$36.62	$34.55	-5.7%
99203	$111.51	$104.02	-6.7%

Need the facility amount, a modifier, or a date of service? Use the rate calculator, already set to this locality. Or start with your field's usual procedure mix on the specialty fee schedules.

Common questions Copy link

Why do Medicare rates in Iowa 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 costs for physician work, running an office, and liability insurance therefore move the final amount up or down. Iowa currently has all three GPCIs at or below the national baseline, so services priced with the standard RVU formula usually come out below the national amount for the Q2 2024 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 ZIP code where the service was performed to assign a claim to its contractor and locality. Look up your ZIP to find your locality. About 5 ZIP codes in Iowa 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 pay a percentage of Medicare, but its own wording decides which Medicare release, percentage, geography, and adjustments apply.

Does my locality affect what I owe as a patient?

For a covered service, a higher allowed amount in your locality usually means a higher 20% coinsurance. 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. GPCIs are usually set once a year in the fee schedule rule, though later files can correct them. See what changed each release.

Source & method Copy link

We compute GPCIs and rates from the CMS Medicare Physician Fee Schedule Q2 2024 release (effective April 2024). ZIP coverage from the CMS ZIP-to-locality crosswalk, Q2 2024 release. Example amounts use the standard (non-QP) physician conversion factor ($33.2875) and apply this locality's GPCIs to nationally priced Office (non-facility) RVUs, before the ~2% sequestration cut. Past releases are never edited, so a rate for an earlier quarter always matches what CMS published for it.

Geographic practice cost indices (Q2 2024) · rvu24b-updated-03-18-2024.zip (GPCI2024.csv row 53)

ZIP code to carrier locality crosswalk (Q2 2024) · ZIP5_APR2024_RECONSTRUCTED.zip (ZIP5_APR2024_RECONSTRUCTED.txt)

Iowa

Price a code in Iowa Copy link

ZIP codes in this locality Copy link

GPCI history Copy link

Example rates in Iowa Copy link

Common questions Copy link

Source & method Copy link

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