Medicare payment locality · Q3 2026 release

Metropolitan Kansas City MO Medicare Locality 02

MAC 05302 · Locality 02

This locality's GPCIs are all at or below the national baseline, so services priced with the standard RVU formula usually come out below 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

1.000

Adjusts the physician-work component for professional labor costs

Practice expense GPCI

0.939

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

Malpractice GPCI

0.977

Adjusts the malpractice component using liability-cost data

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

Example rates in Metropolitan Kansas City Copy link

National and Metropolitan Kansas City Office (non-facility) amounts for frequently reviewed codes in the Q3 2026 release (before sequestration). Conversion factor: 2026 standard (non-QP) physician conversion factor · $33.4009.

Code	National	Metropolitan Kansas City	Difference
99214	$135.61	$131.43	-3.1%
99213	$95.19	$92.15	-3.2%
99215	$192.39	$186.62	-3.0%
66984	$462.60	$449.68	-2.8%
99204	$177.36	$172.14	-2.9%
92014	$127.26	$122.44	-3.8%
97110	$29.06	$28.22	-2.9%
88305	$70.14	$67.38	-3.9%
97530	$35.07	$33.84	-3.5%
99203	$117.57	$113.86	-3.2%

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

ZIP codes in this locality Copy link

Metropolitan Kansas City covers 126 ZIP codes across WM, per the CMS ZIP-to-locality crosswalk (Q3 2026). 9 of them span more than one locality and need ZIP+4 for an exact match.

64002 64013 64014 64015 64016 64018 64024 64028 64029 64030 64034 64048 64050 64051 64052 64053 64054 64055 64056 64057 64058 64060 64063 64064 64065 64066 64068 64069 64070 64072 64073 64075 64079 64081 64082 64086 64087 64088 64089 64092 64098 64101 64102 64105 64106 64108 64109 64110 64111 64112 64113 64114 64116 64117 64118 64119 64120 64121 64123 64124 64125 64126 64127 64128 64129 64130 64131 64132 64133 64134 64136 64137 64138 64139 64141 64142 64144 64145 64146 64147 64148 64149 64150 64151 64152 64153 64154 64155 64156 64157 64158 64160 64161 64162 64163 64164 64165 64166 64167 64168 64170 64171 64172 64173 64179 64180 64183 64184 64185 64187 64188 64189 64190 64191 64192 64193 64194 64195 64196 64197 64198 64199 64439 64444 64944 64999

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

Common questions Copy link

Why do Medicare rates in Metropolitan Kansas City 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. Metropolitan Kansas City 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 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 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 9 ZIP codes in Metropolitan Kansas City 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 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 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 (Q3 2026) · rvu26c-updated-06-30-2026.zip (GPCI2026.csv row 68)

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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