Medicare fee schedule by locality · Q3 2026 release

New Jersey Medicare fee schedule localities

New Jersey has 2 Medicare payment localities, each with its own GPCIs. For 99213 in an office, the Q3 2026 standard non-QP amount ranges from $101.71 to $105.93. National amounts use GPCI 1.000. Each row below shows what a nationally priced common code pays once each locality's GPCIs apply.

Localities in New Jersey Copy link

99213 office (non-facility) amount by locality, Q3 2026 standard non-QP conversion factor (before sequestration)—national baseline $95.19.

Locality	Work GPCI	PE GPCI	MP GPCI	99213 amount
Northern Nj	1.063	1.160	1.068	$105.93 (+11.3% increase )
Rest of New Jersey	1.040	1.092	1.097	$101.71 (+6.8% increase )

Need a different code or the facility rate? Use the rate calculator with any locality above selected.

Common questions Copy link

How many Medicare payment localities are in New Jersey?

New Jersey has 2 Medicare payment localities, each with its own work, practice-expense, and malpractice GPCIs.

Do Medicare rates vary within New Jersey?

Yes. New Jersey's 2 localities have different GPCIs—the work GPCI ranges from 1.040 to 1.063. The same nationally priced code can therefore pay a different amount depending on where in the state it's billed.

Source & method Copy link

GPCIs and example rates computed from the CMS Medicare Physician Fee Schedule Q3 2026 release . Example amounts apply each 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 release.

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