Price a code in Tennessee Copy link
ZIP codes in this locality Copy link
Tennessee covers 814 ZIP codes across TN, per the CMS ZIP-to-locality crosswalk (Q2 2020).
- 37010
- 37011
- 37012
- 37013
- 37014
- 37015
- 37016
- 37018
- 37019
- 37020
- 37022
- 37023
- 37024
- 37025
- 37026
- 37027
- 37028
- 37029
- 37030
- 37031
- 37032
- 37033
- 37034
- 37035
- 37036
- 37037
- 37040
- 37041
- 37042
- 37043
- 37044
- 37046
- 37047
- 37048
- 37049
- 37050
- 37051
- 37052
- 37055
- 37056
- 37057
- 37058
- 37059
- 37060
- 37061
- 37062
- 37063
- 37064
- 37065
- 37066
- 37067
- 37068
- 37069
- 37070
- 37071
- 37072
- 37073
- 37074
- 37075
- 37076
Show all 814 ZIP codes
- 37077
- 37078
- 37079
- 37080
- 37082
- 37083
- 37085
- 37086
- 37087
- 37088
- 37089
- 37090
- 37091
- 37095
- 37096
- 37097
- 37098
- 37101
- 37110
- 37111
- 37115
- 37116
- 37118
- 37119
- 37121
- 37122
- 37127
- 37128
- 37129
- 37130
- 37131
- 37132
- 37133
- 37134
- 37135
- 37136
- 37137
- 37138
- 37140
- 37141
- 37142
- 37143
- 37144
- 37145
- 37146
- 37147
- 37148
- 37149
- 37150
- 37151
- 37152
- 37153
- 37155
- 37160
- 37161
- 37162
- 37165
- 37166
- 37167
- 37171
- 37172
- 37174
- 37175
- 37178
- 37179
- 37180
- 37181
- 37183
- 37184
- 37185
- 37186
- 37187
- 37188
- 37189
- 37190
- 37191
- 37201
- 37202
- 37203
- 37204
- 37205
- 37206
- 37207
- 37208
- 37209
- 37210
- 37211
- 37212
- 37213
- 37214
- 37215
- 37216
- 37217
- 37218
- 37219
- 37220
- 37221
- 37222
- 37224
- 37227
- 37228
- 37229
- 37230
- 37232
- 37234
- 37235
- 37236
- 37237
- 37238
- 37239
- 37240
- 37241
- 37242
- 37243
- 37244
- 37245
- 37246
- 37247
- 37248
- 37249
- 37250
- 37301
- 37302
- 37303
- 37304
- 37305
- 37306
- 37307
- 37308
- 37309
- 37310
- 37311
- 37312
- 37313
- 37314
- 37315
- 37316
- 37317
- 37318
- 37320
- 37321
- 37322
- 37323
- 37324
- 37325
- 37326
- 37327
- 37328
- 37329
- 37330
- 37331
- 37332
- 37333
- 37334
- 37335
- 37336
- 37337
- 37338
- 37339
- 37340
- 37341
- 37342
- 37343
- 37345
- 37347
- 37348
- 37349
- 37350
- 37351
- 37352
- 37353
- 37354
- 37355
- 37356
- 37357
- 37359
- 37360
- 37361
- 37362
- 37363
- 37364
- 37365
- 37366
- 37367
- 37369
- 37370
- 37371
- 37372
- 37373
- 37374
- 37375
- 37376
- 37377
- 37378
- 37379
- 37380
- 37381
- 37382
- 37383
- 37384
- 37385
- 37387
- 37388
- 37389
- 37391
- 37394
- 37395
- 37396
- 37397
- 37398
- 37401
- 37402
- 37403
- 37404
- 37405
- 37406
- 37407
- 37408
- 37409
- 37410
- 37411
- 37412
- 37414
- 37415
- 37416
- 37419
- 37421
- 37422
- 37424
- 37450
- 37499
- 37501
- 37544
- 37601
- 37602
- 37604
- 37605
- 37614
- 37615
- 37616
- 37617
- 37618
- 37620
- 37621
- 37625
- 37640
- 37641
- 37642
- 37643
- 37644
- 37645
- 37650
- 37656
- 37657
- 37658
- 37659
- 37660
- 37662
- 37663
- 37664
- 37665
- 37669
- 37680
- 37681
- 37682
- 37683
- 37684
- 37686
- 37687
- 37688
- 37690
- 37691
- 37692
- 37694
- 37699
- 37701
- 37705
- 37707
- 37708
- 37709
- 37710
- 37711
- 37713
- 37714
- 37715
- 37716
- 37717
- 37719
- 37721
- 37722
- 37723
- 37724
- 37725
- 37726
- 37727
- 37729
- 37730
- 37731
- 37732
- 37733
- 37737
- 37738
- 37742
- 37743
- 37744
- 37745
- 37748
- 37752
- 37753
- 37754
- 37755
- 37756
- 37757
- 37760
- 37762
- 37763
- 37764
- 37765
- 37766
- 37769
- 37770
- 37771
- 37772
- 37773
- 37774
- 37777
- 37778
- 37779
- 37801
- 37802
- 37803
- 37804
- 37806
- 37807
- 37809
- 37810
- 37811
- 37813
- 37814
- 37815
- 37816
- 37818
- 37819
- 37820
- 37821
- 37822
- 37824
- 37825
- 37826
- 37828
- 37829
- 37830
- 37831
- 37840
- 37841
- 37842
- 37843
- 37845
- 37846
- 37847
- 37848
- 37849
- 37851
- 37852
- 37853
- 37854
- 37857
- 37860
- 37861
- 37862
- 37863
- 37864
- 37865
- 37866
- 37867
- 37868
- 37869
- 37870
- 37871
- 37872
- 37873
- 37874
- 37876
- 37877
- 37878
- 37879
- 37880
- 37881
- 37882
- 37885
- 37886
- 37887
- 37888
- 37890
- 37891
- 37892
- 37893
- 37901
- 37902
- 37909
- 37912
- 37914
- 37915
- 37916
- 37917
- 37918
- 37919
- 37920
- 37921
- 37922
- 37923
- 37924
- 37927
- 37928
- 37929
- 37930
- 37931
- 37932
- 37933
- 37934
- 37938
- 37939
- 37940
- 37950
- 37955
- 37990
- 37995
- 37996
- 37997
- 37998
- 37999
- 38001
- 38002
- 38004
- 38006
- 38007
- 38008
- 38010
- 38011
- 38012
- 38014
- 38015
- 38016
- 38017
- 38018
- 38019
- 38021
- 38023
- 38024
- 38025
- 38027
- 38028
- 38029
- 38030
- 38033
- 38034
- 38036
- 38037
- 38039
- 38040
- 38041
- 38042
- 38043
- 38044
- 38045
- 38046
- 38047
- 38048
- 38049
- 38050
- 38052
- 38053
- 38054
- 38055
- 38056
- 38057
- 38058
- 38059
- 38060
- 38061
- 38063
- 38066
- 38067
- 38068
- 38069
- 38070
- 38071
- 38074
- 38075
- 38076
- 38077
- 38079
- 38080
- 38083
- 38088
- 38101
- 38103
- 38104
- 38105
- 38106
- 38107
- 38108
- 38109
- 38110
- 38111
- 38112
- 38113
- 38114
- 38115
- 38116
- 38117
- 38118
- 38119
- 38120
- 38122
- 38124
- 38125
- 38126
- 38127
- 38128
- 38129
- 38130
- 38131
- 38132
- 38133
- 38134
- 38135
- 38136
- 38137
- 38138
- 38139
- 38140
- 38141
- 38142
- 38143
- 38145
- 38146
- 38147
- 38148
- 38150
- 38151
- 38152
- 38157
- 38159
- 38161
- 38163
- 38165
- 38166
- 38167
- 38168
- 38173
- 38174
- 38175
- 38177
- 38181
- 38182
- 38183
- 38184
- 38186
- 38187
- 38188
- 38190
- 38193
- 38194
- 38195
- 38197
- 38201
- 38220
- 38221
- 38222
- 38223
- 38224
- 38225
- 38226
- 38229
- 38230
- 38231
- 38232
- 38233
- 38235
- 38236
- 38237
- 38238
- 38240
- 38241
- 38242
- 38251
- 38253
- 38254
- 38255
- 38256
- 38257
- 38258
- 38259
- 38260
- 38261
- 38271
- 38281
- 38301
- 38302
- 38303
- 38305
- 38308
- 38310
- 38311
- 38313
- 38314
- 38315
- 38316
- 38317
- 38318
- 38320
- 38321
- 38324
- 38326
- 38327
- 38328
- 38329
- 38330
- 38331
- 38332
- 38333
- 38334
- 38336
- 38337
- 38338
- 38339
- 38340
- 38341
- 38342
- 38343
- 38344
- 38345
- 38346
- 38347
- 38348
- 38351
- 38352
- 38355
- 38356
- 38357
- 38358
- 38359
- 38361
- 38362
- 38363
- 38365
- 38366
- 38367
- 38368
- 38369
- 38370
- 38371
- 38372
- 38374
- 38375
- 38376
- 38377
- 38378
- 38379
- 38380
- 38381
- 38382
- 38387
- 38388
- 38389
- 38390
- 38391
- 38392
- 38393
- 38401
- 38402
- 38425
- 38449
- 38450
- 38451
- 38452
- 38453
- 38454
- 38455
- 38456
- 38457
- 38459
- 38460
- 38461
- 38462
- 38463
- 38464
- 38468
- 38469
- 38471
- 38472
- 38473
- 38474
- 38475
- 38476
- 38477
- 38478
- 38481
- 38482
- 38483
- 38485
- 38486
- 38487
- 38488
- 38501
- 38502
- 38503
- 38504
- 38505
- 38506
- 38541
- 38542
- 38543
- 38544
- 38545
- 38547
- 38548
- 38549
- 38550
- 38551
- 38552
- 38553
- 38554
- 38555
- 38556
- 38557
- 38558
- 38559
- 38560
- 38562
- 38563
- 38564
- 38565
- 38567
- 38568
- 38569
- 38570
- 38571
- 38572
- 38573
- 38574
- 38575
- 38577
- 38578
- 38579
- 38580
- 38581
- 38582
- 38583
- 38585
- 38587
- 38588
- 38589
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 | 0.909 | 0.537 |
| January 2024 to October 2025 | 1.000 | 0.896 | 0.544 |
| January 2023 to October 2023 | 1.000 | 0.894 | 0.518 |
| January 2021 to October 2022 | 1.000 | 0.892 | 0.492 |
| January 2020 to October 2020 (this page) | 1.000 | 0.897 | 0.509 |
| April 2018 to October 2019 | 1.000 | 0.901 | 0.526 |
Example rates in Tennessee Copy link
National and local Office (non-facility) amounts for frequently reviewed codes in the Q2 2020 release, before sequestration. Conversion factor: 2020 standard (non-QP) physician conversion factor, $36.0896.
| Code | National | Local | Difference |
|---|---|---|---|
| 99214 | $110.43 | $103.09 | -6.6% |
| 99213 | $76.15 | $70.79 | -7.0% |
| 99215 | $148.33 | $138.79 | -6.4% |
| 66984 | $557.58 | $520.05 | -6.7% |
| 99204 | $167.09 | $155.84 | -6.7% |
| 92014 | $128.12 | $119.50 | -6.7% |
| 97110 | $31.40 | $29.56 | -5.9% |
| 88305 | $71.46 | $66.61 | -6.8% |
| 97530 | $40.42 | $37.61 | -7.0% |
| 99203 | $109.35 | $101.55 | -7.1% |
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 Tennessee 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. Tennessee 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 2020 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. 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 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 2020 release (effective April 2020). ZIP coverage from the CMS ZIP-to-locality crosswalk, Q2 2020 release. Example amounts use the standard (non-QP) physician conversion factor ($36.0896) 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.
ZIP code to carrier locality crosswalk (Q2 2020)
·
Zip-Code-to-Carrier-Locality.zip
(ZIP5_APR2020.txt)
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