Dallas (TX) Medicare rates & GPCIs—Q3 2025

ZIP codes in this locality Copy link

Dallas covers 186 ZIP codes across TX, per the CMS ZIP-to-locality crosswalk (Q3 2025). 17 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.

75001
75006
75011
75014
75015
75016
75017
75019 (split ZIP)
75030
75037
75038
75039
75040
75041
75042
75043
75044 (split ZIP)
75045
75046
75047
75048 (split ZIP)
75049
75050 (split ZIP)
75051 (split ZIP)
75052 (split ZIP)
75053
75054 (split ZIP)
75059
75060
75061
75062
75063
75064
75080 (split ZIP)
75081
75082 (split ZIP)
75083
75084
75085
75088 (split ZIP)
75089 (split ZIP)
75099
75104 (split ZIP)
75106
75115
75116
75123
75134
75137
75138
75141
75146 (split ZIP)
75149
75150
75159 (split ZIP)
75172
75180
75181
75182 (split ZIP)
75185

Show all 186 ZIP codes

75187
75201
75202
75203
75204
75205
75206
75207
75208
75209
75210
75211
75212
75214
75215
75216
75217
75218
75219
75220
75221
75222
75223
75224
75225
75226
75227
75228
75229
75230
75231
75232
75233
75234
75235
75236
75237
75238
75239
75240
75241
75242
75243
75244
75245
75246
75247
75248 (split ZIP)
75249
75250
75251
75253
75254
75258
75260
75261 (split ZIP)
75262
75263
75264
75265
75266
75267
75270
75275
75277
75283
75284
75285
75286
75294
75295
75301
75303
75310
75312
75313
75315
75320
75323
75326
75334
75336
75339
75340
75342
75343
75344
75346
75350
75353
75354
75355
75356
75357
75358
75359
75360
75363
75364
75367
75368
75369
75370
75371
75372
75373
75374
75376
75378
75379
75380
75381
75382
75386
75387
75388
75389
75390
75391
75392
75393
75394
75395
75396
75397
75398

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	1.009	0.996	0.858
January 2024 to October 2025 (this page)	1.011	1.007	0.877
January 2023 to October 2023	1.017	1.017	0.711
January 2021 to October 2022	1.023	1.026	0.546
January 2020 to October 2020	1.018	1.020	0.657
January 2018 to October 2019	1.012	1.014	0.768
January 2017 to October 2017	1.015	1.012	0.770
January 2015 to October 2016	1.018	1.009	0.772
April 2014 to October 2014	1.014	1.013	0.803
January 2013 to April 2013	1.009	1.017	0.834

Example rates in Dallas Copy link

National and local Office (non-facility) amounts for frequently reviewed codes in the Q3 2025 release, before sequestration. Conversion factor: 2025 standard (non-QP) physician conversion factor, $32.3465.

Code	National	Local	Difference
99214	$125.18	$125.67	+0.4%
99213	$88.95	$89.32	+0.4%
99215	$175.64	$176.35	+0.4%
66984	$521.75	$524.04	+0.4%
99204	$163.35	$163.82	+0.3%
92014	$120.98	$121.84	+0.7%
97110	$28.79	$29.01	+0.8%
88305	$69.54	$70.04	+0.7%
97530	$34.61	$34.87	+0.8%
99203	$109.01	$109.30	+0.3%

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 Dallas 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. Dallas currently has mixed GPCI components, so the net payment effect varies by code for the Q3 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 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 17 ZIP codes in Dallas 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 2025 release (effective July 2025). ZIP coverage from the CMS ZIP-to-locality crosswalk, Q3 2025 release. Example amounts use the standard (non-QP) physician conversion factor ($32.3465) 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 2025) · rvu25c-updated-06-05-2025.zip (GPCI2025.csv row 99)

ZIP code to carrier locality crosswalk (Q3 2025) · 2025.zip (ZIP5_JUL2025_06252025.txt)

Dallas

Price a code in Dallas Copy link

ZIP codes in this locality Copy link

GPCI history Copy link

Example rates in Dallas Copy link

Common questions Copy link

Source & method Copy link

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