Medicare payment locality · Q3 2026 release

Fort Worth, Tx TX Medicare Locality 28

MAC 04412 · Locality 28

This locality's GPCIs are mixed, so the net payment effect varies by code 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

1.009

Adjusts the physician-work component for professional labor costs

Practice expense GPCI

0.986

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

Malpractice GPCI

0.871

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 Fort Worth, Tx Copy link

National and Fort Worth, Tx 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	Fort Worth, Tx	Difference
99214	$135.61	$134.65	-0.7%
99213	$95.19	$94.51	-0.7%
99215	$192.39	$191.04	-0.7%
66984	$462.60	$459.56	-0.7%
99204	$177.36	$175.95	-0.8%
92014	$127.26	$126.41	-0.7%
97110	$29.06	$28.96	-0.3%
88305	$70.14	$69.64	-0.7%
97530	$35.07	$34.88	-0.5%
99203	$117.57	$116.54	-0.9%

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

Fort Worth, Tx covers 98 ZIP codes across TX, 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.

76001 76002 76003 76004 76005 76006 76007 76010 76011 76012 76013 76014 76015 76016 76017 76018 76019 76020 76021 76022 76034 76036 76039 76040 76051 76052 76053 76054 76060 76063 76092 76094 76095 76096 76099 76101 76102 76103 76104 76105 76106 76107 76108 76109 76110 76111 76112 76113 76114 76115 76116 76117 76118 76119 76120 76121 76122 76123 76124 76126 76127 76129 76130 76131 76132 76133 76134 76135 76136 76137 76140 76147 76148 76150 76155 76161 76162 76163 76164 76166 76177 76178 76179 76180 76181 76182 76185 76190 76191 76192 76193 76195 76196 76197 76198 76199 76244 76248

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

Common questions Copy link

Why do Medicare rates in Fort Worth, Tx 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. Fort Worth, Tx currently has mixed GPCI components, so the net payment effect varies by code 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 Fort Worth, Tx 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 100)

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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