localis
Calculator

Describe a service in plain words, or type a CPT/HCPCS code.

Medicare payment locality · Q3 2023 release

Virgin Islands flag

Virgin Islands

U.S. Virgin Islands MAC 09202 · Locality 50

Work GPCI
1.000
Practice expense GPCI
1.000
Malpractice GPCI
1.000

All three GPCIs sit at the national baseline of 1.000, so codes priced with the standard RVU formula come out at the national amount.

Effective CMS RVU23C Updated

Price a code in Virgin Islands Copy link

The locality-adjusted amount for the Q3 2023 release, with the facility and office settings and the full calculation.

ZIP codes in this locality Copy link

Virgin Islands covers 16 ZIP codes across VI, per the CMS ZIP-to-locality crosswalk (Q2 2022).

We don't have the Q3 2023 ZIP-to-locality crosswalk file yet; figures are from the Q2 2022 release and may not reflect Q3 2023 changes.

  • 00801
  • 00802
  • 00803
  • 00804
  • 00805
  • 00820
  • 00821
  • 00822
  • 00823
  • 00824
  • 00830
  • 00831
  • 00840
  • 00841
  • 00850
  • 00851

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 1.011 0.985
January 2024 to October 2025 1.000 1.007 0.982
October 2023 1.000 1.008 0.984
January 2023 to July 2023 (this page) 1.000 1.000 1.000
January 2021 to October 2022 1.000 1.008 0.986
January 2020 to October 2020 1.000 1.008 0.988
January 2018 to October 2019 1.000 1.007 0.990
January 2017 to October 2017 1.000 1.006 0.993
January 2015 to October 2016 1.000 0.960 0.996
April 2014 to October 2014 1.000 1.004 1.003
January 2013 to April 2013 1.000 1.002 1.010

Example rates in Virgin Islands Copy link

National and local Office (non-facility) amounts for frequently reviewed codes in the Q3 2023 release, before sequestration. Conversion factor: 2023 standard (non-QP) physician conversion factor, $33.8872.

Code National Local Difference
99214 $128.43 $128.43 0.0%
99213 $90.82 $90.82 0.0%
99215 $179.94 $179.94 0.0%
66984 $541.86 $541.86 0.0%
99204 $167.40 $167.40 0.0%
92014 $127.08 $127.08 0.0%
97110 $29.82 $29.82 0.0%
88305 $71.84 $71.84 0.0%
97530 $37.61 $37.61 0.0%
99203 $112.84 $112.84 0.0%

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 Virgin Islands 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. Virgin Islands currently has all three GPCI components at the national baseline for the Q3 2023 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 Q3 2023 release (effective July 2023). ZIP coverage from the CMS ZIP-to-locality crosswalk, Q2 2022 release. Example amounts use the standard (non-QP) physician conversion factor ($33.8872) 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 2023) · rvu23c.zip (GPCI2023.csv row 110)
ZIP code to carrier locality crosswalk (Q2 2022) · Zip-Code-to-Carrier-Locality.zip (ZIP5_APR2022_V2.txt)

Did this answer your question about Virgin Islands (VI)?

Tell us what you were trying to work out and we'll answer you or build the page that does.

Did this page answer your question?