RVU18D — the October 2018 Physician Fee Schedule files

The official CMS data behind Q4 2018 on this site — in effect October 1 – December 31, 2018. The quarterly RVU zips (RVU26A, RVU25D, …) carrying every code's RVUs and status indicator, the locality GPCIs, the conversion factor, and the anesthesia conversion factors — the inputs to every Medicare PFS rate on this site.

Get the file from CMS Copy link

Direct download: rvu18d.zip

SHA-256 of the file we ingested: b0d20c339662ac85ec392d4e9f9892fabf7b038fe5220338c0e688f0aacd3d68

Direct CMS links rot when cms.gov reorganizes — the stable fallback is the official CMS PFS relative value files page.

Files inside this release Copy link

The member files we parsed, exactly as recorded at ingest — row counts and checksums let anyone verify our copy against CMS's. Where the name is a link, it downloads the exact bytes we parsed, straight out of the CMS zip.

File	What it is	Rows
ANES2018.csv 4 KB SHA-256 dba50a279321…	ANES — anesthesia conversion factors	112
GPCI2018.csv 5 KB SHA-256 21ed101a0289…	GPCI — geographic practice cost indices	112
PPRRVU18_OCT.csv SHA-256 c6312c12acd1…	PPRRVU — the relative value file	16,682

Files without a download link carry CMS's short descriptor for every code, and CPT descriptors are AMA-copyrighted — we can store them but not republish them. Their columns are documented below all the same, and CMS's own copy is one click up.

What the columns mean Copy link

CMS ships these files with minimal documentation, and both the column names and their order drift between releases — which is why we parse by header name, never by position. Any column position shown here is the one we recorded when parsing this release.

PPRRVU — the relative value file Copy link

One row per CPT/HCPCS code (plus a separate row for each pricing modifier, like 26 or TC). This is the file Medicare payment math starts from: the three RVU components here, multiplied by a locality's GPCIs and the conversion factor, produce the allowed amount. A blank RVU is not zero — carrier-priced (status C) rows leave the RVU columns empty because no national value exists.

#	Column	What it means
1	HCPCS	The 5-character CPT or HCPCS Level II code the row prices.
2	Modifier	The pricing modifier this row applies to — 26 (professional component), TC (technical component), 53 (discontinued procedure). Blank means the global, unmodified service.
3	Description	CMS's short descriptor of the service. CPT descriptors are AMA-copyrighted, which is why our pages describe codes in our own words instead of reprinting this column.
4	Status code	The one-letter status indicator that decides whether — and how — the code is payable under the PFS. Payability comes from this column, never from whether RVU values happen to be present.
6	Work RVU	Relative value of the clinician's own work: time, skill, and intensity.
7	Non-facility PE RVU	Practice-expense relative value when the service is performed in an office or other non-facility setting, where the practice bears the overhead.
8	Non-facility NA indicator	"NA" flags that Medicare never prices this code in the non-facility setting.
9	Facility PE RVU	Practice-expense relative value when the service is performed in a hospital or ASC, where the facility bills its own overhead separately — usually lower than the non-facility value.
10	Facility NA indicator	"NA" flags that Medicare never prices this code in the facility setting.
11	MP RVU	Malpractice relative value — the professional-liability-insurance share of the payment.
12	Non-facility total	CMS's pre-summed work + non-facility PE + MP RVUs. We recompute totals from the components rather than trusting this column.
13	Facility total	CMS's pre-summed work + facility PE + MP RVUs.
14	PC/TC indicator	Whether the code splits into professional (26) and technical (TC) components, and how each is priced.
15	Global days	The global surgical period — 000, 010, or 090 days of follow-up bundled into the payment; XXX when the concept doesn't apply.
19	Multiple procedure	How payment is reduced when the code is billed alongside other procedures on the same day (the MPPR rules).
20	Bilateral surgery	Whether the 150% bilateral adjustment applies when the procedure is performed on both sides.
21	Assistant at surgery	Whether an assistant at surgery (modifiers 80/81/82 for a physician, AS for a PA, NP, or CNS) can be paid for this procedure.
22	Co-surgeons	Whether two surgeons (modifier 62) can each be paid for this procedure.
23	Team surgery	Whether a surgical team (modifier 66) is payable for this procedure.
25	Conversion factor	The dollars-per-RVU multiplier for the release, repeated on every row. This is where the annual conversion-factor change actually lives in the file.

GPCI — geographic practice cost indices Copy link

Open GPCI2018.csv (5 KB)

One row per Medicare payment locality. The three indices scale each RVU component to local costs: a locality at 1.000 pays the national rate for that component; above 1.000 pays more, below pays less. The work GPCI is published with a statutory 1.0 floor applied.

#	Column	What it means
1	MAC	The Medicare Administrative Contractor that processes claims for the locality.
—	State	Two-letter state or territory. Missing entirely in pre-2018 files.
2	Locality number	The two-digit locality code within the MAC. MAC + locality number together identify a payment locality.
3	Locality name	The fee schedule area's name — a state, a metro area, or "rest of state".
4	Work GPCI	Multiplier applied to the work RVU, with the statutory 1.0 floor applied.
—	Work GPCI (no floor)	The same index before the 1.0 floor — published so the floor's effect is visible.
5	PE GPCI	Multiplier applied to the practice-expense RVU — the widest-ranging of the three, since rent and wages vary most by geography.
6	MP GPCI	Multiplier applied to the malpractice RVU, tracking local liability-insurance premiums.

ANES — anesthesia conversion factors Copy link

Open ANES2018.csv (4 KB)

One row per payment locality. Anesthesia is paid outside the RVU formula — (base units + time units) × this locality-specific conversion factor — so it gets its own file. Since CY2026 the file carries separate factors for QPP and non-QPP participants; earlier files have a single combined column.

#	Column	What it means
1	Contractor	The MAC for the locality (labeled "Carrier" in pre-2018 files).
2	Locality number	The two-digit payment locality code within the contractor.
3	Locality name	The fee schedule area's name.
4	Anesthesia CF (non-QPP)	Dollars per anesthesia unit for clinicians not in a qualifying APM — the standard rate.
—	Anesthesia CF (QPP)	Dollars per anesthesia unit for qualifying-APM participants. Only present from CY2026 on.

What this release backs on this site Copy link

Every Q4 2018 rate on our code pages and locality pages is computed from this release's files. The codes it moved most are on the Q4 2018 changes page. Ingested Aug 4, 2026. See the full pipeline in our methodology.