ADDENDUM E. PROPOSED CY 2026 GEOGRAPHIC PRACTICE COST INDICES (GPCIs) BY STATE AND MEDICARE LOCALITY												
												
Medicare Administrative Contractor (MAC)	State	Locality Number	Locality Name	2025 PW GPCI (with 1.0 Floor)	2025 PE GPCI	2025 MP GPCI	2026 PW GPCI (without 1.0 Floor)	2026 PE GPCI	2026 MP GPCI	2027 PW GPCI (without 1.0 Floor)	2027 PE GPCI	2027 MP GPCI
10112	AL	00	ALABAMA	1.000	0.869	0.575	0.988	0.875	0.566	0.975	0.880	0.557
02102	AK	01	ALASKA*	1.500	1.081	0.592	1.500	1.065	0.551	1.500	1.049	0.511
03102	AZ	00	ARIZONA	1.000	0.975	0.854	0.991	0.969	0.856	0.982	0.963	0.859
07102	AR	13	ARKANSAS	1.000	0.860	0.518	0.974	0.859	0.515	0.948	0.858	0.512
01112	CA	54	BAKERSFIELD	1.017	1.093	0.662	1.019	1.096	0.609	1.021	1.099	0.555
01112	CA	55	CHICO	1.014	1.093	0.560	1.017	1.096	0.536	1.021	1.099	0.512
01182	CA	71	EL CENTRO	1.014	1.093	0.570	1.017	1.096	0.541	1.021	1.099	0.512
01112	CA	56	FRESNO	1.014	1.093	0.560	1.017	1.096	0.536	1.021	1.099	0.512
01112	CA	57	HANFORD-CORCORAN	1.014	1.093	0.560	1.017	1.096	0.536	1.021	1.099	0.512
01182	CA	18	LOS ANGELES-LONG BEACH-ANAHEIM (LOS ANGELES/ORANGE CNTY)	1.042	1.194	0.690	1.041	1.183	0.664	1.040	1.171	0.637
01112	CA	58	MADERA	1.014	1.093	0.560	1.017	1.096	0.536	1.021	1.099	0.512
01112	CA	59	MERCED	1.014	1.093	0.560	1.017	1.096	0.536	1.021	1.099	0.512
01112	CA	60	MODESTO	1.014	1.093	0.560	1.017	1.096	0.536	1.021	1.099	0.512
01112	CA	51	NAPA	1.058	1.310	0.521	1.063	1.318	0.508	1.068	1.325	0.496
01182	CA	17	OXNARD-THOUSAND OAKS-VENTURA	1.026	1.183	0.651	1.028	1.182	0.623	1.030	1.181	0.596
01112	CA	61	REDDING	1.014	1.093	0.560	1.017	1.096	0.536	1.021	1.099	0.512
01112	CA	62	RIVERSIDE-SAN BERNARDINO-ONTARIO	1.014	1.093	0.892	1.018	1.096	0.853	1.021	1.099	0.814
01112	CA	63	SACRAMENTO-ROSEVILLE-FOLSOM	1.034	1.156	0.560	1.036	1.163	0.536	1.037	1.171	0.512
01112	CA	64	SALINAS	1.035	1.165	0.560	1.031	1.159	0.536	1.027	1.152	0.512
01182	CA	72	SAN DIEGO-CHULA VISTA-CARLSBAD	1.028	1.191	0.572	1.030	1.196	0.542	1.033	1.200	0.512
01112	CA	05	SAN FRANCISCO-OAKLAND-BERKELEY (SAN FRANCISCO/SAN MATEO/ALAMEDA/CONTRA COSTA CNTY)	1.088	1.419	0.445	1.095	1.410	0.425	1.101	1.401	0.405
01112	CA	52	SAN FRANCISCO-OAKLAND-BERKELEY (MARIN CNTY)	1.088	1.419	0.470	1.095	1.410	0.459	1.101	1.401	0.448
01112	CA	65	SAN JOSE-SUNNYVALE-SANTA CLARA (SAN BENITO CNTY)	1.100	1.435	0.560	1.110	1.442	0.536	1.120	1.448	0.512
01182	CA	73	SAN LUIS OBISPO-PASO ROBLES	1.014	1.132	0.560	1.017	1.139	0.536	1.021	1.147	0.512
01112	CA	09	SAN JOSE-SUNNYVALE-SANTA CLARA (SANTA CLARA CNTY)	1.100	1.435	0.420	1.110	1.442	0.397	1.120	1.448	0.374
01112	CA	66	SANTA CRUZ-WATSONVILLE	1.017	1.209	0.560	1.021	1.215	0.536	1.026	1.222	0.512
01182	CA	74	SANTA MARIA-SANTA BARBARA	1.022	1.175	0.560	1.028	1.166	0.536	1.033	1.157	0.512
01112	CA	67	SANTA ROSA-PETALUMA	1.027	1.232	0.560	1.030	1.228	0.536	1.033	1.225	0.512
01112	CA	68	STOCKTON	1.014	1.093	0.560	1.017	1.096	0.536	1.021	1.099	0.512
01112	CA	53	VALLEJO	1.058	1.310	0.470	1.063	1.318	0.459	1.068	1.325	0.448
01112	CA	69	VISALIA	1.014	1.093	0.560	1.017	1.096	0.536	1.021	1.099	0.512
01112	CA	70	YUBA CITY	1.014	1.093	0.560	1.017	1.096	0.536	1.021	1.099	0.512
01112	CA	75	REST OF CALIFORNIA	1.014	1.093	0.560	1.017	1.096	0.536	1.021	1.099	0.512
04112	CO	01	COLORADO	1.008	1.053	0.827	1.012	1.064	0.781	1.015	1.076	0.735
13102	CT	00	CONNECTICUT	1.022	1.091	1.207	1.020	1.077	1.210	1.017	1.062	1.214
12202	DC	01	DC + MD/VA SUBURBS	1.057	1.192	1.168	1.054	1.178	1.113	1.050	1.164	1.057
12102	DE	01	DELAWARE	1.009	0.992	0.949	1.005	0.988	0.899	1.000	0.983	0.850
09102	FL	03	FORT LAUDERDALE	1.000	0.998	1.770	0.993	1.013	1.808	0.985	1.028	1.847
09102	FL	04	MIAMI	1.000	1.027	2.500	0.994	1.041	2.529	0.988	1.056	2.559
09102	FL	99	REST OF FLORIDA	1.000	0.940	1.467	0.989	0.956	1.503	0.977	0.971	1.540
10212	GA	01	ATLANTA	1.000	0.997	1.128	1.003	1.016	1.201	1.007	1.034	1.273
10212	GA	99	REST OF GEORGIA	1.000	0.883	1.125	0.986	0.892	1.192	0.972	0.901	1.258
01212	HI	01	"HAWAII, GUAM"	1.000	1.149	0.561	0.998	1.137	0.579	0.996	1.125	0.597
02202	ID	00	IDAHO	1.000	0.908	0.461	0.980	0.920	0.473	0.960	0.932	0.484
06102	IL	16	CHICAGO	1.007	1.023	2.018	1.007	1.005	2.295	1.007	0.987	2.571
06102	IL	12	EAST ST. LOUIS	1.000	0.918	1.784	0.988	0.920	2.014	0.976	0.922	2.243
06102	IL	15	SUBURBAN CHICAGO	1.007	1.048	1.556	1.007	1.027	1.772	1.007	1.006	1.987
06102	IL	99	REST OF ILLINOIS	1.000	0.912	1.381	0.988	0.913	1.563	0.977	0.914	1.744
08102	IN	00	INDIANA	1.000	0.922	0.485	0.988	0.927	0.486	0.975	0.931	0.487
05102	IA	00	IOWA	1.000	0.913	0.457	0.984	0.915	0.397	0.967	0.916	0.338
05202	KS	00	KANSAS	1.000	0.906	0.540	0.984	0.904	0.504	0.967	0.901	0.468
15102	KY	00	KENTUCKY	1.000	0.877	0.913	0.981	0.889	0.915	0.963	0.900	0.917
07202	LA	01	NEW ORLEANS	1.000	0.935	1.156	0.989	0.941	1.136	0.978	0.948	1.115
07202	LA	99	REST OF LOUISIANA	1.000	0.881	0.982	0.985	0.885	0.958	0.970	0.890	0.935
14112	ME	03	SOUTHERN MAINE	1.000	1.012	0.656	0.990	0.991	0.631	0.980	0.970	0.606
14112	ME	99	REST OF MAINE	1.000	0.913	0.650	0.984	0.920	0.622	0.967	0.927	0.594
12302	MD	01	BALTIMORE/SURR. CNTYS	1.020	1.078	1.309	1.016	1.073	1.236	1.012	1.069	1.164
12302	MD	99	REST OF MARYLAND	1.012	1.016	0.973	1.010	1.012	0.918	1.008	1.009	0.864
14212	MA	01	METROPOLITAN BOSTON	1.042	1.197	0.894	1.041	1.194	0.890	1.041	1.190	0.886
14212	MA	99	REST OF MASSACHUSETTS	1.017	1.061	0.796	1.016	1.053	0.797	1.014	1.046	0.798
08202	MI	01	DETROIT	1.003	0.986	1.718	0.997	0.965	1.686	0.992	0.944	1.653
08202	MI	99	REST OF MICHIGAN	1.000	0.911	1.173	0.986	0.913	1.129	0.973	0.914	1.085
06202	MN	00	MINNESOTA	1.000	1.025	0.300	1.000	1.029	0.296	0.999	1.033	0.293
07302	MS	00	MISSISSIPPI	1.000	0.852	0.768	0.974	0.861	0.739	0.948	0.869	0.710
05302	MO	02	METROPOLITAN KANSAS CITY	1.000	0.948	0.992	0.989	0.939	0.977	0.979	0.930	0.963
05302	MO	01	METROPOLITAN ST. LOUIS	1.000	0.952	0.994	0.988	0.952	1.002	0.977	0.952	1.011
05302	MO	99	REST OF MISSOURI	1.000	0.859	0.974	0.976	0.862	0.974	0.951	0.866	0.974
03202	MT	01	MONTANA**	1.000	1.000	0.978	0.984	1.000	0.998	0.968	1.000	1.018
05402	NE	00	NEBRASKA	1.000	0.917	0.304	0.983	0.923	0.378	0.966	0.929	0.451
01312	NV	00	NEVADA**	1.000	1.000	0.844	0.989	1.001	0.833	0.978	1.002	0.823
14312	NH	40	NEW HAMPSHIRE	1.000	1.034	0.898	0.997	1.041	0.875	0.995	1.048	0.852
12402	NJ	01	NORTHERN NJ	1.064	1.172	1.032	1.063	1.160	1.068	1.062	1.147	1.104
12402	NJ	99	REST OF NEW JERSEY	1.042	1.106	1.069	1.040	1.092	1.097	1.038	1.078	1.126
04212	NM	05	NEW MEXICO	1.000	0.908	1.172	0.990	0.917	1.201	0.981	0.926	1.229
13202	NY	01	MANHATTAN	1.065	1.166	1.656	1.064	1.162	1.586	1.064	1.158	1.516
13202	NY	02	NYC SUBURBS/LONG ISLAND	1.065	1.200	1.911	1.064	1.189	1.857	1.064	1.178	1.803
13202	NY	03	POUGHKPSIE/N NYC SUBURBS	1.046	1.106	1.269	1.045	1.095	1.210	1.044	1.085	1.151
13292	NY	04	QUEENS	1.065	1.195	1.462	1.064	1.182	1.442	1.064	1.169	1.422
13282	NY	99	REST OF NEW YORK	1.000	0.949	0.732	0.995	0.950	0.703	0.991	0.950	0.674
11502	NC	00	NORTH CAROLINA	1.000	0.926	0.665	0.991	0.933	0.639	0.982	0.940	0.613
03302	ND	01	NORTH DAKOTA**	1.000	1.000	0.517	0.987	1.000	0.406	0.975	1.000	0.295
15202	OH	00	OHIO	1.000	0.911	1.033	0.990	0.913	1.008	0.980	0.916	0.983
04312	OK	00	OKLAHOMA	1.000	0.891	0.813	0.983	0.893	0.777	0.965	0.896	0.740
02302	OR	01	PORTLAND	1.013	1.103	0.688	1.016	1.111	0.744	1.018	1.119	0.800
02302	OR	99	REST OF OREGON	1.000	0.986	0.643	0.991	0.996	0.703	0.982	1.006	0.762
12502	PA	01	METROPOLITAN PHILADELPHIA	1.024	1.053	1.177	1.018	1.041	1.193	1.012	1.029	1.208
12502	PA	99	REST OF PENNSYLVANIA	1.000	0.927	0.925	0.990	0.918	0.945	0.980	0.909	0.966
09202	PR	20	PUERTO RICO	1.000	1.007	0.982	1.000	1.011	0.985	1.000	1.015	0.987
14412	RI	01	RHODE ISLAND	1.025	1.039	0.849	1.019	1.033	0.892	1.013	1.027	0.936
11202	SC	01	SOUTH CAROLINA	1.000	0.913	0.817	0.986	0.924	0.850	0.973	0.934	0.882
03402	SD	02	SOUTH DAKOTA**	1.000	1.000	0.382	0.990	1.000	0.336	0.979	1.000	0.290
10312	TN	35	TENNESSEE	1.000	0.896	0.544	0.984	0.909	0.537	0.967	0.922	0.529
04412	TX	31	AUSTIN	1.000	1.046	0.914	1.002	1.058	0.886	1.005	1.070	0.857
04412	TX	20	BEAUMONT	1.000	0.903	0.947	0.989	0.910	0.929	0.978	0.916	0.910
04412	TX	09	BRAZORIA	1.014	1.006	0.795	1.008	0.991	0.780	1.002	0.976	0.766
04412	TX	11	DALLAS	1.011	1.007	0.877	1.009	0.996	0.857	1.007	0.984	0.838
04412	TX	28	FORT WORTH	1.011	0.998	0.902	1.009	0.986	0.871	1.007	0.974	0.841
04412	TX	15	GALVESTON	1.014	1.000	0.855	1.008	0.993	0.827	1.002	0.985	0.798
04412	TX	18	HOUSTON	1.014	1.003	1.409	1.008	0.993	1.376	1.002	0.983	1.344
04412	TX	99	REST OF TEXAS	1.000	0.945	0.934	0.991	0.949	0.903	0.982	0.952	0.873
03502	UT	09	UTAH	1.000	0.933	0.930	0.985	0.940	0.898	0.971	0.948	0.867
14512	VT	50	VERMONT	1.000	0.993	0.518	0.988	0.990	0.506	0.977	0.988	0.494
11302	VA	00	VIRGINIA	1.002	0.984	0.755	1.000	0.983	0.706	0.997	0.982	0.657
09202	VI	50	VIRGIN ISLANDS	1.000	1.007	0.982	1.000	1.011	0.985	1.000	1.015	0.987
02402	WA	02	SEATTLE (KING CNTY)	1.043	1.220	0.853	1.050	1.227	0.816	1.057	1.235	0.780
02402	WA	99	REST OF WASHINGTON	1.007	1.040	0.803	1.013	1.053	0.761	1.018	1.065	0.719
11402	WV	16	WEST VIRGINIA	1.000	0.862	1.333	0.980	0.869	1.431	0.961	0.876	1.529
06302	WI	00	WISCONSIN	1.000	0.957	0.331	0.993	0.958	0.308	0.986	0.958	0.285
03602	WY	21	WYOMING**	1.000	1.000	0.739	0.991	1.000	0.740	0.983	1.000	0.740
"MAC Assignments as of November 22, 2023"												
												
*Work GPCI reflects a 1.5 floor in Alaska established by the MIPPA.												
**PE GPCI reflects a 1.0 floor for frontier states established by the ACA.												
												
"Note:The WORK GPCI floor of 1.0 that was applied in previous updates was extended only through September 30, 2025 by Section 2206 of Full-Year Continuing Appropriations and Extensions Act, 2025."												
"   Therefore, the Work GPCIs for 2025 reflect the 1.0 work GPCI floor, and Work GPCIs for 2026 and 2027 do not reflect a 1.0 floor."												
												
"Note: For CY 2024 and on, Addendum E will reflect the retirement of 3 California localities, as finalized in the CY 2023 PFS final rule. "												
