Every year, I do a quick analysis of the GPCI adjustments released by CMS, this year is no different.
The purpose here is to see how large the adjustments are for each locality and compare the results to last year in order to see what the Feds think is happening in your town (or elsewhere). When using RVUs to do anything from setting your fees to measuring your physician productivity, it's important to keep an eye on the GPCI value - you could find your "value" changing by a couple percentage points each year even if you do the same amount of work.
Two big changes this year. First, in addition to a comparison between 2016 and 2017 I've added a new column to the results to help approximate what the scores mean. Take a look at that column in the far right...RVUs in Alabama are worth about 91.26% of the base RVU values, Chicago IL is worth about 109.98% of the base values. Glad to share my methodology with anyone who asks.
| 2016 | 2017 | Approximate | ||||||
| Locality name | Work | PE | MP | Work | PE | MP | Difference | Relative Value |
| Alabama | 1.000 | 0.886 | 0.611 | 1.000 | 0.888 | 0.552 | -0.55% | 91.26% |
| Alaska | 1.500 | 1.107 | 0.712 | 1.500 | 1.112 | 0.710 | 0.16% | 125.83% |
| Arizona | 1.000 | 1.000 | 0.877 | 1.000 | 0.986 | 0.856 | -0.86% | 98.20% |
| Arkansas | 1.000 | 0.867 | 0.534 | 1.000 | 0.870 | 0.555 | 0.38% | 90.46% |
| Colorado | 1.000 | 1.011 | 1.090 | 1.000 | 1.015 | 1.066 | -0.06% | 101.22% |
| Connecticut | 1.024 | 1.121 | 1.232 | 1.023 | 1.117 | 1.244 | -0.10% | 108.39% |
| DC + MD/VA Suburbs | 1.051 | 1.205 | 1.280 | 1.048 | 1.205 | 1.271 | -0.20% | 113.81% |
| Delaware | 1.012 | 1.031 | 1.083 | 1.010 | 1.025 | 1.101 | -0.18% | 102.42% |
| Fort Lauderdale, FL | 1.000 | 1.030 | 1.715 | 1.000 | 1.021 | 1.756 | 0.00% | 107.01% |
| Miami, FL | 1.000 | 1.033 | 2.490 | 1.000 | 1.031 | 2.528 | 0.25% | 113.65% |
| Rest of Florida | 1.000 | 0.960 | 1.315 | 1.000 | 0.956 | 1.337 | 0.04% | 100.67% |
| Atlanta, GA | 1.000 | 1.005 | 0.943 | 1.000 | 1.001 | 1.016 | 0.55% | 100.17% |
| Rest of Georgia | 1.000 | 0.899 | 0.904 | 1.000 | 0.899 | 0.989 | 0.89% | 95.27% |
| Hawaii/Guam | 1.003 | 1.162 | 0.618 | 1.002 | 1.154 | 0.616 | -0.41% | 104.10% |
| Idaho | 1.000 | 0.898 | 0.508 | 1.000 | 0.900 | 0.616 | 1.28% | 92.33% |
| Chicago, IL | 1.016 | 1.037 | 2.019 | 1.012 | 1.036 | 1.972 | -0.62% | 109.98% |
| East St. Louis, IL | 1.000 | 0.934 | 1.885 | 1.000 | 0.935 | 1.835 | -0.43% | 103.69% |
| Suburban Chicago, IL | 1.012 | 1.057 | 1.636 | 1.011 | 1.055 | 1.601 | -0.45% | 107.84% |
| Rest of Illinois | 1.000 | 0.909 | 1.253 | 1.000 | 0.914 | 1.231 | 0.01% | 97.89% |
| Indiana | 1.000 | 0.921 | 0.617 | 1.000 | 0.920 | 0.498 | -1.35% | 92.30% |
| Iowa | 1.000 | 0.896 | 0.493 | 1.000 | 0.902 | 0.458 | -0.09% | 91.16% |
| Kansas | 1.000 | 0.903 | 0.662 | 1.000 | 0.907 | 0.639 | -0.05% | 92.83% |
| Kentucky | 1.000 | 0.872 | 0.795 | 1.000 | 0.876 | 0.807 | 0.32% | 92.75% |
| New Orleans, LA | 1.000 | 0.983 | 1.390 | 1.000 | 0.975 | 1.332 | -0.92% | 101.51% |
| Rest of Louisiana | 1.000 | 0.887 | 1.205 | 1.000 | 0.887 | 1.202 | -0.03% | 96.42% |
| Southern Maine | 1.000 | 1.007 | 0.642 | 1.000 | 1.007 | 0.656 | 0.14% | 97.57% |
| Rest of Maine | 1.000 | 0.918 | 0.642 | 1.000 | 0.920 | 0.656 | 0.25% | 93.57% |
| Baltimore/Surr. Cntys, MD | 1.023 | 1.097 | 1.181 | 1.023 | 1.096 | 1.238 | 0.49% | 107.38% |
| Rest of Maryland | 1.015 | 1.036 | 0.971 | 1.012 | 1.035 | 1.027 | 0.37% | 102.38% |
| Metropolitan Boston | 1.017 | 1.163 | 0.617 | 1.025 | 1.171 | 0.839 | 2.74% | 107.73% |
| Rest of Massachusetts | 1.017 | 1.066 | 0.617 | 1.019 | 1.067 | 0.839 | 2.30% | 102.67% |
| Detroit, MI | 1.000 | 0.994 | 1.328 | 1.000 | 0.992 | 1.510 | 1.65% | 103.71% |
| Rest of Michigan | 1.000 | 0.920 | 0.954 | 1.000 | 0.920 | 0.986 | 0.33% | 96.21% |
| Minnesota | 1.000 | 1.020 | 0.319 | 1.000 | 1.016 | 0.341 | 0.04% | 95.46% |
| Mississippi | 1.000 | 0.864 | 0.613 | 1.000 | 0.867 | 0.492 | -1.21% | 89.82% |
| Metropolitan Kansas City, MO | 1.000 | 0.952 | 1.025 | 1.000 | 0.958 | 1.049 | 0.52% | 98.46% |
| Metropolitan St Louis, MO | 1.000 | 0.955 | 1.025 | 1.000 | 0.957 | 1.039 | 0.23% | 98.33% |
| Rest of Missouri | 1.000 | 0.848 | 0.946 | 1.000 | 0.856 | 0.970 | 0.64% | 93.14% |
| Montana | 1.000 | 1.000 | 1.226 | 1.000 | 1.000 | 1.429 | 1.95% | 103.43% |
| Nebraska | 1.000 | 0.908 | 0.362 | 1.000 | 0.909 | 0.340 | -0.20% | 90.53% |
| Nevada | 1.005 | 1.051 | 0.982 | 1.004 | 1.034 | 0.946 | -1.16% | 101.32% |
| New Hampshire | 1.000 | 1.058 | 0.873 | 1.000 | 1.052 | 0.962 | 0.61% | 102.09% |
| Northern NJ | 1.040 | 1.182 | 1.090 | 1.041 | 1.181 | 1.014 | -0.69% | 110.32% |
| Rest of New Jersey | 1.025 | 1.125 | 1.090 | 1.025 | 1.124 | 1.014 | -0.75% | 106.97% |
| New Mexico | 1.000 | 0.919 | 1.161 | 1.000 | 0.920 | 1.204 | 0.48% | 97.95% |
| Manhattan, NY | 1.052 | 1.168 | 1.764 | 1.052 | 1.174 | 1.690 | -0.40% | 115.92% |
| NYC Suburbs/Long I., NY | 1.046 | 1.209 | 2.215 | 1.044 | 1.207 | 2.182 | -0.41% | 121.00% |
| Poughkpsie/N NYC Suburbs, NY | 1.010 | 1.074 | 1.484 | 1.013 | 1.072 | 1.399 | -0.75% | 107.10% |
| Queens, NY | 1.052 | 1.199 | 2.181 | 1.052 | 1.200 | 2.151 | -0.21% | 120.80% |
| Rest of New York | 1.000 | 0.945 | 0.760 | 1.000 | 0.948 | 0.678 | -0.73% | 95.03% |
| North Carolina | 1.000 | 0.930 | 0.768 | 1.000 | 0.931 | 0.732 | -0.33% | 94.68% |
| North Dakota | 1.000 | 1.000 | 0.554 | 1.000 | 1.000 | 0.547 | -0.07% | 96.38% |
| Ohio | 1.000 | 0.918 | 0.993 | 1.000 | 0.918 | 0.999 | 0.06% | 96.22% |
| Oklahoma | 1.000 | 0.872 | 0.845 | 1.000 | 0.882 | 0.900 | 1.07% | 93.77% |
| Portland, OR | 1.005 | 1.049 | 0.708 | 1.008 | 1.052 | 0.746 | 0.65% | 100.73% |
| Rest of Oregon | 1.000 | 0.967 | 0.708 | 1.000 | 0.967 | 0.746 | 0.40% | 96.45% |
| Metropolitan Philadelphia, PA | 1.021 | 1.087 | 1.264 | 1.022 | 1.081 | 1.322 | 0.33% | 107.31% |
| Rest of Pennsylvania | 1.000 | 0.929 | 0.987 | 1.000 | 0.933 | 1.010 | 0.42% | 97.00% |
| Puerto Rico | 1.000 | 0.705 | 0.293 | 1.000 | 0.856 | 0.642 | 11.44% | 90.51% |
| Rhode Island | 1.022 | 1.053 | 0.759 | 1.025 | 1.052 | 0.879 | 1.26% | 102.57% |
| South Carolina | 1.000 | 0.912 | 0.715 | 1.000 | 0.912 | 0.634 | -0.88% | 93.02% |
| South Dakota | 1.000 | 1.000 | 0.400 | 1.000 | 1.000 | 0.395 | -0.05% | 95.16% |
| Tennessee | 1.000 | 0.898 | 0.524 | 1.000 | 0.900 | 0.525 | 0.11% | 91.60% |
| Austin, TX | 1.000 | 1.019 | 0.766 | 1.000 | 1.020 | 0.757 | -0.05% | 98.98% |
| Beaumont, TX | 1.000 | 0.902 | 0.955 | 1.000 | 0.913 | 0.897 | -0.09% | 95.17% |
| Brazoria, TX | 1.019 | 0.990 | 0.955 | 1.020 | 0.994 | 0.897 | -0.36% | 99.82% |
| Dallas, TX | 1.018 | 1.009 | 0.772 | 1.015 | 1.012 | 0.770 | -0.02% | 99.40% |
| Fort Worth, TX | 1.005 | 0.995 | 0.772 | 1.006 | 0.991 | 0.760 | -0.26% | 97.94% |
| Galveston, TX | 1.019 | 1.013 | 0.955 | 1.020 | 1.012 | 0.897 | -0.58% | 100.65% |
| Houston, TX | 1.019 | 1.006 | 0.955 | 1.020 | 1.009 | 0.946 | 0.09% | 100.90% |
| Rest of Texas | 1.000 | 0.920 | 0.822 | 1.000 | 0.929 | 0.809 | 0.29% | 95.21% |
| Utah | 1.000 | 0.922 | 1.169 | 1.000 | 0.925 | 1.167 | 0.12% | 97.89% |
| Vermont | 1.000 | 1.004 | 0.682 | 1.000 | 1.010 | 0.639 | -0.17% | 97.57% |
| Virginia | 1.000 | 0.983 | 0.824 | 1.000 | 0.985 | 0.866 | 0.52% | 98.24% |
| Virgin Islands | 1.000 | 0.960 | 0.996 | 1.000 | 1.006 | 0.993 | 2.04% | 100.22% |
| Seattle (King Cnty), WA | 1.025 | 1.155 | 0.495 | 1.026 | 1.151 | 0.713 | 1.95% | 105.85% |
| Rest of Washington | 1.000 | 1.015 | 0.475 | 1.000 | 1.013 | 0.689 | 2.10% | 98.11% |
| West Virginia | 1.000 | 0.836 | 1.282 | 1.000 | 0.847 | 1.289 | 0.59% | 95.27% |
| Wisconsin | 1.000 | 0.955 | 0.566 | 1.000 | 0.956 | 0.457 | -1.13% | 93.63% |
| Wyoming | 1.000 | 1.000 | 1.219 | 1.000 | 1.000 | 1.050 | -1.68% | 100.40% |
Some interesting "winners" and "losers" here. Wyoming, Indiana, Mississippi, Nevada, and Wisconsin each lost >1% relative to 2016. Meanwhile, the Virgin Islands, Washington State, all of Massachusetts, and Puerto Rico had big gains (PR had otherwise been cut substantially in previous years).
The second big change is CALIFORNIA. It from a handful of locales to over 30! I did my best to match up the previous localities with the new ones in this chart. I welcome any corrections to my estimates for which locales match to which.
| 2016 | 2017 | Approximate | |||||||
| 2016 Locality | Work | PE | MP | 2017 Locality | Work | PE | MP | Difference | Relative Value |
| Rest of California | 1.027 | 1.083 | 0.658 | BAKERSFIELD, CA | 1.024 | 1.079 | 0.610 | -0.8% | 101.62% |
| Rest of California | 1.027 | 1.083 | 0.658 | CHICO, CA | 1.024 | 1.079 | 0.610 | -0.8% | 101.62% |
| Rest of California | 1.027 | 1.083 | 0.658 | EL CENTRO, CA | 1.024 | 1.079 | 0.610 | -0.8% | 101.62% |
| Rest of California | 1.027 | 1.083 | 0.658 | FRESNO, CA | 1.024 | 1.079 | 0.610 | -0.8% | 101.62% |
| Rest of California | 1.027 | 1.083 | 0.658 | HANFORD-CORCORAN, CA | 1.024 | 1.079 | 0.610 | -0.8% | 101.62% |
| Los Angeles, CA | 1.047 | 1.161 | 0.908 | LOS ANGELES-LONG BEACH-ANAHEIM (LOS ANGELES CNTY), CA | 1.047 | 1.169 | 0.801 | -0.7% | 108.34% |
| Anaheim/Santa Ana, CA | 1.035 | 1.216 | 0.908 | LOS ANGELES-LONG BEACH-ANAHEIM (ORANGE CNTY), CA | 1.041 | 1.197 | 0.801 | -1.5% | 109.36% |
| Rest of California | 1.027 | 1.083 | 0.658 | MADERA, CA | 1.024 | 1.079 | 0.610 | -0.8% | 101.62% |
| Rest of California | 1.027 | 1.083 | 0.658 | MERCED, CA | 1.024 | 1.079 | 0.610 | -0.8% | 101.62% |
| Rest of California | 1.027 | 1.083 | 0.658 | MODESTO, CA | 1.024 | 1.079 | 0.610 | -0.8% | 101.62% |
| Marin/Napa/Solano, CA | 1.059 | 1.286 | 0.496 | NAPA, CA | 1.057 | 1.271 | 0.477 | -0.9% | 110.90% |
| Ventura, CA | 1.030 | 1.180 | 0.834 | OXNARD-THOUSAND OAKS-VENTURA, CA | 1.027 | 1.178 | 0.754 | -1.0% | 107.46% |
| Rest of California | 1.027 | 1.083 | 0.658 | REDDING, CA | 1.024 | 1.079 | 0.610 | -0.8% | 101.62% |
| Rest of California | 1.027 | 1.083 | 0.658 | RIVERSIDE-SAN BERNARDINO-ONTARIO, CA | 1.024 | 1.079 | 0.626 | -0.6% | 101.75% |
| Rest of California | 1.027 | 1.083 | 0.658 | SACRAMENTO--ROSEVILLE--ARDEN-ARCADE, CA | 1.024 | 1.080 | 0.610 | -0.7% | 101.66% |
| Rest of California | 1.027 | 1.083 | 0.658 | SALINAS, CA | 1.024 | 1.083 | 0.610 | -0.6% | 101.80% |
| Rest of California | 1.027 | 1.083 | 0.658 | SAN DIEGO-CARLSBAD, CA | 1.024 | 1.088 | 0.610 | -0.4% | 102.03% |
| Oakland/Berkeley, CA | 1.061 | 1.260 | 0.457 | SAN FRANCISCO-OAKLAND-HAYWARD (ALAMEDA/CONTRA COSTA CNTY), CA | 1.068 | 1.293 | 0.439 | 1.5% | 112.12% |
| San Francisco, CA | 1.079 | 1.388 | 0.457 | SAN FRANCISCO-OAKLAND-HAYWARD (MARIN CNTY), CA | 1.058 | 1.271 | 0.477 | -5.5% | 110.95% |
| San Francisco, CA | 1.079 | 1.388 | 0.457 | SAN FRANCISCO-OAKLAND-HAYWARD (SAN FRANCISCO CNTY), CA | 1.077 | 1.357 | 0.439 | -1.5% | 115.48% |
| San Mateo, CA | 1.079 | 1.372 | 0.416 | SAN FRANCISCO-OAKLAND-HAYWARD (SAN MATEO CNTY), CA | 1.077 | 1.349 | 0.419 | -1.0% | 114.95% |
| Rest of California | 1.027 | 1.083 | 0.658 | SAN JOSE-SUNNYVALE-SANTA CLARA (SAN BENITO CNTY), CA | 1.031 | 1.121 | 0.610 | 1.4% | 103.87% |
| Santa Clara, CA | 1.088 | 1.347 | 0.416 | SAN JOSE-SUNNYVALE-SANTA CLARA (SANTA CLARA CNTY), CA | 1.086 | 1.351 | 0.402 | -0.0% | 115.32% |
| Rest of California | 1.027 | 1.083 | 0.658 | SAN LUIS OBISPO-PASO ROBLES-ARROYO GRANDE, CA | 1.024 | 1.079 | 0.610 | -0.8% | 101.62% |
| Rest of California | 1.027 | 1.083 | 0.658 | SANTA CRUZ-WATSONVILLE, CA | 1.024 | 1.103 | 0.610 | 0.3% | 102.72% |
| Rest of California | 1.027 | 1.083 | 0.658 | SANTA MARIA-SANTA BARBARA, CA | 1.024 | 1.091 | 0.610 | -0.3% | 102.17% |
| Rest of California | 1.027 | 1.083 | 0.658 | SANTA ROSA, CA | 1.024 | 1.093 | 0.610 | -0.2% | 102.26% |
| Rest of California | 1.027 | 1.083 | 0.658 | STOCKTON-LODI, CA | 1.024 | 1.079 | 0.610 | -0.8% | 101.62% |
| Rest of California | 1.027 | 1.083 | 0.658 | VALLEJO-FAIRFIELD, CA | 1.057 | 1.271 | 0.477 | 7.3% | 110.90% |
| Rest of California | 1.027 | 1.083 | 0.658 | VISALIA-PORTERVILLE, CA | 1.024 | 1.079 | 0.610 | -0.8% | 101.62% |
| Rest of California | 1.027 | 1.083 | 0.658 | YUBA CITY, CA | 1.024 | 1.079 | 0.610 | -0.8% | 101.62% |
| Rest of California | 1.027 | 1.083 | 0.658 | REST OF CALIFORNIA, CA | 1.024 | 1.079 | 0.610 | -0.8% | 101.62% |