Medicare Physician Fee Schedule (MPFS)

Key facts

Legal basis

Section 1848 of the Social Security Act

In use since

January 1, 1992, based on the resource-based relative value scale

Update cycle

Annual proposed rule in summer; final rule in the fall

Payment inputs

Work, practice expense and malpractice RVUs, GPCIs, conversion factor

Change from 2026

Separate conversion factors for qualifying APM participants and others

What is the Medicare Physician Fee Schedule?

The MPFS sets what Original Medicare pays for professional services under Part B: office visits, surgical procedures, the professional component of imaging and tests, and many services of nonphysician practitioners. Each service is identified by a CPT or HCPCS code, and the schedule assigns it relative values.

Medicare built the schedule on the resource-based relative value scale (RBRVS), which replaced charge-based payment starting in 1992. Many commercial insurers and state Medicaid programs use MPFS relative values as the base for their own fee schedules, often quoting rates as a percentage of Medicare.

How MPFS payment is calculated

Each payment rate combines three parts:

• Relative value units (RVUs) for physician work, practice expense and malpractice insurance, with practice expense values that differ between facility and non-facility settings.
• Geographic practice cost indices (GPCIs) that adjust each RVU component for costs in each Medicare payment locality.
• A conversion factor, a dollar amount set each year, that turns the adjusted RVUs into a payment.

Why the MPFS matters

Changes to relative values must generally be budget neutral, so raising the value of some services lowers payment for others, and each annual rule redistributes payment among specialties. Practices, specialty societies and companies whose products depend on physician-billed services follow the proposed and final rules closely.

For pricing and market access work, the MPFS is the anchor for estimating reimbursement for a procedure, comparing payment across sites of service, and modeling how commercial rates quoted as a percentage of Medicare will move.

Recent changes to physician payment

Under MACRA, the base fee schedule update was 0 percent for 2020 through 2025, with Congress adding temporary increases in some years. Starting in 2026, the statute provides two conversion factors: a 0.75 percent annual update for qualifying APM participants and 0.25 percent for other clinicians. For 2026 only, the One Big Beautiful Bill Act added a 2.5 percent increase.