Medicare Advantage, Part D, Medicaid

CMS ZIP5 → PFS Locality Crosswalk (authoritative)

medicare_silver.medicare_zip5_locality·live·silver

Rows

687,053

Columns

History

N/A

Card

nocolumns only

Typed tools

What it is

1The authoritative CMS Zip Code to Carrier Locality File (ZIP5) — maps every 5-digit ZIP to its Medicare PFS pricing locality (+ carrier/MAC, state, rural indicator).
2This is the routing table GPCI localization needs to price a professional claim to the provider's geography.
3It supersedes medicare_zip_to_locality, which collapsed big-metro ZIPs into rest-of-state.
4Annual end-of-year ZIP5 history is loaded for 2011-2025 plus the current 2026Q3 file;
594110 -> SF locality 05, 90001 -> LA 18, 10001 -> Manhattan 01.

Grain

Key	Grain
N/A	1One row per (loaded year, 5-digit ZIP) from the CMS Zip Code to Carrier Locality File (ZIP5) \u2014 state, carrier/MAC, PFS pricing locality, rural indicator, and CMS year-quarter.

Columns (23)

Column	Type	Meaning
`year`	int
`row_seq`	bigint
`zip_code`	string
`state`	string
`carrier`	string
`locality_number`	string
`rural_indicator`	string
`year_quarter`	string
`observed_period`	date
`asserted_at`	date
`effective_period_start`	date
`effective_period_end`	date
`cms_vintage_sequence`	int
`parse_revision`	int
`parser_artifact_hash`	string
`source_url`	string
`sha256_content_hash`	string
`source_id`	string
`is_current`	boolean
`bronze_object_key`	string
`s3_version_id`	string
`vintage_tag`	string
`drug_source_version_id`	string

Query it

describe_data_source(source_fqn="medicare_silver.medicare_zip5_locality")     # the card, live
query_substrate(sql="SELECT * FROM medicare_silver.medicare_zip5_locality WHERE <filter> LIMIT 100")

Item	Value
Typed tools that read it	none; raw SQL
Identity key	`zip_code`
Join	`how_to_join(source_fqn="medicare_silver.medicare_zip5_locality")`
Raw door	Athena (read-only via query_substrate): medicare_silver.medicare_zip5_locality
Note	Iceberg table medicare_silver.medicare_zip5_locality. Fixed-width ZIP5 layout (state 1-2, zip 3-7, carrier 8-12, locality 13-14). Read per-book by vlada/rbp/gpci.py (resolve_localities). Source-truth manifest docs/reference/source-audit/source-mastery/manifests/cms_zip5_locality_recovery_manifest.json.

This page as markdown: /docs-md/data/medicare_silver_medicare_zip5_locality.md · every page in one file: /llms-full.txt