Five questions to ask about wRVU compensation

Physicians employed by a medical group, hospital or academic institution are commonly compensated using a productivity formula based on work relative value units (wRVUs).

Since wRVUs drive your paycheck, it’s to your advantage to ask questions in order to understand how the system works - and specifically how your employer counts wRVUs.

What are wRVUs?

Medicare establishes an RVU for each CPT code to determine reimbursement. The RVU has three components: physician work, practice expense and malpractice. The physician work RVU, or wRVU, is a "neutralized" way to quantify and compare the productivity of physicians because it eliminates variables such as fee schedules or geographical costs.

Most groups multiply the wRVUs for services provided by a conversion factor to determine all or part of a physician’s compensation. For example, a surgeon who is paid at $60.00 per wRVU and produces 6,000 wRVUs would be compensated $360,000.

What’s there to understand?

It seems pretty simple, but as the saying goes, the devil is in the details. Counting wRVUs is not entirely straightforward, and too often a lack of transparency between administrators and physicians, whether intentional or not, sows seeds of doubt that can grow into a tree of distrust and hostility.