-
Rvu rate
Searched on the forum and couldnt find anything clear,
Spoke to a group that is offering 30/wrvu for days. Is that a reasonable amount?
-
37 Replies
-
My understanding is that in the current market that is not good.
-
No.
-
Absolutely not. Don’t settle for these low ball offers. Aim for 40 and settle for 37 for a remote gig. This is assuming the cases are “easy”. If lots of oncology or post op cases, then not even worth it at 37.
-
That is a poor rate, even for tele.
-
So who is paying $37/RVU for remote daytime work? Ive been trying to find something at $35/RVU or above and striking out.
-
I would consider $35 reasonable. Doesnt sound like much but thats +10% more than the OPs quote if $30. Significant to me at our salaries.
-
-
-
-
-
-
Quote from Sam679
Searched on the forum and couldnt find anything clear,
Spoke to a group that is offering 30/wrvu for days. Is that a reasonable amount?
Is this a remote tele-job?
If I recall (and understand correctly), Dan Corbett stated that PP’s average between 50-70/wRVU-
I get $36 and think that’s pretty good, only for when there’s a backlog of cases. You’re not going to get >40 for remote daytime work unless you get very lucky.
-
Whats the average wrvu if youre reading around 100-120 community cases? Ive never worked at a place that tracked before and dont know what my conversion would be
-
Quote from Sam679
Whats the average wrvu if youre reading around 100-120 community cases? Ive never worked at a place that tracked before and dont know what my conversion would be
For traditional PP its between $50-70/wRVU. If you are reading at CMS rates then its around $35/wRVU whether you read 1 case or 1000 cases/shift-
No I meant how to roughly estimate my daily wrvu range if I read 100-120 community cases, mixed (I know it matters how many ct, mri, etc – I just want a rough range)
-
70
-
Quote from Sir Read Alot
70
That’s a good guesstimate without having precise breakdown…This is a rough estimate of wRVU/exam that I use:
CT a/p, CTA chest: 1.7-1.9
CT chest, CT head, CT C/S, CT extremity, US abd: 0.85-1.0
CT c/a/p: around 3.0
MRI brain, MRI c/s or L/S etc without contrast: 1.5
Same MRI’s with contrast: 2.2-2.5
CTA head/neck: 2.5-3.0
Xrays: around 0.2-0.3
-
Last I checked CTA H/N is 3.5, 1.75 for H, 1.75 for N
-
If individual numbers are not tracked, you could always find out the total practice procedure count and wRVU, and just divide. An average wRVU per procedure of 0.6 would be in the ballpark for general diagnostic radiology.
If anyone has a link to a spreadsheet calculator where you can input your study counts of various types and it spits out the wRVU, would be interested. I’ve been meaning to make my own, but if it already exists, all the better.-
Attached is a spreadsheet I’ve created just for my own use. I’ve had to upload it in .png format, which I think can be converted easily enough back into excel format. The CPT list includes the most common exams I read but is NOT comprehensive. Additional exam wRVU values can be found here: [link=https://www.cms.gov/medicare/physician-fee-schedule/search]https://www.cms.gov/medic…an-fee-schedule/search[/link]
Cheers -
Nice, I tried to extract the image using the web based Excel but it hangs up at 20% for some reason.
Maybe you can try uploading the spreadsheet here? Should generate a download link
[link]https://upload.disroot.org/#![/link] -
I’m confused about payment. If medicare pays $30-35 per rvu, how do we earn so much more in private practice? Are private insurance rates significantly higher? Hospital stipends?
-
Common misconception that medicare pays $30-35/wRVU. The Medicare conversion factor ($33.8872 for 2023) is multiplied by an exam’s TOTAL RVU (not wRVU) to generate payment. TOTAL RVU for a given exam and practice location = work RVU*geographic price index work (or GPCIwork) + practice expense RVU*GPCIpractice expense + malpractice RVU*GPCImalpractice.
Use CT head wo contrast (CPT 70450) in the state of TN (locality 1031235) as an example: Total RVU = 0.85*1 + 0.31*0.894 + .04*0.518 = 1.14786, which is then multiplied by CF $33.8872 to give payment $38.90.
If you express that as a multiple of the wRVU only, that’s $45.76/wRVU. The other data for each exam and locality are available at that MPFS link I posted earlier, here again: [link=https://www.cms.gov/medicare/physician-fee-schedule/search]https://www.cms.gov/medic…an-fee-schedule/search[/link]
It’s also true that many commercial insurance contracts reimburse higher, some substantially, than Medicare. -
Quote from HankKingsley
Common misconception that medicare pays $30-35/wRVU. The Medicare conversion factor ($33.8872 for 2023) is multiplied by an exam’s TOTAL RVU (not wRVU) to generate payment. TOTAL RVU for a given exam and practice location = work RVU*geographic price index work (or GPCIwork) + practice expense RVU*GPCIpractice expense + malpractice RVU*GPCImalpractice.
Use CT head wo contrast (CPT 70450) in the state of TN (locality 1031235) as an example: Total RVU = 0.85*1 + 0.31*0.894 + .04*0.518 = 1.14786, which is then multiplied by CF $33.8872 to give payment $38.90.
If you express that as a multiple of the wRVU only, that’s $45.76/wRVU. The other data for each exam and locality are available at that MPFS link I posted earlier, here again: [link=https://www.cms.gov/medicare/physician-fee-schedule/search]https://www.cms.gov/medic…an-fee-schedule/search[/link]
It’s also true that many commercial insurance contracts reimburse higher, some substantially, than Medicare.
I’ve attempted to explain this over and over. The confusion remains among people that should know better. And rather than give a range, I can share that the average $/wRVU for a pretty diverse DR practice receiving full pro fee RVUs based on 100% of Medicare was $49.5 in 2022. -
Quote from Thread Enhancer
Quote from HankKingsley
Common misconception that medicare pays $30-35/wRVU. The Medicare conversion factor ($33.8872 for 2023) is multiplied by an exam’s TOTAL RVU (not wRVU) to generate payment. TOTAL RVU for a given exam and practice location = work RVU*geographic price index work (or GPCIwork) + practice expense RVU*GPCIpractice expense + malpractice RVU*GPCImalpractice.
Use CT head wo contrast (CPT 70450) in the state of TN (locality 1031235) as an example: Total RVU = 0.85*1 + 0.31*0.894 + .04*0.518 = 1.14786, which is then multiplied by CF $33.8872 to give payment $38.90.
If you express that as a multiple of the wRVU only, that’s $45.76/wRVU. The other data for each exam and locality are available at that MPFS link I posted earlier, here again: [link=https://www.cms.gov/medicare/physician-fee-schedule/search]https://www.cms.gov/medic…an-fee-schedule/search[/link]
It’s also true that many commercial insurance contracts reimburse higher, some substantially, than Medicare.
I’ve attempted to explain this over and over. The confusion remains among people that should know better. And rather than give a range, I can share that the average $/wRVU for a pretty diverse DR practice receiving full pro fee RVUs based on 100% of Medicare was $49.5 in 2022.
Thank you both. It’s confusing stuff but we should know what our work is actually full worth -
So 30/wRVU or less like so many telerad and corporate outfits provide is terrible, lower than Medicare.
-
Keep in mind that $50/wRVU (or $34/-26RVU) is a gross collection rate. This is before you have billed and collected on it. This is before you have either paid your own admin staff or contracted a management company and before you paid for medmal coverage. Yes, you can run a radiology practice on a very low overhead, but there is always some. So what is paid out to the rads, is not going to be right at the collection rate. As for the prevailing rates paid for tele, well they are a reflection of the fact what people accept. There is a discount for working in your jammies.
-
Quote from fw
Keep in mind that $50/wRVU (or $34/-26RVU) is a gross collection rate. This is before you have billed and collected on it. This is before you have either paid your own admin staff or contracted a management company and before you paid for medmal coverage. Yes, you can run a radiology practice on a very low overhead, but there is always some. So what is paid out to the rads, is not going to be right at the collection rate. As for the prevailing rates paid for tele, well they are a reflection of the fact what people accept. There is a discount for working in your jammies.
[font=”arial, helvetica, sans-serif”][size=”3″]Good point to keep in mind. With this said, if a PP was 100% CMS (no self-pay or commercial), would a rad’s net pay per wRVU be closer to $33.88 or $45.67? I know there’s a lot of variance to overhead but just trying to get a feel of whats reasonable [/size][/font] -
Quote from jd4540
[font=”arial, helvetica, sans-serif”][size=”3″]Good point to keep in mind. With this said, if a PP was 100% CMS (no self-pay or commercial), would a rad’s net pay per wRVU be closer to $33.88 or $45.67? I know there’s a lot of variance to overhead but just trying to get a feel of whats reasonable [/size][/font]
Depends on how the practice is structured and how much overhead you incur.
I knew one solo practitioner who paid 6% for billing and back then $12,000/year for medmal. The rest was pre-tax income. He didn’t bother with any insurance contracts, it was either Medicare/medicaid or non-par private. Took home 90+% of his collections, and he collected a lot.
20% would be a more typical overhead, whether you contract out your admin services or whether you do them with employed staff.
So in the proposed medicare only practice, a payout of 37 per wRVU would mean that nobody is skimming or subsidizing anything. In that context, 30/wRVU for daytime tele wouldnt be a crazy skim.
-
Quote from fw
Quote from jd4540
[font=”arial, helvetica, sans-serif”][size=”3″]Good point to keep in mind. With this said, if a PP was 100% CMS (no self-pay or commercial), would a rad’s net pay per wRVU be closer to $33.88 or $45.67? I know there’s a lot of variance to overhead but just trying to get a feel of whats reasonable [/size][/font]
Depends on how the practice is structured and how much overhead you incur.
I knew one solo practitioner who paid 6% for billing and back then $12,000/year for medmal. The rest was pre-tax income. He didn’t bother with any insurance contracts, it was either Medicare/medicaid or non-par private. Took home 90+% of his collections, and he collected a lot.
20% would be a more typical overhead, whether you contract out your admin services or whether you do them with employed staff.
So in the proposed medicare only practice, a payout of 37 per wRVU would mean that nobody is skimming or subsidizing anything. In that context, 30/wRVU for daytime tele wouldnt be a crazy skim.
Thanks!…I am 10 years out yet still learning the in’s/outs of this stuff. Think many of us evaluate/accept job offers without any clue of what we will be making per wRVU, I know I have. -
Quote from fw
Quote from jd4540
[font=”arial, helvetica, sans-serif”][size=”3″]Good point to keep in mind. With this said, if a PP was 100% CMS (no self-pay or commercial), would a rad’s net pay per wRVU be closer to $33.88 or $45.67? I know there’s a lot of variance to overhead but just trying to get a feel of whats reasonable [/size][/font]
Depends on how the practice is structured and how much overhead you incur.
I knew one solo practitioner who paid 6% for billing and back then $12,000/year for medmal. The rest was pre-tax income. He didn’t bother with any insurance contracts, it was either Medicare/medicaid or non-par private. Took home 90+% of his collections, and he collected a lot.
20% would be a more typical overhead, whether you contract out your admin services or whether you do them with employed staff.
So in the proposed medicare only practice, a payout of 37 per wRVU would mean that nobody is skimming or subsidizing anything. In that context, 30/wRVU for daytime tele wouldnt be a crazy skim.
30 is the teaser rate. 20-25 is where corps want to be to pay shareholders and c suite properly.
-
Quote from fw
Quote from jd4540
[font=”arial, helvetica, sans-serif”][size=”3″]Good point to keep in mind. With this said, if a PP was 100% CMS (no self-pay or commercial), would a rad’s net pay per wRVU be closer to $33.88 or $45.67? I know there’s a lot of variance to overhead but just trying to get a feel of whats reasonable [/size][/font]
Depends on how the practice is structured and how much overhead you incur.
I knew one solo practitioner who paid 6% for billing and back then $12,000/year for medmal. The rest was pre-tax income. He didn’t bother with any insurance contracts, it was either Medicare/medicaid or non-par private. Took home 90+% of his collections, and he collected a lot.
20% would be a more typical overhead, whether you contract out your admin services or whether you do them with employed staff.
So in the proposed medicare only practice, a payout of 37 per wRVU would mean that nobody is skimming or subsidizing anything. In that context, 30/wRVU for daytime tele wouldnt be a crazy skim.
Solo practice is mostly dead so that example is not really relevant. Large groups have much higher overhead. Large groups often have own pacs and IT and admin departments. Also subsidized IR team.
-
Quote from HankKingsley
Common misconception that medicare pays $30-35/wRVU. The Medicare conversion factor ($33.8872 for 2023) is multiplied by an exam’s TOTAL RVU (not wRVU) to generate payment. TOTAL RVU for a given exam and practice location = work RVU*geographic price index work (or GPCIwork) + practice expense RVU*GPCIpractice expense + malpractice RVU*GPCImalpractice.
Use CT head wo contrast (CPT 70450) in the state of TN (locality 1031235) as an example: Total RVU = 0.85*1 + 0.31*0.894 + .04*0.518 = 1.14786, which is then multiplied by CF $33.8872 to give payment $38.90.
If you express that as a multiple of the wRVU only, that’s $45.76/wRVU. The other data for each exam and locality are available at that MPFS link I posted earlier, here again: [link=https://www.cms.gov/medicare/physician-fee-schedule/search]https://www.cms.gov/medic…an-fee-schedule/search[/link]
It’s also true that many commercial insurance contracts reimburse higher, some substantially, than Medicare.
This is correct.
-
Quote from RoleCall
I’m confused about payment. If medicare pays $30-35 per rvu, how do we earn so much more in private practice? Are private insurance rates significantly higher? Hospital stipends?
See the explanation above. In PP groups typically get the entire Medicare pro fee for that part of their practice plus a better rate for private insurance. Depending on payor mix including no pay, Medicaid etc., average $/wRVU should be $50 on the low end up to $70 in advantaged locations. (of course there are outliers on either end). Then throw in hospital subsidies for well respected groups and maybe some technical fee, if partners built wisely and can hire staff at a reasonable salary, and a PP can be quite lucrative. -
Thanks Hank! Was able to download it no issues.
-
That works; thanks! Here is link: [link=https://upload.disroot.org/r/T7h10ce9#2YShAj+91fnOQX2cXX53d3EXi9E/SHHkZinAaPt5CX0=]https://upload.disroot.or…EXi9E/SHHkZinAaPt5CX0=[/link]
-
Quote from HankKingsley
Attached is a spreadsheet I’ve created just for my own use. I’ve had to upload it in .png format, which I think can be converted easily enough back into excel format. The CPT list includes the most common exams I read but is NOT comprehensive. Additional exam wRVU values can be found here: [link=https://www.cms.gov/medicare/physician-fee-schedule/search]https://www.cms.gov/medic…an-fee-schedule/search[/link]
Cheers
Thanks. It’s depressing when looking at those numbers. Double edged sword when talking $/wRVU. It sounds decent to see one is being paid $50/wRVU at Medicare rates, but one must understand that this number comes about because of how low the wRVU value is for each exam and how little we get paid for each study. The only reason we can make a reasonable income off of these rates is because we have become tremendously efficient reading DR on PACS.
Where it really looks horrible is the work part of the pro fee for any procedural based exam. I wonder if the patient knows we get $105 to do their breast biopsy? -
That’s right. The efficiency we have is in response to many larger parasites in the system, which is sadder. But keep in mind it’s printed USD/world reserve, and that won’t get better at all. Over time, it will cause more stress because the greater inflation is already obvious and will get much, much worse. Invest wisely. Maybe if things get bad enough we can put more pressure on the system, but that’s pretty difficult to do, especially for physicians. Still, our demand is yuge right now.
The system usually makes things harder and harder to work for because it steals so much labor and more importantly, you can’t choose flexibility (typically) without getting crazy lowballed. The all or nothing part of the physician (work and get paid “well” or don’t do all these crazy late nights and overnights and no group wants you, etc) is very, very annoying. I guess locums is the only option for that if you can’t carve something specific out … that all depends on demand, which right now is good… -
For subspecialized jobs the $ per wRVU at the individual level is very misleading.
MSK folks reading tons of ortho plain films will have much HIGHER take home $ per RVU than the Neuro guys reading all CT/MR assuming they are in private practice where all partners get paid equally and work equally hard. The MSK guy cannot be expected to have the same total daily RVU as the Neuro person.
On the other hand if they work at a eat-what-you-kill practice where you get paid directly related to the wRVUs you read then the MSK person gets screwed. Mammo and Neuro can make easy money this way.
A 100% neurorad getting paid $40 per wRVU would be making bank easy. MRI Brain and MRI C/T spine both w&wo contrast for MS follow up is 2.29 wRVU x 3 = 6.87 wRVU. $274.8 total.
-
-
Quote from W24
Last I checked CTA H/N is 3.5, 1.75 for H, 1.75 for N
Yeah, I always assume the worst (eg. some type of pay-cut via bundling etc)
-
-
-
-
-
-
-
-
Quote from jd4540
Quote from Sam679
Searched on the forum and couldnt find anything clear,
Spoke to a group that is offering 30/wrvu for days. Is that a reasonable amount?
Is this a remote tele-job?
If I recall (and understand correctly), Dan Corbett stated that PP’s average between 50-70/wRVU
50-70 wrvu. This is collections before overhead.
-
