RVU Compensation:
The Disconnect Between Actual Work
and Reported Revenues

Productivity based compensation, using work RVUs (wRVU) to determine compensation, is the norm in employed physician groups and prevalent in academic practices. Getting paid based upon output seems both equitable and motivational. Yet, the resounding refrain from employed physicians re-negotiating their contracts is that productivity based compensation is not working for them. They are working harder than ever, only to hear their wRVUs are not meeting expectations. How is this happening?

If you are considering hospital employment learn the important details before you sign a contract.

There is a notorious disconnect between the work surgeons perceive they are doing and the wRVUs (and resulting revenue) the employer reports.

The reasons are complicated and include:

  • The terms of the original contract. Focusing solely on the dollar amount per wRVU, can be a recipe for disaster and may actually be one of the least important factors in your compensation.
  • Understand the factors significantly impacting your wRVU calculation. Who is doing the final coding? What codes were ultimately submitted and paid or appealed? Who is submitting the claims and managing the denials? Does anyone ever ask to meet with you about difficulties with prior authorization documentation, denials or appeals? If not, that’s a sign of trouble.

    Hospital employment for surgeons should be a mutually beneficial proposition for the surgeon and the institution if the correct processes are adopted by both stakeholders.

Join us for a complimentary  webinar to learn why problems occur, where to look for “leaks” and some definitive steps to take to address the main issues.

Slides and a handout of action steps will be provided to each participant.


Teri Romano has over twenty-five years of consulting and teaching experience in the health care field. Ms. Romano works with physician groups and hospitals combining a background in clinical systems with solid approaches to operational and organizational problem solving.

Find out about more about Teri Romano, BSN, MBA, CPC, CMDP

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Please email education@karenzupko.com if you have questions.

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