How many RVUs/year do you usually hit?

[Forwho]

For those who are hospital employed or on an RVU system, how many RVUs are you hitting yearly, and what's your schedule looking like in order to hit that?

Do RVU values increase on a yearly basis?

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[Ducttape]

you should look at the MGMA data for the average answer to these types of questions.

by "RVU values", i assume you mean $/wRVU. generally speaking, they do not change much.

 

[Forwho]

I took a look at the MGMA data as well. I just wanted to see how everyone here is doing as I know MGMA can be a little misleading. For instance the salaries and $/RVU seem to be much higher per MGMA data compared to what I’ve seen posted here and also from what I’ve heard from colleagues.

You do make a good point about the $/RVU and should’ve been more clear. I meant to ask about the wRVU per CPT code, does that ever increase periodically?

I’d imagine the $/wRVU wouldn’t increase unless it’s stated somewhere in the contract?

 

[lobelsteve]

Less than Bob.

 

[gaspasser127]

~10,000-12,000

Usually home by 530 every day

Hospital employed

Part of a NSG group

Injections/RFA, trials/implants, vertiflex, MILD, intracept, osteocool, others

 

[afob100]

9,000-10,000 annually. About 850/month if no vacation.

hospital employed ortho group. 8-4 M-F without call or weekends. Clinic days are 18-20 patients. Injection day is ~25 at asc (a couple sedation but mostly local)

B&b procedures plus stim trials (surgeon implants). 1.5 procedure days per week. 0.5 day of tele from home.

 

[clubdeac]

9,000-10,000 annually. About 850/month if no vacation.

hospital employed ortho group. 8-4 M-F without call or weekends. Clinic days are 18-20 patients. Injection day is ~25 at asc (a couple sedation but mostly local)

B&b procedures plus stim trials (surgeon implants). 1.5 procedure days per week. 0.5 day of tele from home.

You have my exact schedule and total wRVU. It’s a pretty nice life isn’t it

 

[paindoctor2014]

15000. Private ortho group.

3 half day procedures. Don’t work Friday afternoon.

Hectic but doable with mid level support. See all new and 30-40% of follow ups.

 

[Status Sciaticus]

15000. Private ortho group.

3 half day procedures. Don’t work Friday afternoon.

Hectic but doable with mid level support. See all new and 30-40% of follow ups.

how many patients per day?

 

[Forwho]

15000. Private ortho group.

3 half day procedures. Don’t work Friday afternoon.

Hectic but doable with mid level support. See all new and 30-40% of follow ups.

what kind of procedures?

 

[DrMDAware]

what kind of procedures?

I’m always curious what kind of bump one gets from SCS trials, Intracepts, PNS, SI fusion vs epidurals and MBB/RFAs in a pure wRVU model

 

[DOctorJay]

I’m always curious what kind of bump one gets from SCS trials, Intracepts, PNS, SI fusion vs epidurals and MBB/RFAs in a pure wRVU model

RVU Calculator - AAPC Relative Value Units

CPT® RVU calculator provides a quick analysis of the work relative value units associated with a certain volume of CPT or HCPCS codes.

www.aapc.com

Here’s a calculator. Just drop the code in and put “1” in the number of units field to see what each is worth.

 

[Forwho]

is anyone getting wRVUs for MILD despite it being a T code?

 

[gaspasser127]

is anyone getting wRVUs for MILD despite it being a T code?

there’s technically no defined wRVU. If you do MILD then you have to work with your hospital leadership to figure out what the reimbursement is and how they want to value the procedure in terms of “wRVU.”

Others will use “similar codes” to get a roundabout estimate of what the wRVU should be

 

[txpain]

I get 50% of the pro fee for every mild. The pro fee is about 1000 so comes it out to $500. Which for a 10-15 min procedure is not bad for me.

 

[afob100]

I’m always curious what kind of bump one gets from SCS trials, Intracepts, PNS, SI fusion vs epidurals and MBB/RFAs in a pure wRVU model

Depends on how much time you spend doing those advanced procedures. For me, I average about 10-12 wrvu/hr doing b&b (4 local cases per hour). A stim trial is 7 wrvu per lead... so 14 wrvu. If you book a trial for 1 hr, doesn't make you much vs doing it in 15-30 min.

Like any procedure, if you are fast and have high volume, you will make more.

However, most hospital pain jobs limit your wrvu production to 90%tile. That level of production signals they need to hire another doc usually. This is even written in my contract where there will be more scrutiny and audits at that level/need analysis for another doc.

 

[DrMDAware]

RVU Calculator - AAPC Relative Value Units

CPT® RVU calculator provides a quick analysis of the work relative value units associated with a certain volume of CPT or HCPCS codes.

www.aapc.com

Here’s a calculator. Just drop the code in and put “1” in the number of units field to see what each is worth.

Thanks.

Sorry for being unclear.

Just seems to me if someone is in a quick turnover room doing bread and butter cases there isn’t a huge difference between adding in 1-2 larger cases in terms of wRVUs.

Seems like the room and staff are familiar with an epidural but need to open 5 trays and do a 40 minute timeout if we do a larger case.

This is my sense. I could be wrong

 

[DrMDAware]

Depends on how much time you spend doing those advanced procedures. For me, I average about 10-12 wrvu/hr doing b&b (4 local cases per hour). A stim trial is 7 wrvu per lead... so 14 wrvu. If you book a trial for 1 hr, doesn't make you much vs doing it in 15-30 min.

Like any procedure, if you are fast and have high volume, you will make more.

However, most hospital pain jobs limit your wrvu production to 90%tile. That level of production signals they need to hire another doc usually. This is even written in my contract where there will be more scrutiny and audits at that level/need analysis for another doc.

Well said.

If the room takes 30 minutes to set up and turnover and it takes 20 mins to do the SCS trial case then I wonder if going for 5 bread and butter cases per hour would be more optimal.

Again, we’re not taking into account facility fees.

 

[Ronin1]

I’m on track for about 11500 for the year. Coincidentally that’s my cap. I do no implants maybe 30 trials a year. Lots of RFA and bread and butter spine. It’s all about your support. Staff. Average 60 wrvu/day pretty easily with my team

 

[cowboydoc]

Thanks.

Sorry for being unclear.

Just seems to me if someone is in a quick turnover room doing bread and butter cases there isn’t a huge difference between adding in 1-2 larger cases in terms of wRVUs.

Seems like the room and staff are familiar with an epidural but need to open 5 trays and do a 40 minute timeout if we do a larger case.

This is my sense. I could be wrong

If your staff is generally slow with turnover, a few larger cases are probably better. If they are reasonably efficient, doing what's in everyone's wheelhouse beats the random/obscure one-off procedure.

With bread-and-butter pain cases, your staff have more control of the schedule than you. It still takes me 4-6 minutes with most simple injections. My production is WAY up and coffee consumption modestly down since getting the OR to schedule cases q15 min instead of q30 min.

 

[drusso]

I’m always curious what kind of bump one gets from SCS trials, Intracepts, PNS, SI fusion vs epidurals and MBB/RFAs in a pure wRVU model

The money is in the facility fee. Admin could care less what the actual procedure is. Hospitals are in the room rental business first and foremost.

 

[BobBarker]

I get 50% of the pro fee for every mild. The pro fee is about 1000 so comes it out to $500. Which for a 10-15 min procedure is not bad for me.

They are compensated for the procedure in the facility fee. There is no justification to let them take 50% of your professional fee.

 

[txpain]

They are compensated for the procedure in the facility fee. There is no justification to let them take 50% of your professional fee.

I’m employed private practice. Most of my procedures are at a non-affiliated ASC. So the ASC makes the facility fee. The practice gets part of pro fee. Not an ideal scenario but just reality of being employeed for now. I am overall compensated pretty well compared to average for what it’s worth.

 

[paindoctor2014]

what kind of procedures?

Bread and butter mostly. Rfa, stims, unfortunately a decent bit of genicular nerve stuff.

We have a very efficient surgery center that which allows me to still do a half day of clinic after doing 30 procedures. About half the procedures are generated from my clinic and the other direct referrals from our spine guys ( who are good).

Normally 40 on the clinic schedule btw me and my mid level for a whole day.

Don’t get paid by the rvu either, thats just how I track how busy I am year over year.

 

[DrSpine]

Weird, something didn't make sense when I worked for the hospital. I would see 15-20 patients a day, have 1.5-2 days of procedure, yet my wRVUs were running very low. In fact, they were running extremely low for everyone I felt. Was hitting maybe 3000-3500 wRVU for the year. I remained convinced that the numbers were being cooked and intentionally weren't being counted correctly. Didn't matter though since I was one foot out the door anyway after guarantee was up.

 

[DOctorJay]

Weird, something didn't make sense when I worked for the hospital. I would see 15-20 patients a day, have 1.5-2 days of procedure, yet my wRVUs were running very low. In fact, they were running extremely low for everyone I felt. Was hitting maybe 3000-3500 wRVU for the year. I remained convinced that the numbers were being cooked and intentionally weren't being counted correctly. Didn't matter though since I was one foot out the door anyway after guarantee was up.

at that volume you were at least double that for sure. always have to keep track of your own numbers, at least initially to ensure things are being tracked accurately.

i know of a guy who did procedures out of 2 different locations. numbers were looking low and admin started coming down on him. they hadn't been keeping track of his numbers at one of the locations. no apology to him though.

 

[Ducttape]

happened to me too.

 

[paindoctor2014]

Weird, something didn't make sense when I worked for the hospital. I would see 15-20 patients a day, have 1.5-2 days of procedure, yet my wRVUs were running very low. In fact, they were running extremely low for everyone I felt. Was hitting maybe 3000-3500 wRVU for the year. I remained convinced that the numbers were being cooked and intentionally weren't being counted correctly. Didn't matter though since I was one foot out the door anyway after guarantee was up.

Happened at my first job, they weren’t capturing them all. I started keeping track

 

[JustPushTheButton]

you should look at the MGMA data for the average answer to these types of questions.

by "RVU values", i assume you mean $/wRVU. generally speaking, they do not change much.

Do you mind sharing that MGMA data for all specialties (you can DM it)...its behind a huge paywall.

 

[SpineandWine]

9000 work RVUs- most Fridays off

 

[DrMDAware]

9000 work RVUs- most Fridays off

Niiiiice. Any tips for the internet on how to replicate this?

 

[GatorCHOMPions]

Niiiiice. Any tips for the internet on how to replicate this?

My partner does about this level with most Fridays off and half-day Wednesdays. Biggest factor is 10 min follow up and 20 min new patient slots. Also need to have a flexible hospital administration.

 

[clubdeac]

My partner does about this level with most Fridays off and half-day Wednesdays. Biggest factor is 10 min follow up and 20 min new patient slots. Also need to have a flexible hospital administration.

I’m guessing he has a scribe? My biggest obstacle in seeing more patients is the damn documentation. I’ve got everything templated in epic but it’s still too much damn busy work if I want things done right

 

[lobelsteve]

Dictation after leaving room takes 60 seconds. Transcription has a pedal to slow my recording down.

 

[GatorCHOMPions]

I’m guessing he has a scribe? My biggest obstacle in seeing more patients is the damn documentation. I’ve got everything templated in epic but it’s still too much damn busy work if I want things done right

Like Steve above, he dictates and it takes like a minute or two. No scribes, and a loyal patient base that knows he’s straight to the point.

 

[TeslaCoil]

I get 50% of the pro fee for every mild. The pro fee is about 1000 so comes it out to $500. Which for a 10-15 min procedure is not bad for me.

They are ripping you off man. The entire reason why I dont even do MILD at all is that the professional fee is $750 and I dont have my own ASC. Not worth my time when I can make the same on a 15 min RFA in clinic. They should not be taking anything out of your professional fee. Did you agree to that formally in writing?

 

[TeslaCoil]

15k RVU's per year. Thats with 2 midlevels. We see patients and do procedures in clinic 5 days per week. I see all new pts (up to 6 per day, 4 days per week). Averaging 60ish procedures weekly (1 stim trial and something like 7 or 8 RFAs weekly. Typical day is 50-60 total patients on the schedule (and growing). Sometimes more. $500k/yr and 5 weeks vacay. I do travel to our satellite clinics on Fridays (90-100 miles each way) which is reimbursed. Im happy with all but my tax setup, which is $h!t. I know Im underpaid.

 

[DOctorJay]

15k RVU's per year. Thats with 2 midlevels. We see patients and do procedures and see pts in clinic 5 days per week. I see all new pts (up to 6 per day, 4 days per week). Averaging 60ish procedures weekly (1 stim trial and something like 7 or 8 RFAs weekly. Typical day is 50-60 total patients on the schedule (and growing). Sometimes more. $500k/yr and 5 weeks vacay. I do travel to our satellite clinics on Fridays (90-100 miles each way) which is reimbursed. Im happy with all but my tax setup, which is $h!t. I know Im underpaid.

you're saying you do 15k wRVUs per year and make 500k. is that correct?

$33.33/wRVU???

 

[callmeanesthesia]

15k RVU's per year. Thats with 2 midlevels. We see patients and do procedures and see pts in clinic 5 days per week. I see all new pts (up to 6 per day, 4 days per week). Averaging 60ish procedures weekly (1 stim trial and something like 7 or 8 RFAs weekly. Typical day is 50-60 total patients on the schedule (and growing). Sometimes more. $500k/yr and 5 weeks vacay. I do travel to our satellite clinics on Fridays (90-100 miles each way) which is reimbursed. Im happy with all but my tax setup, which is $h!t. I know Im underpaid.

That’s inclusive of the mid levels, right? Otherwise I have a hard time making that add up. I do 25-30 procedures per day, 3.5 days per week, and on some individual days I’ll do 7 RFs (probably average 3-4 per day). SCS trials and implants aren’t frequent, maybe 1 a month on average. Clinic 1.5 days a week and I’ll admit I’m a lot slower than most of you seem to be - 30 minute new patient and 15 minute f/u visits. We track and pay ourselves based on collections not RVUs but the billers do still include RVUs in their report, and I think mine were somewhere around 10k.

 

[TeslaCoil]

That’s inclusive of the mid levels, right? Otherwise I have a hard time making that add up. I do 25-30 procedures per day, 3.5 days per week, and on some individual days I’ll do 7 RFs (probably average 3-4 per day). SCS trials and implants aren’t frequent, maybe 1 a month on average. Clinic 1.5 days a week and I’ll admit I’m a lot slower than most of you seem to be - 30 minute new patient and 15 minute f/u visits. We track and pay ourselves based on collections not RVUs but the billers do still include RVUs in their report, and I think mine were somewhere around 10k.

yes midlevels included.

 

[TeslaCoil]

you're saying you do 15k wRVUs per year and make 500k. is that correct?

$33.33/wRVU???

Well I have the aid of two midlevels, so my actual workload is pretty reasonable. Their pay comes out of our total earnings and is 90th percentile for PA pay.

 

[paindoc007]

Well I have the aid of two midlevels, so my actual workload is pretty reasonable. Their pay comes out of our total earnings and is 90th percentile for PA pay.

Damnnnn. I don’t touch 15k wrvu a year. And still make a boat load more than you. What a raw deal.

 

[SSdoc33]

Damnnnn. I don’t touch 15k wrvu a year. And still make a boat load more than you. What a raw deal.

you are not helping his mental state

 

[TeslaCoil]

Damnnnn. I don’t touch 15k wrvu a year. And still make a boat load more than you. What a raw deal

Care to elaborate? Whats your work setup? Pay structure? Care to share how much you get paid?

 

[specepic]

at that volume you were at least double that for sure. always have to keep track of your own numbers, at least initially to ensure things are being tracked accurately.

i know of a guy who did procedures out of 2 different locations. numbers were looking low and admin started coming down on him. they hadn't been keeping track of his numbers at one of the locations. no apology to him though.

They were probably only giving you credit for your clinic only and not giving you credit whatsoever for the fluoroscopy procedures

 

[DOctorJay]

They were probably only giving you credit for your clinic only and not giving you credit whatsoever for the fluoroscopy procedures

wasn't me but someone I know closely, did procedures in an OR (got the wRVUS) and a separate IR suite (didn't get the wRVUs).

 

[paindoc007]

Care to elaborate? Whats your work setup? Pay structure? Care to share how much you get paid?

Sure. Paid wrvu like you. At 74$/wrvu flat rate. Anywhere from 9-12k wrvu/year. So income has been all over the place last 5 years, but no where near 5.

15k wrvu is INSANE for our speciality. That’s like 2x median. Your income needs to be commensurate with that. Even big market/city pain docs get 65 or so /wrvu. 500k is nowhere close to what’s appropriate.

 

[bedrock]

Care to elaborate? Whats your work setup? Pay structure? Care to share how much you get paid?

are you private practice? Pain group? ortho group? Hospital?

And only professional fees from procedures?

 

[Forwho]

curious to see what everyone is getting on $/rvu basis?

 

[clubdeac]

Sure. Paid wrvu like you. At 74$/wrvu flat rate. Anywhere from 9-12k wrvu/year. So income has been all over the place last 5 years, but no where near 5.

15k wrvu is INSANE for our speciality. That’s like 2x median. Your income needs to be commensurate with that. Even big market/city pain docs get 65 or so /wrvu. 500k is nowhere close to what’s appropriate.

this right here