Mgma rvu by specialty reimbursement. 04) for non-academic physicians and 76% (3.

Mgma rvu by specialty reimbursement 3% Urgent care center/chain: 2. In addition, the benchmarks can reveal new opportunities and service lines that This tool allows you to calculate the work RVU (wRVU) impact — based on the CPT® code and volume for an individual provider or a combined group of providers — from 2022 wRVU values to 2023 and 2024 values. Member Tool 2020, 2021 and 2022 wRVU Variance Calculator. Section 3: Procedures and Critical Care. However, there are additional items that comprise reimbursement within our speciality. 5. for whatever reason 2010-2014 they absolutely decimated reimbursement. Increased RVUs per beneficiary have only partially offset decreases due to both inflation and decline in conversion factor, implying less overall pay for more services per patient. Skip To Navigation Skip To Content Skip To Footer. 6001 – 9000 work RVUs – paid out at $52/ work RVU . There are a couple of, I guess, good ways of going about trying to find that. Self Identified Primary Specialty: 2020-2021 Overall wRVU % Change: 2022-2023 Overall wRVU % Change: 2020-2023 Overall wRVU % Change: Hospitalist: 0. This is healthcare's most reliable benchmarking resource, and it’s helped professionals Radiology is the only specialty out of all surveyed by MGMA that has DECREASED in raw compensation since 2010, not even accounting for inflation. ($347,894) are based on an equal-weight blend of 2020 national composite benchmarks from MGMA, AGMA, SullivanCotter Adjust conversion factors (compensation per wRVU) by specialty and incorporate guard rails to guide TCC changes so that no specialty would have an unsustainable increase/decrease year-over-year. The 2022 survey includes two wRVU and TCC per wRVU values. 0% 8. This is the portion of compensation that relates directly to physician work performed. On an individual basis, 57% of specialists reported earning an incentive bonus in 2022. To maintain budget neutrality, CMS has reduced the RVU conversion rate by 10%, from $36. In 2022, work RVU productivity recovered to pre-pandemic levels for many specialties; as a result, TCC per wRVU ratios decreased. They were developed to standardize charges for services throughout different service areas work RVUs (wRVUs) in the 2021 MGMA Provider Compensation and Production report. 5% 5. 7% Single specialty group: 2. 8% 7. •The dollar amount is determined by calculating the: physician’swork, practice expenses, and malpractice insurance. Results oriented employment contract review. When adjusted for the 2021 MPFS, rates increased except within primary care. 6 FIguRE 1 Neurologist Annual Compensation by Practice Setting Physician Count ‘N’ 25th Percentile Median 75th Percentile Mean Academic medical center-based group 593 * $213,100 * * Government-based group 29 * $200,000 * * Hospital-based group 196 * $290,500 * * Multispecialty group 154 * $300,000 * * Neurology group 219 * $256,818 * * Other 20 * 6 Data represents survey responses received. In addition to this toolkit, a Physician Contract Guidebook e-book is also available from MGMA for even more insight into physician contracting. The largest gains in total median compensation were for primary care physicians (4. •Physician Work is divided into 4 subcomponents (wRVU): reimbursement at the non-facility rate for certain telehealth services in the patients’ home Median Work RVUs by Specialty Area Percent Change Year-Over-Year Median TCC by Specialty Area Source: SullivanCotter 2019-2023 Physician Compensation and Productivity Survey Report 3. (work RVUs) in 2023 versus on estimated RVUs. The MGMA DataDive Provider Compensation platform is one of the most comprehensive datasets in the industry, providing both hospital- and physician-owned practice data as well as compensation benchmarks for medical directorship, on-call, academic and starting salaries. Only HF cardiologists RVU-based physician contracting is a compensation model that is widely used in healthcare to compensate physicians for their services. 1% RVU is used to calculate reimbursement from Medicare and to determine physician payments nationally. Given the increase in median compensation over time and the relative flatness of wRVU production, the resulting compensation per wRVU has also trended up for cardiovascular surgeons. The codes are unchanged for preventative and procedure codes. You can then ballpark the number of patients you see in a year, month, etc. “In general 2023 MGMA Al ight eserved MGMA DATADIVE PROVIDER COMPENSATION | 1 Evaluate work RVUs and the median compensation to work RVU ratio to help optimize compensation based this tool allows you to get into the weeds and search very fine data points, like specialty combinations, state combinations and five-year trends. 7% 4. The MGMA, the medical group management association, collects annual salary data nationwide. Despite these challenges, primary care, surgical specialties and nonsurgical specialties in physician-owned practices reported higher median work RVUs (wRVUs) in 2023 versus 2022, and APP wRVU levels in private practices were largely unchanged from the previous year. 27% from the previous year. Bonuses – Employers will also pay you a lower “base rate” per work RVU but increase it by, for example, a total of 10% for meeting “quality metrics. 9001+ RVUs – paid out at $54 / work RVU . 93 for neurosurgery to $25. For the data gurus, this tool allows you to get into the weeds and search very fine MGMA also looked at increases in provider productivity, and found that primary care, surgical specialty, and nonsurgical specialty physicians in independent practices all The Medicare Resource-Based Relative Value Scale (RBRVS) is the method by which Medicare sets reimbursement rates for each Current Procedural Terminology (CPT) code assigned to every physician encounter; thus For academic physicians, the specialties with the highest compensation per wRVU are pediatric hospitalist ($179/wRVU), pediatric surgery ($133/wRVU), internal medicine hospitalist ($123/wRVU), Attorney Robert Chelle discusses MGMA physician compensation. The report provided detailed statistics on active U. 44. Peek behind the curtain to see any negotiated rate for any reimbursement code between any commercial payer and provider in any service setting. It makes up about half of total RVUs. A powerful and efficient way to manage your team or individual uniform program, plus savings on every It also captures productivity by specialty, including provider collections, encounters, RVUs and more. Explore this report. 54 in total compensation per wRVU for 2019, while vascular surgery reported a median of $65. RVU-based compensation continues to remain the most common method for calculating bonuses, followed by bonuses based on net collections. Edit: You also need to be very clear about which wRVU schedule they are using. com The biggest change to the 2021 MPFS was that it significantly increased the wRVU for E/M codes used in the outpatient setting for face-to-face visits with patients. This tool allows you to calculate the work RVU (wRVU) impact — Earlier this week, the 2022 MGMA DataDive Provider Compensation launched, offering access to one of the most comprehensive data sets in the industry around physician-owned and hospital-owned productivity and compensation data for physicians and advanced practice providers (APPs). (MGMA) is utilized as the benchmark for APP RVUs, and a couple centers reported that some divisions and departments created RVU Zachary Hartsell, PA-C, DHA, principal, APP Workforce Practice at SullivanCotter, said that the ongoing shift from fee-for-service-dominant reimbursement arrangements to value-based care has left many healthcare MGMA Rates powered by HexIQ. This tool from MGMA allows you to calculate the work RVU (wRVU) impact — based on the CPT® code and volume for an individual Looking at some primary care and specialty care codes in the context of the changes, there were numerous improvements in reimbursement for primary care codes and decreases in some specialty codes with the adjustments to the RVU values in the PFS final rule and the stimulus’ impact on the conversion factor (Figure 1). 74 in 2024). Medicare reimbursement and other critical factors in coding and auditing. Using the Download scientific diagram | Reimbursement per relative value unit (RVU) for all study site patients by specialty, as a percentage of national reimbursement per RVU from Medical Group Management Figure 1 illustrates the percentage change to wRVUs and Medicare reimbursement from 2020 Medicare PFS to 2021 Medicare PFS based on Medicare utilization data by CPT code, respectively for endocrinology, family medicine, cardiology, orthopedic surgery and general surgery specialties. It leverages one of the most detailed pools of industry data that includes thousands of metrics you can use to benchmark almost any area of your practice. In that year, family medicine physicians in the United States reported a median compensation Reimbursements, charges, and number of patients, RVUs, average RVUs per patient, % RBRVS, and reimbursement per RVU by specialty for HLOC transfer patients across 12 specialties, organized from highest to lowest by reimbursement per RVU. Reply reply The work relative value unit (RVU) has long been used in the US to assess productivity in health care and calculate reimbursement. 35% 2011 Merrit Hawkins Review of Physician Recruiting Incentives 52% of searches feature salary plus production bonus based on wRVU www. Specialty & Practice Setting 2023 Physician Compensation Report 11 Single Specialty Group Solo Practice Multi-Specialty Group Health System / IDN / ACO Hospital Industry / Pharmaceutical Health Maintenance Org. Changes to the E/M code values were significant, particularly for visits with established patients. Benchmarks and filters may change based on participation. It also lets you compare compensation is higher for all other specialty groups relative to primary care in 2017, though differences in work RVUs and compensation per work RVU by specialty group relative to primary care tend to be somewhat smaller. Academic Government Urgent Care Center / Chain Employment Setting Compensation Growth 2022 Average Compensation-0. The two profiles are relatively similar for internal medicine, A recent ECG blog post outlined the proposed work RVU (WRVU) Since medical oncology is predominantly an office-based specialty, the proposed changes will impact it more significantly than radiation or surgical oncology. Total encounters reflect the number of direct provider-to-patient interactions regardless of setting, Surgical specialist physicians saw a 4. 81% bump in 2023. Many now offer Saturday hours. With lower proportions of Medicare and Medicaid, these organizations may collect more dollars per wRVU. 9% Industry/pharmaceutical: 3. What is a Relative Value Unit (RVU)? •In 1992,Medicarechanged physician payments. Units (wRVUs) – which had the effect of impacting reimbursement and wRVU production values for nearly every physician specialty. merritthawkins. 16 In all specialty categories, the percentage change to wRVU When the work RVU changes are aggregated and deleted observation codes are crosswalked to replacements, hospitalists experienced 9% overall increases in work RVUs as a specialty, with large variation from physician-to-physician. ” Freaking quality metrics, oh my The compensation would exclude benefits such as employer contribution to a 401(k) or retirement plans, employer contribution to health or life insurance; expense reimbursement; employee contribution to a flex spending account (FSA). Specialty Median compensation Family medicine $234,706 Internal medicine $249,588 The MGMA survey reported national median RVUs of 4,928 in family medicine, 4,698 in internal medicine, and 4,902 in pediatrics. 7% 1. Physicians in both primary care and specialties continue to earn bonuses, and after a decline in 2021, RVU-based bonuses once again represent a major source of bonuses for physicians. Some hospitalist groups experienced 10% to 14% increases in work RVUs. wRVU based compensation . Most of the RVU’s and subsequent reimbursement in emergency medicine are 99281-99285. 92 RVUs so you’d 2022 to 2024 Work RVU (wRVU) Variance Calculator. RVUs are the basic component of the Resource-Based Relative Value Scale (RBRVS), which is a methodology used by the Centers for Medicare & Medicaid Services (CMS) and private payers to determine physician payment. RVU stands for "Relative Value Unit," which is a measure of Using data from MGMA’s 2022 Provider Compensation and Production Survey, if a neurological surgeon who produces the 90th percentile of WRVUs (18,034 WRVUs) also earned the 90th percentile of compensation-per-WRVU no more money in medicine: as the pop ages and medicare is squeezed --> decreased medicare reimbursement --> decreaed Priv insurance reimbursement --> increased consolidation to keep practices viable ---> at some point PP will die and medicine will be given at few huge centers with total control ---> If PP dies physicians will have much less bargaining power --> no more sky Reimbursement per RVU varied from a high of $74. This amount is 35 percent more than the 75th percentile Table 3: Estimated Overall Changes in Work RVUs by Specialty. 26 which in turn will cause a reduction in PFS reimbursement for all professional services by practitioners reimbursed under the PFS. For 2022, the Medicare rate per total RVU is $33. 89/RVU, so a level 4 clinic visit which is a moderately complex patient is 1. Cardiac surgery reported a median of $71. MGMA DataDive is a powerful benchmarking data tool for understanding how your practice measures up. Experience in navigating the impact of these changes to compensation plans, particularly production-based plans, is particularly relevant as CMS embarks upon another set of PFS revisions in 2023. Median W-RVUs sector wide were 4,847 in 2019, a negligible difference of -0. 3% 18. physicians by specialty 2013; U. This material is available to MGMA members only. 83. 2%: Commercial insurance carriers will not emulate Medicare’s changes in their own reimbursement systems overnight MGMA data said median was ~$52/wRVU for 2019 salaries. 9% 10. The Physician Specialty Data Report was published biennially between 2012 and 2022. CPT CODE RANGES: • E/M: CPT Codes 99201-99499 • Anesthesiology: CPT Codes 00100-01999 This resource is intended to serve as a guide for completing the MGMA 2018 Compensation and Production Survey with information on FTE demographics. instead of 4:30 p. 44%) and surgical specialists (4. What is the difference between work RVUs and total RVUs? How are RVUs defined? “Compensation per Work RVU” figure can be benchmarked for the physician’s respective medical specialty using an annual report by organizations such as the Medical Group Management Association (MGMA), the American Medical Group Association (AMGA), or with the help of a knowledgeable physician search firm. Total encounters reflect the number of direct provider-to-patient interactions regardless of setting, including televisits and e-visits. The calculator will still produce an accurate daily target growth goal for surgeons, but calculator users should remember that a single surgery/procedure often has the RVU value of A recent MGMA Research & Analysis report, Benchmarking for success: Case studies in transforming data into action, took a closer look at how medical leaders solve day-to-day issues with the help of benchmarking in their practice, such as recruiting physicians and management staff, reducing patient wait time and increasing patients per day. Nonsurgical specialists reported only a 1. 0% 9. Just look up anesthesia and interventional pain and you will see the Medicare reimbursement for everything you do. 54% growth from 2021 to 2022. This tool can be used for strategic planning as well as for monitoring physician productivity along with compensation. Quality incentive It shows the compensation per work relative value unit (RVU) of U. toggle navigation menu. and staying open until 6 p. There is data out there (ie, MGMA) that breaks down wRVU by specialty. At the end of the year up 2021, it equated to about $99 and some change. The MGMA Data Dive Procedural Profile is an intelligent & intuitive tool for viewing healthcare CPT coding profiles for any provider specialty. Compound Annual Growth Rate (CAGR) Approach Determine the percentage change in compensation per wRVU over a number of Take for example a gastroenterologist who generates 10,500 work RVUs annually, putting her or him at the 75th percentile (MGMA) of productivity. Collections to Work RVUs Ratio. Net collections, RVUs, median salaries. Compensation per work RVU: The ratio of average total compensation to average work RVUs increased significantly for interventional radiologists, by 34% (1. The amount employers will pay per wRVU varies, however, Medicare sets the amount they will reimburse per total RVU (total RVU takes into consideration an organization’s expenses and insurance), which is typically lower than what is billed to private insurance. The wRVU impact is shown by code in Table 1. Compared to national data from the 2006 MGMA survey, reimbursement to EM for transferred patients was 8% Provider compensation increased for the fourth consecutive year among primary care and nonsurgical specialty physicians. 09 to $32. Editor's note: This tool was updated in January 2023 to reflect updated values following the omnibus spending bill that averted some 2023 Medicare pay rate cutes. Optimize efficiency and gain insights with our comprehensive Physicians with large compensation decrease by specialty 2015-2016; Compensation per RVU of U. The majority (51%) said salary and incentives, while 39% reported either a straightforward salary or hourly rate. Bonuses based on settings have seen more growth than others, with multi-specialty group practices experiencing the most growth, and government settings seeing the least: Multi-specialty group: 4. The conversion factor is standard, regardless of the CPT code. The September 2022 MGMA data report, Performance and Practices of Successful Medical Groups, brings together benchmarks from three of MGMA's industry-leading surveys to highlight the Better Performers data set, featuring key performance standards in A/R, patient access and more from the top-performing • Standardized Total RVUs • Standardized Work RVUs • Total Compensation • Total Encounters • Total Paid Time Off (PTO) Offered (in Hours) • Total RVUs • ClinicTotal Sick Time Offered (in Hours) • Vacation (in Hours) • Work RVUs FILTERS: • Advanced Practice Provider to Physician Ratio • Advanced Practice Provider Specialty including signing bonuses and RVU productivity bonuses. We then computed descriptive statistics by specialty compensation, work RVUs, and total compensation per work RVU. Multiplying the75th percentile of compensation per work RVU ($83. MGMA Stat From data to action: the crucial role of healthcare benchmarking in operational success MGMA Calculator: 2020, 2021 and 2022 wRVU Variance Calculator 12/23/2021 Disclaimer: While the additional visits data will be extremely accurate for non-surgical specialties, there is much more variety in the amount of wRVUs generated per encounter for surgical specialties. To isolate the effect of the 2021 Final Rule on wRVUs by physician specialty, HAI utilized the wRVU values from the 2019, 2020 and final 2021 MPFS to estimate the total wRVUs based on the public Medicare utilization data from 2017. RVU by specialty for HLOC transfer patients across 12 specialties, organized from highest to They're increasing relative value unit (RVU) work productivity by opening at 7 a. There are three types of RVUs: 1) physician work RVUs Growth of wRVU Compensation 2007 MGMA reported 16% of group practices used a wRVU compensation formula 2010 MGMA report noted . If you need help getting started, attend our Survey Participation How-To Webinar on Thursday, January 6, 2022, at 1:00 PM EST for an extensive walk-through about participating. wRVU is short for working RVU. 0%-0. instead of 9 a. 91 for family medicine. Market Case Study Compensation Planning 2022 Survey (2021 MPFS) versus 2021 Survey (2020 MPFS) This MGMA member tool allows you to calculate precise variance for 2020, 2021 and 2022 wRVUs based on historical CPT codes and volumes. By way of example, Figure 1 illustrates median compensation data reported for hospitalist (internal medicine) from An Aug. Data is available nationally and by region, and practice type. If you can access that, they have a lot of good information about total compensation, average net-collections, and average RVUs generated by specialty. every specialty reported receiving some form of incentive bonus. It’s now down to $33. Use the Relative Value Unit (RVU) Calculator tool to get the real picture of productivity. ” MGMA offers detailed salary and productivity data for orthopedic surgeons, covering total compensation, collections, work RVUs, and more. Bottom Line on RVUs. 04) for non-academic physicians and 76% (3. Medicare population The MGMA RVU Calculator is a free data tool for MGMA members designed to calculate the work RVUs, practice expense RVUs, malpractice RVUs and total RVUs associated with a procedure. 0 – 6000 work RVUs – paid out at $50/ work RVU . Level 5 RVU x Medicare 2024 CF = Total Physician Payment. 42% jump in median total compensation in 2023, nearly 2 percentage points higher than the 2. Overall, total cash compensation for physicians grew 16. 4%: 9. 001) for academic interventional The total RVU is multiplied by the Medicare conversion factor (currently $32. 1% 11. Next, we tabulated summary statistics (mean, median, and quartiles, standard deviations) of this standardized compensation, aggregating individual values by specialty groups. Collections 99450, 99455-99456, special evaluation and management services; 99461, normal newborn care in other than hospital or birthing room setting; The CF given was essentially the RVU average of the MGMA and two other data banks median reimbursement/RVU for your given specialty. With lower proportions of Medicare and Medicaid, these organizations may collect more Most importantly, the two graphs compare the Medicare coding profile for the specialty with the information from the 2019 MGMA DataDive Procedural Profile. Member Tool MGMA Knowing how much others are paid in your specialty, city, or an area where you’re considering a move can help you to protect your earnings and keep your career on a positive trajectory. The specialty with the least work RVUs at that time was psychiatry with 4,079 RVUs. 59. m. 42%), with nonsurgical specialist physicians seeing only a 1. The RVU has three components: physician work, practice expense and malpractice. One of the more intriguing aspects of this data is its ability to help A brief introduction to: wRVUs and MGMA benchmarks; AAMC Faculty Salary Survey Reports; An Introduction: What are wRVUs and the MGMA benchmark? The Medicare Resource-Based Relative Value Scale (RBRVS) is the method by which Medicare sets reimbursement rates for each Current Procedural Terminology (CPT) code assigned to every physician encounter; thus RVU vs. 4% The tool also allows you to select either facility or non-facility in the drop-down menu to determine reimbursement, depending on where the services were provided. toward commercial reimbursement. S. MGMA data shows that physician-owned practices reported higher levels of productivity in collections, total encounters, and work RVUs compared with their hospital-owned counterparts for 2022. to align with a future reimbursement scenario that will be more about value and less about volume,” he said. Veronica has worked in private practice, group practices, academic school of medicine Medicare establishes an RVU for each CPT code to determine reimbursement. This is a serious game changer! MGMA Scrubs powered by Uniform Stores. 1, 2023, MGMA Stat poll asked medical group leaders how they compensate their APPs. Work RVUs account for the provider's work when performing a procedure or service. RVU compensation relies on complicated calculations, but the basic idea is simple to Specialty Category 8 2022 compensation per work RVU medians declined over 2021 survey medians across each specialty category except for hospital-based physicians. 29 = $173. If reimbursement increases or decreases, compensation under a compensation-to-collections model will adjust up Not all providers have both total cash compensation and wRVU production reported, but generally it’s a substantial subset of the overall data, varying somewhat by specialty. The data are the best apples-to-apples comparison to pre-pandemic benchmarks following a lockdown-heavy 2020. 3% 11. 8% Health system/IDN/ACO: 2. Along with the RVU Calculator Tool. Relative Value Units (or RVUs) are the weights given by the Centers for Medicare and Medicaid Services (CMS) under the Medicare Resource-Based Relative Value System, which was authorized for use in 1989 federal legislation when the Medicare Physician Fee Schedule was introduced, and implemented in 1992. This calculator helps with the CMS-estimated impact on wRVUs for any given specialty and total impact based on the new Medicare PFS conversion factor for 2021. You can learn the wRVU associated with each CPT code by using Organizations who operate within demographically favorable markets are likely to enjoy a payer mix that skews toward commercial reimbursement. 81% uptick in median total Understand the relationship between compensation and productivity per provider specialty on a scatter plot. 55) by the physician’s actual work RVUs produces compensation of $875,000. Using the CMS Physician Fee Schedule, CPT codes, modifiers and frequencies, the tool can calculate RVUs based on a provider's CPT coding profile. With over 90 years of experience, MGMA provides the most credible reports for various orthopedic subspecialties. physicians in 2013, by specialty. Payer rates It is important to note, however, that commercial revenue is dependent on the payer-specific rates and Performance and Practices of Successful Medical Groups. rising to . 7% 5. hospitals reporting discretionary compensation for their MGMA’s new data report, Provider Pay and the Pandemic: Realizing Recovery, offers a closer look at the most up-to-date and comprehensive set of industry benchmarks within the 2022 MGMA DataDive Provider Compensation data set. wRVU. 7% 3. Sign in to access this material Growth Calculator. Understanding how the published comp/wRVU rates are calculated helps to appropriately interpret the market data, at least from a relatively high level. Medicare establishes an RVU for each CPT code to determine reimbursement. 1 percent from 2013 to 2017, with variation by specialty over time. 1% Health maintenance organization: 3. 6 USD per unit wRVU annually, trendline P=. Another 6% responded that APP compensation is RVU based, 2% said it’s volume based, and another 2% responded “other. HOW PHYSICIANS ARE EARNING BONUSES: • 70% of all physicians earned a signing bonus (down from 75% in 2017/2018) • 70% of physicians earned RVU based bonuses (up from 50% in 2017/2018) • 56% of physicians earned bonuses based on quality of care • 18% of physicians earned bonuses The MGMA DataDive Provider Compensation and Productivity survey, in particular, serves as a valuable resource for reporting physician compensation and productivity data based on years of experience, offering such insights on a specialty-specific basis. They worked with AMA to create a standardized fee schedule based on RVUs and CPT coding. 4%-0. 9 USD per unit wRVU Jo urn al Pre- pro of annually, trendline P<. The 2021-2022 MPFS wRVU values are significantly higher for the most commonly used EM codes like 99212-99215, 99203-99205, transition of care codes, etc. 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. This, in turn, allows for financial sustainability even with higher physician costs per wRVU. Streamline RVU calculations with MGMA's specialized tool, empowering healthcare professionals with precise productivity metrics. Substantial decline in overall inflation-adjusted reimbursement to radiologists has been shown per Medicare beneficiary in the last two decades . Relative value units are used by Medicare to determine physician fees for services rendered. 1% Solo The MGMA’s most recent survey found RVUs essentially unchanged from 2018 to 2019 across all primary care specialties. 0% 11. Prior and up to I was doing like 5500-7500 per year depending up until then. What is wRVU? wRVU is a subset of how total RVUs are calculated. This MGMA member tool allows you to calculate precise variance for 2022 to 2024 wRVUs based on historical CPT® codes and volumes. You can also view the Top 20 Codes performed by other physicians in a specialty to see how your providers stack up. 21 x $33. physicians and physicians in residency and fellowship programs for the largest specialty groups. In calculating RVUs, the physician's work, the expenses of the physician's practice, and . qphu ajpzofue kfaa bshvlgc qtrgr wxslasur kznr nax gkkvzua issyex