How to Calculate Your RVUs as a PA (2026 Guide)

There is a number your employer tracks closely and rarely shows you. It is how they measure what you produce, how they decide your bonus, and how they quietly answer the question "is this PA worth what we pay them?"

That number is your RVUs.

Most PAs have never sat down and calculated their own. That is a problem, because you cannot negotiate from a number you do not know. The scoreboard is already running. This post teaches you how to read it, step by step, using nothing more complicated than multiplication.

What an RVU actually is and how to calculate RVUs as a PA

RVU stands for Relative Value Unit. It is the unit Medicare uses to measure the resources a service requires, and almost every other payer and employer builds off the same system.

Every billable code carries three RVU components:

• Work RVU (wRVU) measures your effort: the time, skill, and mental work of the visit. This is the one that measures you.

• Practice Expense RVU covers the overhead: staff, rent, supplies, equipment.

• Malpractice RVU covers liability cost.

Add the three together and you get the Total RVU for a code. Multiply Total RVU by Medicare's annual conversion factor ($33.40 for 2026) and you get the dollar payment.

So the master formula is simple:

Payment = Total RVU × Conversion Factor

Everything else is just looking up the right numbers and adding them up.

The one distinction that matters: wRVU vs Total RVU

Before you calculate anything, know which number you actually want, because they answer different questions.

• Work RVUs (wRVU) answer "how much did I produce?" This is the productivity currency. Most PA compensation and bonus structures are tied to wRVU thresholds, not dollars. If your contract has a production bonus, it is almost certainly counting wRVUs.

• Total RVUs answer "how much revenue did I generate for the practice?" This is what feeds the "what do I bring in" conversation.

You want both. One tells you whether you are hitting your production targets. The other tells you what you are worth to the business. We will calculate each.

Your 2026 reference table

These are the most common outpatient codes, with 2026 values from the CMS Physician Fee Schedule. Work RVUs are national and fixed. Payment uses the 2026 non-QP conversion factor of $33.40 at national rates, before your local adjustment.

Code	What it is	Work RVU	Total RVU	~Medicare payment
99213	Established, level 3 follow-up	1.30	2.85	$95
99214	Established, level 4 follow-up	1.92	4.06	$136
99215	Established, level 5, complex	2.80	5.76	$192
99204	New patient, level 4	2.60	5.31	$177
99205	New patient, level 5	3.50	7.09	$237

If you bill procedures, injections, or anything outside this list, you will pull those values the same way, covered in Step 2.

The step-by-step Guide to Calculate RVUs for Physician Assistants.

Step 1: Pull your most-billed codes

You do not need all of them. The top three to five codes usually account for the bulk of your volume. Two established follow-up codes and one procedure is a realistic starting point for most PAs. If you can get a billing report for a typical week or month, even better. If not, estimate from a normal day.

Step 2: Look up the work RVU for each code

For the common office visits, use the table above. For anything else, the authoritative source is free: the CMS Physician Fee Schedule Look-Up Tool at cms.gov. Enter the code, choose 2026, and it returns the work RVU, the total RVU, and the payment amount. The work RVU is national, so it does not change by location.

Step 3: Multiply by volume and add it up

For each code, multiply its work RVU by how many you do in your chosen period. Add the results. That sum is your wRVU production.

Do the same with the Total RVU column to get your practice revenue-generating RVUs.

Run it per day first, because the daily number is easy to sanity-check, then scale to a week and a year. A conservative year is 48 weeks, which builds in time off.

Step 4: Translate RVUs into dollars

Two translations, two different truths.

What the practice collects on you. Multiply your Total RVUs by the conversion factor ($33.40). That is the Medicare-rate revenue your work generates. Most commercial payers pay more than Medicare, so treat this as a floor. If the practice you work in has mixed payors then most likely you real revenue producing numbers are higher.

What you are paid per unit of production. Take your gross annual salary and divide it by your annual wRVUs. That gives your personal dollars-per-wRVU. Then compare it to published benchmarks for your specialty (MGMA and AMGA are the standard sources; primary care figures for physicians are often cited around $45 to $55 per wRVU, for PAs it runs 25-40). The gap between what you generate and what you are paid per wRVU is the heart of the salary negotiation conversation.

Step 5: Adjust for the real world (GPCI and the 85% rule)

Two adjustments keep you honest and credible.

Location. National payment gets multiplied by your area's geographic cost indices, called GPCIs. The CMS Look-Up Tool applies these automatically when you choose your locality. The work RVUs themselves do not change.

How your work is billed. This one is PA-specific and worth understanding cold. Under Medicare, when a service is billed under your own NPI, it pays at 85% of the physician fee schedule. When it is billed "incident-to" a physician, and every incident-to rule is met, it pays at 100%. The RVUs are identical either way. The payment is not. So if you want to estimate what the practice actually collects on your work, ask how your visits are billed, and apply the 85% where it is your NPI on the claim. This is often the difference between feeling underpaid and being able to prove it.

A worked example: 20 patients per day

Say you see 20 patients a day, four days a week. A typical day breaks down as 8 level-3 follow-ups, 9 level-4 follow-ups, and 3 complex visits.

Daily work RVUs: (8 × 1.30) + (9 × 1.92) + (3 × 2.80) = 10.4 + 17.28 + 8.4 = 36.08 wRVU per day

Annual work RVUs: 36.08 × 4 days × 48 weeks = about 6,927 wRVU per year

Daily revenue-generating RVUs: (8 × 2.85) + (9 × 4.06) + (3 × 5.76) = 22.8 + 36.54 + 17.28 = 76.62 Total RVU per day

Annual revenue at Medicare rates: 76.62 × $33.40 × 4 × 48 = roughly $491,000 a year

Now put your salary against it. If you earn $120,000, your personal rate is $120,000 divided by 6,927 wRVUs, or about $17 per wRVU. Hold that next to a benchmark of $45 to $55, and the question answers itself. You are not imagining the gap. You can calculate it to the dollar.

What the number is for

Knowing your RVUs is not about resentment. It is about leverage. When you walk into a compensation conversation with "I generate roughly half a million in production and I am paid $120,000," you have moved the discussion off feelings and onto math your employer already respects, because it is their own scoreboard.

That is also exactly the gap my [PA Practice Revenue Estimators below] is built to show you in two minutes, and once you can see it, the next question is what that money actually buys you in freedom.

Pick the Estimator that more closely matches your situation:

Surgical PA

Clinic PA

But the foundation is this: run your own RVUs. Own the number before you negotiate from it.

This is educational information, not billing, coding, financial, or legal advice. RVU values and the conversion factor change every year, and your actual reimbursement varies by locality, payer mix, and contract. Verify current figures with the CMS Physician Fee Schedule Look-Up Tool. CPT codes are maintained by the American Medical Association. Sources: CMS Physician Fee Schedule (2026); AAPA; MGMA and AMGA for compensation benchmarks.