RVUs Only Turn Into Dollars Through the Conversion Factor
Physicians talk about work RVUs every day — productivity, compensation formulas, contract negotiations — but an RVU is a relative unit. It only becomes a dollar amount when multiplied by Medicare’s conversion factor, a number CMS sets (and revises) every year. Two physicians can produce identical RVUs and be paid different amounts by different payers.
This free RVU calculator turns your work RVUs into an estimated Medicare payment: enter your wRVU, add practice expense and malpractice components if you have them, and get the total RVUs, the estimated payment, and a clear breakdown — using the verified 2026 conversion factor.
wRVU · practice expense · malpractice · conversion factor
Please enter work RVUs above 0 and a conversion factor above $0.
Estimated Medicare payment
Total RVUs × conversion factor
Educational estimate only. Actual payment varies by payer, geographic adjustment (GPCI), site of service, modifiers, and contract terms. This tool is not medical or financial advice.
How to Use This Calculator
- Enter your work RVUs (wRVU) — for example, the wRVU value CMS assigns to a CPT code, or your productivity total.
- Add practice expense RVU (peRVU) — optional. Leave blank (0) if you only want a wRVU estimate.
- Add malpractice RVU (mpRVU) — optional. Leave blank (0) if unknown.
- Check the conversion factor — pre-filled with the 2026 Medicare rate ($33.40 for most physicians). Change it if you’re estimating a different year or payer.
- Click Calculate Payment — see the estimated payment, total RVUs, work RVU share, and payment per wRVU.
What Is an RVU?
RVU stands for Relative Value Unit. It is Medicare’s standardized unit for measuring the value of a physician service. Every procedure (each CPT code) carries three RVU components:
- Work RVU (wRVU): the physician’s own labor — time, technical skill, mental effort, and stress. This is the piece that drives most productivity-based compensation formulas.
- Practice expense RVU (peRVU): the overhead behind the visit — staff, equipment, rent, supplies. It differs between facility and non-facility (office) settings.
- Malpractice RVU (mpRVU): the cost of professional liability insurance for that service, reflecting its risk level.
Add the three together and you have the total RVU — the full “size” of the service in Medicare’s eyes. Multiply by the conversion factor and you get the dollar payment.
The RVU Formula
Estimated Payment = Total RVU × Conversion Factor
Worked example
A service with 2.5 total RVUs, using the 2026 conversion factor of $33.40:
- Estimated payment: 2.5 × $33.40 = $83.50
- If only the wRVU (say, 1.8) matters for your compensation formula: 1.8 × $33.40 = $60.12 per unit of physician work.
- Work share: 1.8 ÷ 2.5 × 100 = 72% of the total value comes from the physician’s work.
The Conversion Factor — Why It Matters
The conversion factor is the dollar-per-RVU exchange rate CMS publishes in the annual Medicare Physician Fee Schedule. It moves every year:
| Year | Conversion factor | Note |
|---|---|---|
| 2025 | $32.35 | Single rate for all physicians |
| 2026 | $33.40 | Most physicians (non-QP) |
| 2026 | $33.57 | Qualifying APM participants (QP) |
Because the calculator’s field is fully editable, you can estimate any year — just type in the factor that applies to you. Many online RVU calculators still ship with conversion factors that are years out of date, which silently makes every result wrong; here the default is the verified 2026 rate, and you control it.
GPCI: Why the Same Service Pays Differently by City
The formula above is the national version. Actual Medicare payment adjusts each component by a Geographic Practice Cost Index (GPCI) — one factor for work, one for practice expense, one for malpractice — because rent, staff wages, and insurance costs differ by locality:
Payment = [(wRVU × Work GPCI) + (PE RVU × PE GPCI) + (MP RVU × MP GPCI)] × Conversion Factor
Illustrative example: take a service with wRVU 1.30, PE RVU 1.18, and MP RVU 0.07 in a higher-cost locality with GPCI values of 1.09, 1.20, and 1.50. Adjusted components: 1.417 + 1.416 + 0.105 = 2.938 total RVUs, and 2.938 × $33.40 = $98.13. The identical service at national rates (all GPCI = 1.0) pays 2.55 × $33.40 = $85.17. Same work, same code — geography alone adds about 15%. This calculator deliberately shows the unadjusted national estimate; use your locality’s published GPCI values when pricing a real claim.
How Employers Turn wRVUs Into a Paycheck
Medicare payment is only half the RVU story. Most employed-physician contracts pay on work RVUs only, through one of three common models:
- Pure production: pay = wRVUs × your contracted rate. 5,000 wRVUs at $50 each = $250,000 — simple, but your income rides entirely on volume.
- Base salary + bonus: a guaranteed base plus a per-wRVU bonus above a threshold. $200,000 base + $40 per wRVU above 4,000 pays $200,000 + (1,000 × $40) = $240,000 at 5,000 wRVUs.
- Tiered rates: the per-wRVU rate rises with production. 4,000 wRVUs at $45 plus the next 1,000 at $55 = $180,000 + $55,000 = $235,000 at 5,000 wRVUs.
When comparing offers, the three numbers that matter are the threshold where bonuses start, the rate(s) above it, and whether a shortfall year is reconciled (“trued up”) against you later — contract language, not the calculator, decides that.
Tips for Physicians and Practice Managers
- Know your CF before negotiating. Productivity compensation is usually quoted in dollars per wRVU — run your numbers with this year’s factor so a contract offer is anchored to reality.
- Compare settings fairly. The same code pays different peRVU in a hospital versus an office. If you changed settings, compare with the right component values.
- Watch the annual rule. CMS can adjust both RVU values and the conversion factor each January. Re-check the factor before doing any annual forecasting.
- GPCI changes the math by locality. Real Medicare payment applies geographic adjustments to each component before the conversion factor. This calculator gives the national estimate; local payment will differ.
Frequently Asked Questions
What is a work RVU?
A work RVU (wRVU) measures the physician’s personal labor in a service: the time it takes, the skill required, and the intensity or risk involved. CMS assigns a wRVU to every billable procedure, and most productivity-based pay formulas are built on it.
How do you calculate payment from RVUs?
Add the three RVU components (work + practice expense + malpractice) to get total RVUs, then multiply by the conversion factor. Example: 2.5 total RVUs × $33.40 = $83.50 estimated payment.
What is the 2026 Medicare conversion factor?
$33.40 for most physicians and practitioners, and $33.57 for qualifying APM participants. Both replaced the 2025 single rate of $32.35. The calculator defaults to $33.40 and lets you edit it.
What is the difference between wRVU and total RVU?
wRVU counts only the physician’s work. Total RVU adds practice expense and malpractice RVUs — the overhead and liability costs. Medicare payment is based on the total; physician compensation contracts are usually based on wRVU alone.
Why would two doctors get paid different amounts for the same code?
Geographic adjustments (GPCI) scale each RVU component to local costs, site of service changes the practice expense piece, modifiers can reduce or increase payment, and private payers negotiate their own rates and conversion factors.
Does this calculator include GPCI adjustments?
No — it computes the national estimate. Real Medicare claims adjust each component by your locality’s Geographic Practice Cost Indices before applying the conversion factor, so your actual local payment will differ.
Can I use this for private insurance estimates?
Only as a rough starting point. Private payers set their own conversion factors and contracts. Enter your payer’s contracted factor in the editable field for a closer estimate — and always confirm with the contract itself.
What is the difference between facility and non-facility PE RVUs?
Practice expense RVUs come in two versions. Non-facility (office) PE is higher because your practice pays for the staff, space, and equipment. Facility PE is lower because the hospital or surgery center bears those costs and bills its own fee. The same CPT code can carry a notably different PE — and therefore total RVU — depending on where the service happens.
What is a typical dollar amount paid per wRVU?
It varies widely by specialty, region, and employer — commonly reported figures run from roughly $40 per wRVU in some primary-care contracts to $70 or more in high-demand surgical specialties. There is no national standard rate; your contracted dollar-per-wRVU figure, threshold, and tier structure matter far more than any benchmark.
Final Thoughts
An RVU is only half of the payment story — the conversion factor is the other half, and it changes every year. Use the calculator above with the current factor before you sign a contract, forecast a quarter, or compare two offers.
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