Average RVU rate PP setting

[jdm95ls2000]

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What is the typical RVU rate in private podiatry practices?

I’ve noticed that some large podiatry groups, like Upperline, have transitioned to a strict RVU-based compensation model. Through my research—including online sources and ChatGPT—I’ve found that the average RVU rate for podiatrists appears to range between $40 and $50, with senior partners sometimes earning up to $60 per RVU.

Can anyone confirm if these figures align with what’s standard in a private practice setting these days?

 

[heybrother]

I've never met a podiatrist in a PP group who was paid on RVUs. You've been doing this since 2017 - I don't understand how you are still so disconnected from the finances of private practice. Does your group not let you see collections per patient/procedure?

EDIT:
Consider a semi-common insurance in my area:
20550 - $91, 99213 - $76. A hospital gets oodles for these services, a PP - not so much. The doctor doing the injection in this case brings in more money, but produces fewer RVUs. Meanwhile, Medicare pays ...$53 for the 20550 and $85 for the E&M. In the end - collections is the only thing that captures the actual reality of the practices finances.

 

[Feli]

Yep, I'd echo that RVU has no place in PP.
Each thing we do has its (NF) RVU value, and RVU are valued different by different payers.
But collections are what matters...
A code I do for abscess (4 RVU or whatever?) is rejected as I billed avulsion ingrown nail (roughly 4rVU also).
A code I bill for Akin surgery that's 16 RVU is $0 if it's rejected (it will be) because I billed and was paid the Lapidus.

To pay someone on RVU is stupid in PP, though... just like price billed out, much of it doesn't get collected.
I can see a new pt for heel pain and bill visit + inject + wrap + boot + night splint... maybe other stuff.
Well, the night splint and the wrap will get rejected... but you're going to pay me the RVU on all that I billed? Nope.
PP is collections based. The group/office/doc is paid in money, not RVUs.

If some PP group is trying to pay on RVU, that's a huge red flag to me. They are trying to separate the docs from their money/collections. They are trying to create a confusion and avoid the real values (like how casinos do chips, credit cards do miles, etc). It makes no sense in PP.

Hospitals pay that way (wRVU billed out), but they have a ton of fudge factor as they inflate huge facility fees and the docs order tests, rad, PT, etc etc for the hospital. They also tend to have many no/low pay scrubby insurance (or no insurance) patients who they make their employ docs see... so they have to give them something. I'd imagine the hospital docs billing up a storm of codes (most of which will get rejected) to inflate their wRVU eventually get a talk at most places. Maybe not. It's up to the billers/coders and finance people as to whether they are paying attention or not.

 

[msion]

You are not gonna get anything like $40 or $50 per wRVU in a PP setting. Those rates for for hospital employed doctors. The hospitals can pay this rate because they can collect from the facility fees for the surgeries. They are expecting these doctors to be in the OR as often and as long as possible.

PP doesn't work the same way. You are paid pennies for any elective surgery with the 90-day global period. After I get board certified I cut down on the number of elective cases and ended up making more money with clinic.

For example an Austin has a work RVU of 8.25. At $50 rate you will be paid $412.50. Medicare pays maybe $600 at most for this surgery. There is no way the clinic is letting you keep close to 70% of the collection amount. The hospital can afford to do it because the facility fee is over $3k. But even at this rate the hospital may be still losing money if you ended up using more than 2 screws.

If a PP is using a wRVU model for compensation then that rate will be very low. Like in the 20s.

 

[Hybrocure]

me being in PP not knowing RVUs are a thing

 

[jdm95ls2000]

I've never met a podiatrist in a PP group who was paid on RVUs. You've been doing this since 2017 - I don't understand how you are still so disconnected from the finances of private practice. Does your group not let you see collections per patient/procedure?

EDIT:
Consider a semi-common insurance in my area:
20550 - $91, 99213 - $76. A hospital gets oodles for these services, a PP - not so much. The doctor doing the injection in this case brings in more money, but produces fewer RVUs. Meanwhile, Medicare pays ...$53 for the 20550 and $85 for the E&M. In the end - collections is the only thing that captures the actual reality of the practices finances.

Wow, you are wildly rude. As a practice owner, I see my own collections, so you assumed wrong. I think you are the one very disconnected form the _current_ finances of private practice. One of the largest PP companies in the US, Upperline, is RVU based. Many other large private practice firms are moving to an RVU model.

 

[wakaflocka88]

Wow, you are wildly rude. As a practice owner, I see my own collections, so you assumed wrong. I think you are the one very disconnected form the _current_ finances of private practice. One of the largest PP companies in the US, Upperline, is RVU based. Many other large private practice firms are moving to an RVU model.

Not sure why RVU in PP matters. Upperline can make up whatever system they want, their goal is to suck the life out of associates everyday.

 

[pod squad]

From a large organization standpoint, RVU makes sense. Standardizing physician earnings = more overhead predictability = easier to maximize profits. And yes, suck the life out of associates.

 

[Adam Smasher]

Even in a small group, the advantage of an RVU compensation model is that it disincentivizes cherry-picking pts based on who's well insured. You won't end up with a situation where one doctor is stuck doing all the self-pay and medicaid and suffering because their share of gross revenues are low, even though they are putting in as many RVUs as their peers.

Why a predatory PP owner or even a supergroup like Upperline would extend this grace to an associate, I cannot figure out, however.

 

[Naviculosity]

Friend of a friend confirmed this, they did switch to “RVU”. From what it sounds like the benefit is lowball the podiatrists with a lesser RVU (apparently some fought this but idk the outcome) but make up for the lack of income with a bonus structure on their ACO component. So Upperline takes more money in on the fee for service side and gives the associates some scraps that were coming from the government anyways for their ACO scheme and their projections make them keep the same income.

All hinges on the loop hole they’ve found in the ACO by having someone with a limited scope (podiatrist) be the front man/woman for it. Can’t legally manage these problems but can get paid by the government for managing them. Incredible.

 

[GreenHousePub]

Friend of a friend confirmed this, they did switch to “RVU”. From what it sounds like the benefit is lowball the podiatrists with a lesser RVU (apparently some fought this but idk the outcome) but make up for the lack of income with a bonus structure on their ACO component. So Upperline takes more money in on the fee for service side and gives the associates some scraps that were coming from the government anyways for their ACO scheme and their projections make them keep the same income.

All hinges on the loop hole they’ve found in the ACO by having someone with a limited scope (podiatrist) be the front man/woman for it. Can’t legally manage these problems but can get paid by the government for managing them. Incredible.

I've heard of people making like 125k a year in these supergroups, and are seeing upwards of 30-40 patients a day.
If they switched to RVU's it's probably so they can pay their associates less.

 

[heybrother]

In 2021 the RVU value of a 99213 increased by 86%, but the underlying Medicare fee schedule value increased only by 22%.

For my practice, during that same time period, no national commercial payor provided any level of additional E&M reimbursement that would be considered to in some way mirror or resemble the data above. A national "government payor" that is supposed to be based on Medicare but is run by for profit companies cut my rates by something resembling 20-30% without discussion.

 

[dtrack22]

I've heard of people making like 125k a year in these supergroups, and are seeing upwards of 30-40 patients a day.
If they switched to RVU's it's probably so they can pay their associates less.

Paying based off wRVU simply makes the accounting easier and as someone else mentioned, doesn’t penalize providers for bad paying insurance carriers (aka Medicaid and almost every plan heybrother contracts with). I don’t know that any group is switching so they can pay associates less but you can guarantee they are going to come up with a $/wRVU rate that is based on historical per patient/visit collections so that the practice doesn’t make “less” money. Especially if it’s a PE backed/owned supergroup.

The problem they are going to run into is associates who no longer care if something reimburses/pays well/needs auth in a wRVU compensation model. It no longer matters if Upperline (for example) gets paid for what you did, because they have to pay you for the procedure/visit regardless. RVU docs are generally less inclined to sell anything out of their office as well, because why overcharge patients for something you aren’t being compensated for? There are certainly policies/procedures and ways to get ahead of these issues, I just think it’s unlikely any of these groups will think all of it through before they implement a new compensation model.

 

[Feli]

...they are going to run into is associates who no longer care if something reimburses/pays well/needs auth in a wRVU compensation model. It no longer matters if Upperline (for example) gets paid for what you did, because they have to pay you for the procedure/visit regardless...
...There are certainly policies/procedures and ways to get ahead of these issues, I just think it’s unlikely any of these groups will think all of it through before they implement a new compensation model.

Yes, what can go wrong if supergroup DPM associates start billing I&D with 28005 + 20240 + 20240...
...and then the TMA a day or two later as 13160 + 28805 + 20240 + 20240 + 20240 + 20240 + 20240 🙂

 

[dtrack22]

Yes, what can go wrong if supergroup DPM associates start billing I&D with 28005 + 20240 + 20240...
...and then the TMA a day or two later as 13160 + 28805 + 20240 + 20240 + 20240 + 20240 + 20240 🙂

I’m gonna assume in a true PE owned/backed supergroup there are coders that are scrubbing notes and claims before submitting them. But yeah, if that’s not the case, then upcode everything and make yourself more money because it doesn’t matter at all what gets paid. Once the claim is submitted you are credited with those wRVUs and paid accordingly.

Associates finna eat while their group loses money. As a former used and abused podiatry associate, I’m rooting for them.

 

[Hoos2004]

hey all - sharing some insights below on this from the anonymous salary sharing data-set on Marit (PS: I am one of the MDs behind this initiative). Someone had posted about it here a few weeks back when we just started and now have more than 100 contributions, so there are some useful trends to report.

Of the 42 salaries on Marit for Private Practices (we call it Medical Groups) -
- 20 are salary based
- 16 are Net Collections based (Avg collections % - 38%, median - 35.5%)
- 2 are Net Income based models
- 2 are wRVU based ($41/wRVU)

Hope this helps. Here's the link to all anonymous salaries. LMK if you have any feedback

Podiatrist Salary (Apr 2025)

The average salary for a Podiatrist is $240,171 per year. Get paid what you’re worth!

www.marithealth.com

Podiatrist (Foot & Ankle Surgeon) Salary (May 2025)

The average salary for a Podiatrist (Foot & Ankle Surgeon) is $319,253 per year. Get paid what you’re worth!

www.marithealth.com

 

[air bud]

Appreciate the data. Not sure of accuracy since Podiatry models so differently. But it's still data.

 

[Hoos2004]

Yeah - lots of variability, which is why it's almost better to see individual salaries than averages. Btw - if anyone has suggestions on improving the survey for Podiatry specifically, do let me know. Could use more inputs

 

[air bud]

Yeah - lots of variability, which is why it's almost better to see individual salaries than averages. Btw - if anyone has suggestions on improving the survey for Podiatry specifically, do let me know. Could use more inputs

Podiatry has bigger fish to fry I am afraid...

 

[HaimFeldman]

Podiatry has bigger fish to fry I am afraid...

Like which species of fried fish skin will work best as a skin graft substitute.

 

[MicroPod]

Nice to see that most pods who have been out for awhile seem to be making decent money