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GandalfTheWhite said:
So what happens when you hit your RVU target? take the rest of the year off?
Do you just do 8-2pm M-Th?
Seems stupid to disincentivize your production.
Click to expand...
This is extremely common. And yes agree, stupid
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GandalfTheWhite said:
No way, whats the pushback from admins if you decide to only do 15pts in clinic or in the procedure room per day?
Click to expand...

My admin says “we’re not going to pay you more per widget”.
 
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Life is short.. do what is best for you. Hospital admins wishes are irrelevant.
 
how do wRVUs approximate to hours worked per week or patients seen per day?

For above contract, if he does an extra 4,000 wRVUs he brings home 280k. Thats not too bad.
 
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Does anyone have a pdf chart listing procedures and its wrvu value?
 
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GoBeers said:
Does anyone have a pdf chart listing procedures and its wrvu value?
Click to expand...
CPT wRVU
20550 PR INJECT TENDON SHEATH/LIGAMENT 0.75
20552 PR INJECT TRIGGER POINT, 1 OR 2 0.66
20553 PR INJECT TRIGGER POINTS, > 3 0.75
20600 PR ARTHROCENTESIS ASPIR&/INJ SMALL JT/BURSA W/O US 0.66
20604 PR ARTHROCENTESIS ASPIR&/INJ SMALL JT/BURSA W US 0.89
20604 50 PR ARTHROCENTESIS ASPIR&/INJ SMALL JT/BURSA W US 0.89
20605 PR ARTHROCENTESIS ASPIR&/INJ INTERM JT/BURSA W/O US 0.68
20606 PR ARTHROCENTESIS ASPIR&/INJ INTERM JT/BURSA W/US 1.00
20610 PR ARTHROCENTESIS ASPIR&/INJ MAJOR JT/BURSA W/O US 0.79
20610 50 PR ARTHROCENTESIS ASPIR&/INJ MAJOR JT/BURSA W/O US 0.79
20611 PR ARTHROCENTESIS ASPIR&/INJ MAJOR JT/BURSA W/US 1.10
20611 50 PR ARTHROCENTESIS ASPIR&/INJ MAJOR JT/BURSA W/US 1.10
27096 PR INJECTION,SACROILIAC JOINT 1.48
27096 50 PR INJECTION,SACROILIAC JOINT 1.48
62321 PR NJX DX/THER SBST INTRLMNR CRV/THRC W/IMG GDN 1.95
62323 PR NJX DX/THER SBST INTRLMNR LMBR/SAC W/IMG GDN 1.80
63650 PR PERCUT IMPLNT NEUROELECT,EPIDURAL 7.15
64405 PR INJECTION AA&/STRD GREATER OCCIPITAL NERVE 0.94
64418 PR INJECTION AA&/STRD SUPRASCAPULAR NERVE 1.10
64420 PR INJECTION AA&/STRD INTERCOSTAL NRV SINGLE LVL 1.08
64421 PR INJECTION AA&/STRD INTERCOSTAL NRV EA ADDL LVL 0.50
64425 PR INJECTION AA&/STRD ILIOINGUINAL IH NERVES 1.00
64450 PR INJECTION AA&/STRD OTHER PERIPHERAL NERVE/BRANCH 0.75
64451 PR INJECTION AA&/STRD NERVES NRVTG SI JOINT W/IMG 1.52
64451 50 PR INJECTION AA&/STRD NERVES NRVTG SI JOINT W/IMG 1.52
64454 PR INJECTION AA&/STRD GENICULAR NRV BRANCHES W/IMG 1.52
64483 PR NJX AA&/STRD TFRML EPI LUMBAR/SACRAL 1 LEVEL 1.90
64483 50 PR NJX AA&/STRD TFRML EPI LUMBAR/SACRAL 1 LEVEL 1.90
64484 PR NJX AA&/STRD TFRML EPI LUMBAR/SACRAL EA ADDL 1.00
64490 PR INJ DX/THER AGNT PARAVERT FACET JOINT,IMG GUIDE,CERV/THORAC 1.82
64490 50 PR INJ DX/THER AGNT PARAVERT FACET JOINT,IMG GUIDE,CERV/THORAC 1.82
64491 PR INJ DX/THER AGNT PARAVERT FACET JOINT,IMG GUIDE,CERV/THORAC 1.16
64491 50 PR INJ DX/THER AGNT PARAVERT FACET JOINT,IMG GUIDE,CERV/THORAC 1.16
64493 PR INJ DX/THER AGNT PARAVERT FACET JOINT,IMG GUIDE,LUMBAR/SAC, 1.52
64493 50 PR INJ DX/THER AGNT PARAVERT FACET JOINT,IMG GUIDE,LUMBAR/SAC, 1.52
64494 PR INJ DX/THER AGNT PARAVERT FACET JOINT,IMG GUIDE,LUMBAR/SAC, 1.00
64494 50 PR INJ DX/THER AGNT PARAVERT FACET JOINT,IMG GUIDE,LUMBAR/SAC, 1.00
64495 PR INJ DX/THER AGNT PARAVERT FACET JOINT,IMG GUIDE,LUMBAR/SAC, 1.00
64555 PR PERCUT IMPLANT,NEUROELEC,PERIPH NERVE 5.76
64620 PR DEST,INTERCOSTAL,NEUROLYTIC 2.89
64624 PR DESTRUCTION NEUROLYTIC AGT GENICULAR NERVE W/IMG 2.50
64625 PR RADIOFREQUENCY ABLTJ NRV NRVTG SI JT W/IMG GDN 3.39
64633 PR DSTR NROLYTC AGNT PARVERTEB FCT SNGL CRVCL/THORA 3.84
64634 PR DSTR NROLYTC AGNT PARVERTEB FCT ADDL CRVCL/THORA 1.32
64635 PR DSTR NROLYTC AGNT PARVERTEB FCT SNGL LMBR/SACRAL 3.78
64636 PR DSTR NROLYTC AGNT PARVERTEB FCT ADDL LMBR/SACRAL 1.16
64640 PR DESTRUCT BY NEURO AGENT; OTHER PERIPH NERVE 1.98
64999 PR NERVOUS SYSTEM SURGERY UNLISTED 0.00
76942 CHG SONO GUIDE NEEDLE BIOPSY 0.67
76942 26 CHG SONO GUIDE NEEDLE BIOPSY 0.67
77002 26 CHG FLUOROSCOPIC GUIDANCE NEEDLE PLACEMENT 0.54
80305 CHG DRUG TEST PRSMV READ DIRECT OPTICAL OBS PR DATE 0.00
95972 PR ELEC ALYS IMPLT NPGT CPLX SP/PN PRGRMG 0.80
99203 PR OFFICE/OUTPATIENT NEW LOW MDM 30-44 MINUTES 1.42
99204 PR OFFICE/OUTPATIENT NEW MODERATE MDM 45-59 MINUTES 2.43
99213 PR OFFICE/OUTPATIENT ESTABLISHED LOW MDM 20-29 MIN 0.97
99214 PR OFFICE/OUTPATIENT ESTABLISHED MOD MDM 30-39 MIN 1.50
99243 PR OFFICE CONSULTATION NEW/ESTAB PATIENT 40 MIN 1.88
99244 PR OFFICE CONSULTATION NEW/ESTAB PATIENT 60 MIN 3.02
 
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painfree23 said:
In office or asc?
Click to expand...
HOPD I think is the location type, procedures done at the hospital in outpatient procedures area.
GandalfTheWhite said:
So what happens when you hit your RVU target? take the rest of the year off?
Do you just do 8-2pm M-Th?
Seems stupid to disincentivize your production.
Click to expand...
Long visits. 40 new, 20 f/up. 15-18 ppd advertised, about the same for procedure days. Sold as being more work-life friendly, not trying to make docs grind and be miserable. Open to half days or late starts long as you hit targets. Previous doc was in the 7k wRVU neighborhood.
 
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le pain quotidien said:
HOPD I think is the location type, procedures done at the hospital in outpatient procedures area.

Long visits. 40 new, 20 f/up. 15-18 ppd advertised, about the same for procedure days. Sold as being more work-life friendly, not trying to make docs grind and be miserable. Open to half days or late starts long as you hit targets. Previous doc was in the 7k wRVU neighborhood.
Click to expand...

7K wRVU is nice part time work.
 
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drmamba said:
How long are most HOPD contracts?
Click to expand...

I've seen most HOPD docs get roped into 3-year gigs that front-load big salary guarantees and then re-up into production-based comp models when those contracts expire. Then it's just a game of "boil the frog" whittling away your reimbursement or sucking you into non-revenue generating activities that support the "collective commitments" of the HOPD/health system.
 
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drusso said:
I've seen most HOPD docs get roped into 3-year gigs that front-load big salary guarantees and then re-up into production-based comp models when those contracts expire. Then it's just a game of "boil the frog" whittling away your reimbursement or sucking you into non-revenue generating activities that support the "collective commitments" of the HOPD/health system.
Click to expand...
high floor, low ceiling
underperform or get taken advantage of
 
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le pain quotidien said:
HOPD I think is the location type, procedures done at the hospital in outpatient procedures area.

Long visits. 40 new, 20 f/up. 15-18 ppd advertised, about the same for procedure days. Sold as being more work-life friendly, not trying to make docs grind and be miserable. Open to half days or late starts long as you hit targets. Previous doc was in the 7k wRVU neighborhood.
Click to expand...
Hold up. 40 new 20 F/U per day or per week? 60 patients over 3 days and 1-2 days for procedures is decent.

Can you not just see patients in your office after you hit your RVUs?
 
GandalfTheWhite said:
Hold up. 40 new 20 F/U per day or per week? 60 patients over 3 days and 1-2 days for procedures is decent.

Can you not just see patients in your office after you hit your RVUs?
Click to expand...

I think they’re saying 40 min consults and 20 minute follow ups.
 
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drusso said:
I've seen most HOPD docs get roped into 3-year gigs that front-load big salary guarantees and then re-up into production-based comp models when those contracts expire. Then it's just a game of "boil the frog" whittling away your reimbursement or sucking you into non-revenue generating activities that support the "collective commitments" of the HOPD/health system.
Click to expand...
Or maybe good base plus good production making 700plus with full benefits.
 
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le pain quotidien said:
Another data point for y'all...midwest community hospital based practice.

450k salary
6000 wRVU target
$70/wRVU above target

Another example of regressive pay for increased work. At target you're doing $75/wRVU, but drops to $70 for every wRVU thereafter. Upside is no official "draw" language if you're below target, but I suspect they would implicitly or explicitly encourage you to get up to target at least.
Click to expand...

$700k at 10K RVUs -- can anyone comment how hard 10k RVUs is to hit?
 
I think the hopd guys are doing pretty good these days. Don’t see the pendulum swinging back
 
nvrsumr said:
I think the hopd guys are doing pretty good these days. Don’t see the pendulum swinging back
Click to expand...
Three words for you: Site neutral payment. Watch how loyalty changes once the all the juice is squeezed from the fruit. I expect a lot of pain doctors will finally find their “entrepreneurial spirit” when the bubble bursts.
 
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These types of contracts are why the mean RVU is about 7000 even though 10000 to 14000 is attainable.

PainDoc2025 said:
$700k at 10K RVUs -- can anyone comment how hard 10k RVUs is to hit?
Click to expand...
4-4.5 days a week at a modest to moderate pace gets me 9000+. 30 min npv, 15 min f/u. 30-35 fluoro procedures a week, roughly same number of clinic injections. ~60 office visits, more new than f/u, as PA sees bulk of f/u.
 
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cowboydoc said:
These types of contracts are why the mean RVU is about 7000 even though 10000 to 14000 is attainable.


4-4.5 days a week at a modest to moderate pace gets me 9000+. 30 min npv, 15 min f/u. 30-35 fluoro procedures a week, roughly same number of clinic injections. ~60 office visits, more new than f/u, as PA sees bulk of f/u.
Click to expand...
this is about identical to my schedule and I'm around 9000 wRVUs. It's enough for me for now. That is until they slash my $/wRVU
 
clubdeac said:
this is about identical to my schedule and I'm around 9000 wRVUs. It's enough for me for now. That is until they slash my $/wRVU
Click to expand...
Whats your base salary for what amount of RVUs? And how much do you get for RVUs above that?
 
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You guys all work 40hrs/week? I’m at 25 hours. Collections based, private..it’s funny how I think I should get paid more but then think about my hours..
 
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i've done around 20k RVU last yr - but i have a midlevel, and RVU is irrelevant as I am office based.
 
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honestly, if you are doing 20k wRVU, you have no time to post on this forum. i think you are thinking total RVU?

to be facetious: thats 80 wRVU per day, meaning you are doing the equivalent of 44 epidurals a day, 250 days a year.

even lobelsteve, the KOL of pain docs, doesnt do 20k wRVU. (i remember reading something in the lines of 12k....)


get back to work. your 30 second break is over.
 
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mid|ine said:
RVUs or wRVUs? Are you adding your midlevel to yours? Im office based too, but we track out wRVUs
Click to expand...
Ducttape said:
honestly, if you are doing 20k wRVU, you have no time to post on this forum. i think you are thinking total RVU?

to be facetious: thats 80 wRVU per day, meaning you are doing the equivalent of 44 epidurals a day, 250 days a year.

even lobelsteve, the KOL of pain docs, doesnt do 20k wRVU. (i remember reading something in the lines of 12k....)


get back to work. your 30 second break is over.
Click to expand...
yes added midlevel #. the admin ran the number for fun as one of the partners was curious about RVU. i 'm not sure if it is RVU or wRVU.
we (midlevel + I) see about 1000 patient encounter per month excluding procedures.
 
TIVAndy said:
yes added midlevel #. the admin ran the number for fun as one of the partners was curious about RVU. i 'm not sure if it is RVU or wRVU.
we (midlevel + I) see about 1000 patient encounter per month excluding procedures.
Click to expand...
1652369643066.gif
 
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Ducttape said:
honestly, if you are doing 20k wRVU, you have no time to post on this forum. i think you are thinking total RVU?

to be facetious: thats 80 wRVU per day, meaning you are doing the equivalent of 44 epidurals a day, 250 days a year.

even lobelsteve, the KOL of pain docs, doesnt do 20k wRVU. (i remember reading something in the lines of 12k....)


get back to work. your 30 second break is over.
Click to expand...
Well ESI is the lowest wrvu thing we do. So maybe. Lots of 99214 can do it easier
 
TIVAndy said:
yes added midlevel #. the admin ran the number for fun as one of the partners was curious about RVU. i 'm not sure if it is RVU or wRVU.
we (midlevel + I) see about 1000 patient encounter per month excluding procedures.
Click to expand...
50 per day on average.
35 per doc and 15 for NP.

Doable, a bit too much for my liking. I would burn out if over 30 per day.
 
BS. The doctors we all read about and hear about with superhuman schedules are floated by very high overheads by way of several midlevels, scribes and MAs.

One of the biggest KOL in our field told me he does 30-40 clinic visits per half day, same number of procedures.

This is someone every one of you know. He's 1st-3rd author on most papers.

NANS = Embellishment Conference.
 
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Ronin1 said:
Well ESI is the lowest wrvu thing we do. So maybe. Lots of 99214 can do it easier
Click to expand...
technically you should not be doing a 99214 in <10 minutes. maybe a 99213...
and according to aapc calculator, a 99214 only give 1.92 wRVU vs. 1.8 for 62323.


20k wRVU would be possible with doc and NP. i was assuming 20k for doc only.
 
Ducttape said:
technically you should not be doing a 99214 in <10 minutes. maybe a 99213...
and according to aapc calculator, a 99214 only give 1.92 wRVU vs. 1.8 for 62323.


20k wRVU would be possible with doc and NP. i was assuming 20k for doc only.
Click to expand...
Incorrect on your 1st sentence.
 
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MitchLevi said:
BS. The doctors we all read about and hear about with superhuman schedules are floated by very high overheads by way of several midlevels, scribes and MAs.

One of the biggest KOL in our field told me he does 30-40 clinic visits per half day, same number of procedures.

This is someone every one of you know. He's 1st-3rd author on most papers.

NANS = Embellishment Conference.
Click to expand...
agree, you can set something up.

i know of one ortho (knee) who does this. he schedules 7 minute appointments. he uses roughly 2 residents, 2 NPs and a fellow. they see the patient, he walks in for literally 2 minutes, then moves to the next patient. from what i gather, they all get at least 99213s. he does not see follow up patients because they are under global period.

MitchLevi said:
Incorrect on your 1st sentence.
Click to expand...
take that up with aapc. maybe their calculator is wrong.

99214 wrvu.GIF


edit: 99214 time based billing should be 30-39 minutes.
 
Last edited:
lobelsteve said:
50 per day on average.
35 per doc and 15 for NP.

Doable, a bit too much for my liking. I would burn out if over 30 per day.
Click to expand...
you nailed it. my NP is very good (i've trained him for few years ) and he can see 20+ easily.
i'm not particularly very happy of this setting. the burnout is real as you have guessed. i'm wondering if I need to go to a lower overhead setting where i can see less patients with better lifestyle. the money is good but not as good as people think.
there are people working 100 to make 50, and there are people working 70 to make 40. the latter is preferable.
 
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Ducttape said:
agree, you can set something up.

i know of one ortho (knee) who does this. he schedules 7 minute appointments. he uses roughly 2 residents, 2 NPs and a fellow. they see the patient, he walks in for literally 2 minutes, then moves to the next patient. from what i gather, they all get at least 99213s. he does not see follow up patients because they are under global period.


take that up with aapc. maybe their calculator is wrong.

View attachment 354645

edit: 99214 time based billing should be 30-39 minutes.
Click to expand...
No one here is doing time based billing
 
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TIVAndy said:
you nailed it. my NP is very good (i've trained him for few years ) and he can see 20+ easily.
i'm not particularly very happy of this setting. the burnout is real as you have guessed. i'm wondering if I need to go to a lower overhead setting where i can see less patients with better lifestyle. the money is good but not as good as people think.
there are people working 100 to make 50, and there are people working 70 to make 40. the latter is preferable.
Click to expand...
I’m curious what’s the salary range with this much volume.. somewhere 1.5 million?
 
Hopd pain physicians can bill however they want to…cause they can…
 
Dr. Ice said:
You guys all work 40hrs/week? I’m at 25 hours. Collections based, private..it’s funny how I think I should get paid more but then think about my hours..
Click to expand...
whats your income at 25 hours/week? sounds pretty cush... 4 six-hour days / week.
 
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Yea yeah you all and your high volume efficient practices...

You're missing out on the 7k wrvu full time, bloated, inefficient HOPD practice supported by our friend the SOS hyena. Advantages include:

- big improvements in chess game doing 10 minute games on chess.com app in between cases
- phone app language practice during patient no shows
- extended lunch breaks allowing one to stop by home sometimes and even taken a nap
- possible workouts at lunch time or with pull-up bar in between patient visits
- ability to take kids to school when patients inevitably show up late or no show
- easily lose money trading stocks on phone in between patient encounters. The advantage here is with the lower base salary there is less money to lose.
 
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just found this so I figured I'd post to share - has all specialties and regions for 2021
 

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