wRvu per year
Started by Dr. Ice
Based on your support staff. 3 days a week should do it.
and your patient population.
3 days a week if you live in an affluent region.
9 if you work in in an urban center.
average is less than that. you will be able to do that easily
45 weeks x 5 days/week x 40 wRVUs/day = 9,000
calculate your total wRVUs for a couple days. let me know if you can't find that spreadsheet on the forum. most of us are probably between 40-50 wRVUs/day. the higher producing docs are above this. you should have no problem hitting 8400.
calculate your total wRVUs for a couple days. let me know if you can't find that spreadsheet on the forum. most of us are probably between 40-50 wRVUs/day. the higher producing docs are above this. you should have no problem hitting 8400.
If you hit around 20-24 patients a day, I think 8400 is def reasonable for a 4 day a week schedule.
On the flip side, if you’re really busy (30/day M-F) then you’re expecting 11-13k /year
On the flip side, if you’re really busy (30/day M-F) then you’re expecting 11-13k /year
It is only 20 office visits plus/minus trigger points and blind joints per day 4 days per week for 48 weeks. 2x20x4x48 equals
7,680
7,680
I got to 8500 in my first year as a doc at my last job. Math doesn’t work out exactly due to no shows and taking time off, etc.
I was working 4 days/week
I was working 4 days/week
The more interesting question is what dollar per wrvu you are. That wide range is $30-40 or more depending on location, hospital, etc.
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so that is 35 rvu per work day based upon 20 work days per month (if you factor in a lot of vacation days maybe 40 rvu/ day)
if you only see 15 pts per day you would need 2.3 rvu per pt
if 20 per day 1.75 per pt, etc.
I tend to average about 3 rvu per pt mainly b/c most of my OV are a E&M plus a procedure (TPI, OMT, acupuncture, joint injections, botox, etc.)
a 99214 is 1.92 wrvu btw
www.aapc.com
if you only see 15 pts per day you would need 2.3 rvu per pt
if 20 per day 1.75 per pt, etc.
I tend to average about 3 rvu per pt mainly b/c most of my OV are a E&M plus a procedure (TPI, OMT, acupuncture, joint injections, botox, etc.)
a 99214 is 1.92 wrvu btw
RVU Calculator - AAPC Relative Value Units
CPT® RVU calculator provides a quick analysis of the work relative value units associated with a certain volume of CPT or HCPCS codes.
www.aapc.com
shoot for about $65 per wrvu give or take, although you will see other opinionsso that is 35 rvu per work day based upon 20 work days per month (if you factor in a lot of vacation days maybe 40 rvu/ day)
if you only see 15 pts per day you would need 2.3 rvu per pt
if 20 per day 1.75 per pt, etc.
I tend to average about 3 rvu per pt mainly b/c most of my OV are a E&M plus a procedure (TPI, OMT, acupuncture, joint injections, botox, etc.)
a 99214 is 1.92 wrvu btw
RVU Calculator - AAPC Relative Value Units
CPT® RVU calculator provides a quick analysis of the work relative value units associated with a certain volume of CPT or HCPCS codes.
4 days a week with 2 half days of fluoro 15 min f/u, 15 min injections, 30 min RF, all bread and butter ~10,000 wRVU, and I’m slow in clinic. ~5% no show rate.
Check which schedule they use, as newer than 2020 will get you more credit for office visit E&M by 10-15%. We’re still on the old value schedule, and it’s costing me considerably. (Short 600 wRVU/ year)
65 is solid. I’m 73 but also rural. I got a friend out west whos at 85! Jealous of that
Same here I’m 3 and 1/2 days a week total , 7 weeks off and hit 10k wrvu yearly on the old e and m scale as well. It’s easy if you have the available volume and staff to help u.
You can do the math pretty easily calculating a mix of new and follow up ovs plus esis and rfas etc.. 20 ovs plus 10 procedures per day and play with the numbers.. just depends on how busy you want to be..
You referring to no show rate or something else?
Unless I’m missing something, a wRVU is a wRVU regardless if pt has Medicaid or BCBS PPO. Of course the $/wRVU you get from hospital varies…
Anyway, thanks for the info guys..I never thought I would consider health system employment until recently. At 45 with two very young kids, even though “I’ll get no love back,” just looking for some more stability which unfortunately in my experience, didn’t get from private practice. Working through an offer I don’t think I can refuse..
I think honesty I would miss the ability to offer regen to my patients being the biggest drawback. I genuinely believe in it and have seen an enormous change in people’s lives that were otherwise without hope. For those who shout “placebo” can’t fake visual functional improvement, but whatever.
7 weeks vacay sounds pretty damn good…
I think honesty I would miss the ability to offer regen to my patients being the biggest drawback. I genuinely believe in it and have seen an enormous change in people’s lives that were otherwise without hope. For those who shout “placebo” can’t fake visual functional improvement, but whatever.
7 weeks vacay sounds pretty damn good…
There is no paid time off except in the guarantee phase when wrvu employed.
If you aren’t at work, you can not generate any units.
If you aren’t at work, you can not generate any units.
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I feel that way in private practice. I barely take two weeks off a year because I’m constantly thinking about collections and overhead. Like I said, this has just been my experience. I’m sure many people on here have different experiences. Unfortunately in my experience, I feel like I’m constantly feeding something that should have by now provided dividends, but it hasn’t
i started Pain at age 45. looked at 2 employed PP jobs, considered academia, and the one i am at now. there was no doubt which was the best job.
both of those private practices are gone.
if you are doing regen now, you may be able to convince the HOPD to allow you to continue, and make a plan of having the hospital reimburse your cash procedures with wRVU in a way that is favorable to you.
with respect to bobs comment - not everyone is wRVU based. some have a base salary with bonus based on exceeding some minimum wRVU, and if that minimum is low enough.... stress free vacation.
I find there is less of a need for vacation in pain than anesthesia. My life is way more relaxed than when I had lots of call and 16 weeks off. And there is a point when more income or wrvus doesn’t matter that much. For me it’s around 700k. So why continue to grind
I take 6-8 weeks off a year in private practice and all the holidays. Doesn’t impact my collections as much because my volume increases when I’m here after vacation and I double book to get them on
Guess I’m still in building phase
Guess I’m still in building phase
Golf. Time with little ones. That sort of thing.
The older I get, the more I value time. I wouldn’t do a PP job slaving away 50 hrs/week because the hospital won’t “love me back”. I don’t give a crap about that.
I’m currently 3.5 days a week. And bc I’m rural, still clear 600. I have lots of time away from work. Life is good.
If you work 4 days a week Mon-Thu as I do, it is basically 10-11 weeks vacation a year including all Fridays off. Some anesthesia folks brag about 8-12 weeks off but they work nights and weekends. I recommend to have 4 days a week schedule for hospital employed pain docs, which also pushes you to be more efficient.
how many hours are you putting in those 4 days per week (10 hour days?)?
8-5 with one hour lunch break
Hospital probably won’t let you run 10 hour clinic days. It would add up to a lot of overtime for the staff.
The staff still comes in on your off day and answers the phone/stocks/works on referrals or works in another area even if you aren’t there typically.
The staff still comes in on your off day and answers the phone/stocks/works on referrals or works in another area even if you aren’t there typically.
Relatively speaking, the RVU model is better in this sense, as vacation will cost you collections, but you’re not burning overhead while you’re out.
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3 days a week.. no call, 8 hour days.. less need for vacation.. although I have more available than I can use. In anesthesia you need it to recover from the 12 hour days of high stress and long nights and weekends. Spend it however you like.. do some anesthesia on the side to keep your skills up.. kids.. new hobbies, work around the house.. start a hobby business whatever. I find going to the gym in the middle of a weekday to be amazing..just spend some time taking care of yourself for once.
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Exactly. I work 4 days a week, Tuesday through Friday. With every single weekend and Mondays off, plus major holidays and I take 1 vacation week every 3 months, it ends up being that I work 183 days a year and am off 182 days. Still on track to hit a little over 15k RVU and just below or right at 7 figures.
As for what to do with the time off, when I first started I used that Monday to travel to area clinics for networking. My patient base built up pretty quick and I don’t do that anymore. Now Mondays are an extension of the weekend. We do a good bit of weekend trips and just living life. At a point with money where the value of time is worth more to me than sacrificing that extra day off for another $200k.
Exactly. I work 4 days a week, Tuesday through Friday. With every single weekend and Mondays off, plus major holidays and I take 1 vacation week every 3 months, it ends up being that I work 183 days a year and am off 182 days. Still on track to hit a little over 15k RVU and just below or right at 7 figures.
As for what to do with the time off, when I first started I used that Monday to travel to area clinics for networking. My patient base built up pretty quick and I don’t do that anymore. Now Mondays are an extension of the weekend. We do a good bit of weekend trips and just living life. At a point with money where the value of time is worth more to me than sacrificing that extra day off for another $200k.
Yep, G2211 and the increased rvu for E&M’s very, very powerful.
That's crazy. You must get RVUs from APP's, right?
I'm 4 days a week, see about 30 patients a day, take maybe 3-4 vacation weeks a year, and hit around 10k RVU. I get some $ per APP chart signed. I can't fathom how you'd earn 50% more RVUs unless they count some of your APP's production.
No, I don’t and won’t work with midlevels.
3 days of clinic a week, 35-40 patients a day, generally a handful of new patients a day. Somewhere between 70 to 90 RVUs a clinic day. Most patients are new or established level 4 with a G2211 added on. A few 99213 for MBB f/u or post-injection f/u with pain now controlled and nothing else to do at the time.
3 days a month procedures, about 100 RVU per injection day (mix of about 40 ESI, MBB/RFA, SIJ, joint injections), 1 day a month larger cases (trials and implants, SIJ fusion, Vflex/Minuteman) also about 100-130 RVU on those days. Throw in an occasional early morning kypho before clinic or middle of the day between morning and afternoon clinic.
All adds up to about 1200-1300 RVU a month.
What situation do you use G2211?
G2211 is applicable for almost all our patient visits. If there is a complex chronic issue which you have provided or are going to provide continued care/management, it meets criteria. Lots of commercial payors don’t pay it, but some do. Hospital based with MCD/MCR/MCR Advantage is best source for it, all of them pay G2211. If RVU based, it’s an additional 0.33 RVU multiplied by about 98% of visits.
Monthly med management, injection follow up, new patient you will do an injection on, etc are all G2211.
Monthly med management, injection follow up, new patient you will do an injection on, etc are all G2211.
@mdo1738 have you analyzed your quarterly reports to see if you make more units on an average clinic day vs an average procedure day? Mine was always about the same. Other physicians were shocked when I told them that.
I still am making about 10-15% more RVU on an average procedure day than an average clinic day but that gap is narrowing by the month.
Depends how efficient staff is at turning over the room. WRVU for epidurals are so pitiful that it’s a wash for me.
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You could certainly make a lot just seeing patients as they are just about equal.. And that’s just what big insurance wants.
I work 8-4pm Monday through Thursday. 450k base hospital employee and keep $67/wrvu after 6500. 9 weeks of vacation including holidays, CME, sick days. Clinic days are around 35 wrvu and procedure dates are between 40-80 wrvu depending on having advanced procedures or not. No opioids and still building my practice so I’m actually spending 30 mins on patients other than “I’m feeling great” type follow-ups.
Don’t get stuck in that rhythm. Book activities outside work in the early p.m., so you can be more efficient and get on with life.
Don’t be a gas. i.e. don’t fill the space you have just because it’s there. Don’t spend 30 min on a f/u visit just because that’s what the schedule looks like.
I like the idea of booking activities in the early PM to incentivize just getting out. Thanks
As much as I think exactly like you and have built my practice this way, if someone enjoys the leisurely pace and doing well, there’s absolutely nothing wrong with that.
@Dr. Ice I think we're in a similar geographic area. It's really all about the referral network/patterns. I'm in year 3 and will probably make it to around 7000 RVU (2020 values). The area is pretty saturated and the main ortho group affiliated with the hospital is private with their own two pain docs. The local neurosurgery group is also private with pain referral patterns solidified before my time. Not to mention Medicaid makes up a third or more of my patients. My well established colleague is hitting nearly 12000 this year so am hopeful to get there in time. Fortunately the schedule is very flexible and I work the equivalent of like 3.5 days most weeks.
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You would be close to 10,000 with the updated rvu values and g2211. It isn’t an apples to apples comparison since you are being handcuffed.
Are you using the g code on all medication management patients
Yes.
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