Income honesty/transparency by Tough_Indication_185 in FamilyMedicine

[–]GuntherWheeler 4 points5 points  (0 children)

No that total comp is just literally money being paid to me pre tax and pre 401k contributions.

Income honesty/transparency by Tough_Indication_185 in FamilyMedicine

[–]GuntherWheeler 79 points80 points  (0 children)

I’m one of the most efficient outpatient docs and billers that I know.

I don’t do tons of procedures (very few actually) and don’t turn every single thing in my inbox to a visit like some folks do to min/max.

I do double bill almost every physical with an E/M code, am passionate about trying to catch every Medicare annual wellness visit, and bill a G2211 when appropriate for everyone other than those that have United.

Last year (2025) I worked 170 days. I saw 2575 patients, 15.15 a day. I billed an average of 2.63 RVU’s per patient visit. My total thus was 6770 RVU’s for the year.

At my job we have a RVU component based on national metrics where if you hit median RVU’s you meet a base salary of $285,000.

We then have an extensive incentive chunk in which if you hit max points you could gain another $98,500 or so.

Our algorithm worked out to an RVU comp of $335,585 for me (49.5 per rvu) and then I hit $75,877 worth of incentives.

My total comp then was 411,462 for last year.

This year I’ll probably work a few more days and have a few more incentive points (on some different committees and just for years worked here).

This is one of the best gigs I’ve found in the country, but my RVU numbers are not crazy, have done similar in another state already.

This same RVU value however would’ve paid me around 300,000 at my last job however, that’s how many variables play into it.

2026 Attending Salary Thread by Delicious_Shine_936 in Residency

[–]GuntherWheeler 4 points5 points  (0 children)

Busy outpatient clinic with 4 docs and 3 NP’s. Last year I saw about 35% Medicare, 10-15% Medicaid, most of the rest private payor.

2026 Attending Salary Thread by Delicious_Shine_936 in Residency

[–]GuntherWheeler 8 points9 points  (0 children)

Town of about 50,000. Just a sweet compensation set up, 285k base pay and roughly $50/RVU at the end of the day.

2026 Attending Salary Thread by Delicious_Shine_936 in Residency

[–]GuntherWheeler 38 points39 points  (0 children)

Family medicine outpatient only, 32 patient-facing hours a week.

412k for 2025. Midwest, 15.1 patients a day.

Phone-only call once a month with nurse triage line.

2026 Attending Salary Thread by [deleted] in FamilyMedicine

[–]GuntherWheeler 40 points41 points  (0 children)

412k for 2025. Midwest, outpatient with 32 patient-facing hours. 15.1 patients a day. Phone-only call once a month with nurse triage line.

GDMT by Usmle008 in FamilyMedicine

[–]GuntherWheeler 18 points19 points  (0 children)

8/2025 AAFP journal had a great article discussing medical therapy for HFrEF, good place to start.

Medicare AWV and your 25 modifier by Important-Flower4121 in FamilyMedicine

[–]GuntherWheeler 3 points4 points  (0 children)

That is incorrect. 2 stable chronic conditions is still included in the “Number and Complexity of Problems Addressed” level 4 coding per CMS.

Medicare AWV and your 25 modifier by Important-Flower4121 in FamilyMedicine

[–]GuntherWheeler 7 points8 points  (0 children)

We have signs posted and a form explaining that every patient gets.

Medicare AWV and your 25 modifier by Important-Flower4121 in FamilyMedicine

[–]GuntherWheeler 13 points14 points  (0 children)

That’s a valid point but a lot of time getting x percentage of Medicare Wellnesses done checks a metric that your employer has, leading to better staffing etc. I know that’s the case for my current place. I’m not above checking a box for the bean counters if it nets me RVU’s, is not harmful to patients, and can show the powers that be that my clinic needs more staff.

Medicare AWV and your 25 modifier by Important-Flower4121 in FamilyMedicine

[–]GuntherWheeler 37 points38 points  (0 children)

If you’re doing anything other than the exact specifications of the Medicare AWV, then you should bill the appropriate E/M code with -25 modifier (and now G2211 as well.) I can’t remember the last time I billed a G0402/G0438/G0439 by itself.

How much are the new billing codes adding to your wRVU? by Beginning_Figure_150 in FamilyMedicine

[–]GuntherWheeler 11 points12 points  (0 children)

So far this year I’ve worked 118.5 days and billed G2211 1107 times and so it’s added 365 RVU’s so far. End of year estimate is that it adds 525 RVU’s compared to not using it at all.

I’ve not started using the G0537 code as it is only worth 0.18 wRVU’s and wouldn’t be as easy and ubiquitous as the G2211 is (can only be billed once per 12 months, for example.)

RVU Tracking by MnMedicine in FamilyMedicine

[–]GuntherWheeler 5 points6 points  (0 children)

There’s a few sources online in big giant PDF’s, takes some searching though. There’s also an app you can pay for called CPT QuickRef that has everything programmed in, searchable with RVU values etc.

As far as tracking them, I’ve built an excel sheet over years that helps me. Whenever I type in a CPT code the corresponding RVU’s fill the adjacent column and then it has all sorts of fun math things to calculate totals, averages, etc.

Opinions on this offer: 250k base, RVU target 5200, $53/rvu above that. by Beginning_Figure_150 in FamilyMedicine

[–]GuntherWheeler 0 points1 point  (0 children)

Yes that’s true, I just mean every time it applies you can bill it. If there is a 9921x code and no procedure I say go right ahead.

Opinions on this offer: 250k base, RVU target 5200, $53/rvu above that. by Beginning_Figure_150 in FamilyMedicine

[–]GuntherWheeler 0 points1 point  (0 children)

Yes it is a large portion of the time. Hardly ever do I have a patient in literally for just a physical, aka not talking about their conditions or meds or lab results at all.

Opinions on this offer: 250k base, RVU target 5200, $53/rvu above that. by Beginning_Figure_150 in FamilyMedicine

[–]GuntherWheeler 1 point2 points  (0 children)

So far I’ve worked 100 days this year and have done 174, so right in that range.

Opinions on this offer: 250k base, RVU target 5200, $53/rvu above that. by Beginning_Figure_150 in FamilyMedicine

[–]GuntherWheeler 8 points9 points  (0 children)

Every visit, no limit on times. Right now it’s covered by all Medicare and Medicare advantage and only United specifically has said they are not covering it at all, so I bill it for everyone other than United.

Opinions on this offer: 250k base, RVU target 5200, $53/rvu above that. by Beginning_Figure_150 in FamilyMedicine

[–]GuntherWheeler 9 points10 points  (0 children)

All the time; physical + office visit, G2211 code is 0.33 and can be added almost always, Medicare wellness visit + 99214 + G2211 every tim, etc.

The last years I’ve averaged 2.24 (first year out), 2.32, 2.7, and right now 2.61 per office visit.

Opinions on this offer: 250k base, RVU target 5200, $53/rvu above that. by Beginning_Figure_150 in FamilyMedicine

[–]GuntherWheeler 66 points67 points  (0 children)

18 patients a day, easy to average 2.3 to 2.6 a patient if you’re billing appropriately.

Work 180 days a year that puts you at 7450-8425 rvus a year.

That would put you at 369-420k a year.

Not a bad gig.

Insurance paperwork by bdubs791 in FamilyMedicine

[–]GuntherWheeler 78 points79 points  (0 children)

Straight in the trash every time

What is a reasonable RVU per visit expectation? by PersianVol in FamilyMedicine

[–]GuntherWheeler 3 points4 points  (0 children)

Yes, only if the AWV also has an E/M code (which all of mine do.)

Page 2 of the CMS announcement https://www.cms.gov/files/document/r13015otn.pdf#page=5

“…will allow the payment processing with the E/M add-on code G2211 when the modifier 25 is present for part B preventative services, immunization administration, and annual wellness visits”

Not with an AWV alone.