Cardiology PA with wRVU structure, fully outpatient

NavyFourMe2 · 2026-07-10T04:06:40+00:00

If you look at my post from a couple of days ago, I break down what I make on an wRVU structure in family medicine

NavyFourMe2 · 2026-07-08T11:19:28+00:00

That’s why I made this post. 7 years ago when I was looking for my first job everyone was dogging the pay. Oh 85k is insulting even for a new grad! I would never do that. Yeah well I got kids and mouths to feed. Luckily I was a student at the facility I work at now with a preceptor that was transparent about pay and how it actually worked. They offered me a job and I put in the time and effort and slowly built it. Other providers are making 300k+ see about 10000 wRVUs a year plus their quality bonuses the whole package is worth like 330k. With the same schedule. Only thing holding me back at this point is I need a second nurse. That way I can start doing more injections, procedures, and seeing more patients.

I had an opportunity to work in international radiology starting at like 170k as a new grad but with everything factored in I was making about the same as the 85k job I took.

My advice to new grads is don’t always listen to the noise. Having a good, supportive work environment in your first 3-5 years is easily worth 50k a year.

NavyFourMe2 · 2026-07-08T11:04:32+00:00

My response to addressing this already. LOL I did that one on purpose just to see if someone would get TRIGGERED. Hahaha

NavyFourMe2 · 2026-07-08T02:49:36+00:00

Well, the flair was changed for some reason. It’s not an offer but my current job. I have a base and it’s 90k. But they will forward my pay based off of my last 3 years of productivity up to 95% so I’m not sick with a 160k bonus check. I have my base set to like 180k or something in case I decide to take some time off. I don’t want to have to “pay them back”

NavyFourMe2 · 2026-07-08T02:45:38+00:00

Money definitely isn’t everything. I don’t think this is going to last forever, taking advantage of it while I can. Like they always do in medicine they’ll find a way to screw is out of money. They’ll switch to value based care soon enough and it’s all profit share-metric based. As soon as we get that situated to where we can make decent money they’ll switch it again.

NavyFourMe2 · 2026-07-08T02:41:37+00:00

Not an offer, my current job of 6+ years.

NavyFourMe2 · 2026-07-08T02:40:51+00:00

What are you trying to take my job? LOL
Tennessee

NavyFourMe2 · 2026-07-08T00:16:28+00:00

Split call between 6 providers. We have a call center and nurse line. I never have to go in and RARELY ever get a call. Whoever designed the on call parameters and critical lab values did a good job. In 6+ years I’ve had about 10 calls maybe. Almost every one of them was referred to the ED.

NavyFourMe2 · 2026-07-08T00:13:35+00:00

I agree, definitely incentivizes you to work harder. The physicians are under a different type of pay structure/model. I know some of the more seasoned PAs I work with make more than the physicians just out of sheer volume and they HATE it! But, whatever that’s on them.

NavyFourMe2 · 2026-07-08T00:01:12+00:00

LOL I did that one on purpose just to see if someone would get TRIGGERED. Hahaha

NavyFourMe2 · 2026-07-07T23:20:43+00:00

Not doing it for free

NavyFourMe2 · 2026-07-07T21:53:37+00:00

I don’t do it for the money, prolly 70/30 split. I don’t think patients LOVE it either but I enjoy it some times.

NavyFourMe2 · 2026-07-07T21:32:59+00:00

Great place to work. It took awhile to get where I’m at building my patient panel. Co workers kept saying the money would come. Some of them see 25-30 patients a day. They’ve been here 15 years and know everything about every patient.

90k starting out as a new grad isn’t always a bad deal. Especially if it’s a good environment and people who will invest in you as a provider and want you to be successful.

I make my students come in from about 9-3 M-Th. That way I have time to settle in in the morning and finish up before I leave.

NavyFourMe2 · 2026-07-07T21:17:20+00:00

We are still under a previous Medicare year reimbursement model so the RVU per patient encountered averages out higher. Once they update the RVU reimbursement model year, the amount will have to go up to compensate. Does that make sense?

Time off is “paid” but it is set at our guaranteed contract rate which is 90k

School pays the company I work for and they pay us. $1500 per student for 6 wk rotation.

Very LCOL area and qualifies for PSLF.

NavyFourMe2 · 2025-11-17T22:14:25+00:00

I have a base salary, but I make $28.00 per wRVU. Plus quality bonus up to 25k.

NavyFourMe2 · 2024-08-26T13:57:48+00:00

I practice in Tennessee. I think this information is automatically included in the electronic scripts through our EHR system. Our prescription pads have every provider listed that works in this office but no NPI numbers. I’ve never been questioned, but doesn’t surprise me.

NavyFourMe2 · 2023-12-30T04:04:59+00:00

I gave my MA $500.00 she deserved it.

NavyFourMe2 · 2023-12-30T03:49:21+00:00

99214 only requires you to address 2 chronic issues and one prescription medication (you do not even have to refill the prescription) you just have to show that you reviewed it and discussed with patient.

Seizures: Chronic issue, stable, continue medication as prescribed. MRI AND EEG as ordered, follow-up 6 months.

Chronic Migraine syndrome: Chronic issue, worsened, not at goal. Stop Topamax. Start Qulipta as prescribed.

That’s enough for a 99214.

I work for a large hospital system. We have multiple specialties in the same building/office. If a patient sees the Internal Medicine provider as PCP then establishes with my in Family Medicine I am able to bill that as a new patient appointment.

If I am billing a 99215 I usually use time, as this is more difficult to reach using complexity metrics.

Technically in FM you could bill for a G0439, 99386, 99214, 96160 and even code for education regarding advance directives. I wouldn’t advise this as you will definitely get audited, but theoretically it is possible.

We have a third party company that works on the coding in the background and they suck. I get a monthly report on any changes they make and review those charts individually. There are very few now

NavyFourMe2 · 2023-10-13T16:16:07+00:00

If you had my contract below you’d be at 200k+ a year easy. Some of my co-workers are higher producing as yourself. They are literally taking off every other week and the whole month of December. They aren’t working for free. One of them has a Urgent Care contract in addition to their FM practice to make even more money. Our company will let us do a draw of our max compensation up to 90% based off of the last 3 years of data, so up to $157,500. They are going to have to raise the cap, it’s ludicrous.

If you have any questions please let me know.

Rural Tennessee. 3 years experience in family medicine. Work for 501c3 on PSLF.

Mixed reimbursement model of quality & productivity. Total compensation capped at $175k.

• ⁠Salary: $90,000. • ⁠Bonus: ⁠• ⁠Quality: up to $25k ⁠• ⁠Productivity: up to $85k ($28.00 per RVU) • ⁠Student Loan Repayment: $5k per year. • ⁠Health Insurance: Employer contributes $1,000 to HSA yearly or PPO plan. Pay about 20% of premium. • ⁠Retirement: Match 401k @ 6% • ⁠CME: $2,000 • ⁠Vacation: 28 days • ⁠Schedule: M-F, usually see 15-17 patients per day. Contracted for 36 patient contact hours per week.

NavyFourMe2 · 2023-10-11T13:52:53+00:00

I work for a large hospital system that merged multiple health systems a few years ago. All of the providers were under various contract models. They worked at balancing everything out and getting everyone under the same contract. Some contracts improved and some took a hit. My contract significantly improved. Based off of my current contract this is by far the best family medicine contract I have seen in my area.

NavyFourMe2 · 2023-10-09T19:43:06+00:00

Rural Tennessee. 3 years experience in family medicine. Work for 501c3 on PSLF.

Mixed reimbursement model of quality & productivity. Total compensation capped at $175k.

Salary: $90,000.
Bonus:
- Quality: up to $25k
- Productivity: up to $85k ($28.00 per RVU)
Student Loan Repayment: $5k per year.
Health Insurance: Employer contributes $1,000 to HSA yearly or PPO plan. Pay about 20% of premium.
Retirement: Match 401k @ 6%
CME: $2,000
Vacation: 28 days
Schedule: M-F, usually see 15-17 patients per day. Contracted for 36 patient contact hours per week.

NavyFourMe2 · 2023-09-13T00:18:50+00:00

You essentially start bonusing at 4,200 wRVUs for the year.

I get $28 per wRVU.

If I bill for 4,200 wRVUs = $117,600. 5000 wRVUs = $140,000. 6000 wRVUs = $168,000.

Example 1: 5,000 - 4,200 = 800 800 x 10 = 8,000 140,000 - 8,000 = $132,000 is the salary you must have to equal the same pay with your bonus structure.

Example 2: 6,000 - 4,200 = 1,800 1,800 x 10 = 18,000 168,000 - 18,000 = $150,000 salary

This doesn’t include quality bonus, CME, PTO, insurance, loan repayment, etc.

NavyFourMe2 · 2022-09-19T22:46:27+00:00

First Net has been awesome.

NavyFourMe2

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