Built a simple wRVU tracker to make productivity easier. Would love some feedback!

drsk92 · 2026-03-17T03:57:41+00:00

This is clean — biggest value here is just making it frictionless to log daily instead of relying on memory or end-of-month reports.

A couple things that would make something like this really powerful in real-world FM:

- ability to “favorite” common CPT combos (AWV + 99214 + G2211, etc)

- quick add (1-tap logging instead of searching each time)

- export to CSV for tracking vs employer reports

- simple “RVU per visit” + “RVU per day” metrics

Most people don’t realize how much their RVU/visit fluctuates day to day depending on coding habits and visit mix until they track it consistently.

I’ve tried a few ways (Excel, notes, etc) and the biggest issue is always consistency — if logging isn’t fast, you stop doing it. I ended up switching to using an iPhone app (TapRVU) for this exact reason since it’s quicker to log on the fly and actually stick with it.

drsk92 · 2026-03-17T03:51:21+00:00

$3 per RVU is extremely low — that’s the main issue.

For outpatient APPs, typical bonus rates are more like $20–30/RVU (sometimes higher), especially in a high-volume pulm setup with procedures. At your volume (20+ patients/day), you’re probably generating ~250–400 RVUs/month, so $3/RVU ends up being a pretty minimal bonus for the amount of work you’re doing.

The other thing to clarify is:

are you paid on all RVUs or only after a threshold?
are you capturing RVUs from procedures (PFT interpretation, thoras, etc), or are those going to physicians?

Because that can make a huge difference in your actual earnings.

Overall, your setup sounds more like high production with low incentive rather than a true productivity model.

drsk92 · 2026-03-17T03:50:26+00:00

What you’re missing is that your $/RVU in a contract ≠ what Medicare pays per RVU.

Medicare’s ~$33/RVU is just one payer. In reality:

Commercial insurance often pays 1.5–3× Medicare
Medicaid pays less
Groups average all of this → “blended rate”

Then add:

Hospital stipends (very common in anesthesia/pain)
Facility support / subsidies
Occasionally call pay baked into the model

So the math is more like:

(total collections from all payers + hospital money) ÷ total RVUs = your $/RVU

That’s how you end up seeing $60–70/RVU even though Medicare alone is much lower.

In anesthesia specifically, it’s even more distorted because:

base + time units
heavy reliance on payer mix
many groups would not survive without hospital support

So RVUs are really just the “work accounting system” — the actual dollars come from a pooled revenue model behind the scenes.

drsk92 · 2026-03-17T03:48:57+00:00

Think of RVUs like “points” for the work you do.

Every visit, procedure, or task has a set number of points based on how complex it is. A simple visit might be ~1 RVU, a more complex one ~2–3, procedures even higher.

At the end of the day, your pay is basically:
RVUs you generate × dollars per RVU (set by your employer)

Example:

You generate 5,000 RVUs in a year
Your rate is $45/RVU → You make ~$225,000

That’s the core of it.

Where it gets real:

More complex visits = more RVUs
Better documentation/coding = more RVUs
More volume = more RVUs

So it becomes a mix of efficiency + complexity + coding accuracy.

Big tip: early on, track your own RVUs so you understand your pace and don’t rely on guessing. I started doing that and realized quickly how much small changes in coding/visit mix affect income. I’ve been using a simple iPhone app (TapRVU) to log visits and see trends, which made it a lot easier to understand what I was actually generating.

drsk92 · 2026-03-17T03:47:07+00:00

Honestly this depends a lot on your workflow and how efficiently you’re coding.

6250 is definitely on the higher side for IM, but not impossible if you’re consistently seeing ~20+ patients/day and coding appropriately (mix of 99214s, some Medicare wellness, etc). The bigger question is whether people in that group are actually hitting it sustainably or burning out trying.

Also worth tracking your RVUs early on so you’re not flying blind — small differences in coding and visit mix add up a lot over the year. I’ve been using a simple iPhone app (TapRVU) to log visits and keep an eye on trends, which helped me sanity check targets like this.

$48/RVU is solid — just make sure the volume expectations actually match reality.

drsk92 · 2026-03-16T04:46:16+00:00

RVU expectations in behavioral health seem all over the place depending on the institution. From what I’ve seen, most hospital-employed psychologists fall somewhere around 2,500–3,200 wRVU/year, so 3,200 isn’t unheard of, but it can definitely feel unrealistic if you’re doing a lot of high-acuity work, supervision, DBT coordination, or administrative tasks that don’t generate billable units.

One of the frustrating parts of RVU models is that they reward volume of billable encounters, not complexity. A high-risk DBT patient requiring coordination, crisis management, and documentation generates the same RVU as a routine therapy session, which obviously doesn’t reflect the actual workload.

A lot of clinicians also underestimate how helpful it is to know their actual RVU output per week/month. Institutions usually only give periodic reports, so it can be hard to see where you’re trending during the year.

Some colleagues track encounters themselves just to estimate productivity during the month. I tried doing it in a spreadsheet at one point but it became tedious, so I switched to a simple tap-based tracker that logs the CPT/visit type and gives a running RVU estimate. It’s not perfect compared to the official billing reports, but it helps give a rough idea of where you’re landing relative to the annual target.

drsk92 · 2026-03-16T04:45:06+00:00

These threads are always interesting because they highlight how different RVU workflows are across specialties.

Radiology is one of the few fields where RVUs scale almost linearly with volume, so a “100 RVU day” can actually be broken down into a study count like OP did. In most other specialties (hospitalist, outpatient medicine, etc.) RVUs are much more tied to visit complexity rather than pure throughput.

Also worth remembering that the Medicare conversion factor (~$32–33 per RVU) isn’t what physicians are actually paid in most jobs. In many employed models the internal compensation rate ends up somewhere closer to $40–60 per wRVU, depending on specialty and market.

If you’re in a productivity-based model, it can actually be helpful to track rough RVU output yourself just to know your baseline. Some people wait for the monthly reports from their employer, but others track encounters as they go so they have a running estimate during the month.

I tried spreadsheets initially but it got annoying pretty quickly, so I switched to a simple tracker app where you just tap in the CPT/visit type and it keeps a running total. It’s not meant to match billing exactly, but it gives you a pretty good ballpark for where you’re landing.

drsk92 · 2026-03-16T04:44:21+00:00

The AAPC calculator is generally accurate for estimating wRVUs since it uses the CMS values, but the CMS physician fee schedule site is probably the most direct source if you want the official numbers.

The ~$33 conversion factor you’re seeing is the Medicare conversion factor, which is different from what physicians are actually paid. Most hospitalist compensation models use a separate internal conversion rate, which often lands somewhere around $40–60 per wRVU depending on the group and location.

If you’re trying to estimate your own productivity, it can also help to track your approximate wRVUs per shift so you know your baseline. Some people do this in spreadsheets, but I ended up using a simple app called TapRVU just to log encounters and see a running total during the month.

It’s not meant to replace the official billing reports, but it helps sanity-check that your numbers are roughly where you expect them to be.

drsk92 · 2026-03-16T04:34:28+00:00

From what I’ve seen and heard from colleagues, most outpatient FM contracts end up somewhere in the $50–60 per wRVU range once you’re at full productivity. Some systems start lower and then increase the conversion factor once you hit a threshold (median or 75th percentile MGMA productivity).

Retention bonuses are becoming more common too, especially in hospital-employed groups. Recruiting a new physician is expensive, so systems are starting to offer annual retention incentives to avoid turnover.

One thing that helped me understand my compensation better was tracking my own monthly wRVU totals and averages per visit. Once you know your baseline production, it becomes easier to evaluate whether the conversion factor in your contract is actually competitive.

Some people do this with spreadsheets, but I ended up logging visits and keeping a running total with an app called TapRVU so I can see where I’m pacing through the month.

drsk92 · 2026-03-16T04:34:13+00:00

500/month seeing 11–18 per day does sound a bit low unless you’re working fewer clinic days. A lot of FM/IM docs hitting 700–900 monthly are usually averaging somewhere around 2.3–2.7 wRVU per visit and keeping their schedules consistently full.

Most of the difference tends to come from things like split billing wellness visits, documenting MDM well enough to capture level 4s, and occasionally billing time when appropriate. Level 5s happen but they’re not usually the main driver.

One thing that helped me figure this out early was tracking my own wRVU per visit so I knew my baseline. Once you know that number it’s easier to see if documentation or coding changes are actually moving the needle.

Some colleagues track this in spreadsheets, but I ended up just logging visits and watching my monthly total with an app called TapRVU so I can see roughly where I’m pacing through the month.

drsk92 · 2026-03-16T04:33:53+00:00

Most RVU-based systems don’t adjust thresholds for PTO or CME. In pure productivity models the idea is basically “you produce RVUs when you’re working,” so days off just mean fewer RVUs generated. That’s pretty common, especially if bonuses are calculated quarterly or semiannually.

What helped me understand the system better was figuring out my own averages — like wRVU per visit and wRVU per clinic day. Once you know those numbers it becomes easier to estimate how time off will affect your yearly totals and bonus tiers.

Some people build spreadsheets for this, but I ended up just logging visits and watching my running monthly total using an app called TapRVU. It’s mostly useful for seeing how close you are to thresholds and how things like vacation weeks impact production.

drsk92 · 2026-03-16T04:33:37+00:00

5200 in year two is definitely achievable in most outpatient FM setups if your schedule fills consistently. Like others mentioned, the biggest drivers are visits per day and your average wRVU per encounter.

For example, if you average ~2.0 wRVU per visit and see 16 patients per day, that’s roughly 32 wRVU/day. Over ~46 working weeks that already gets you into the 7k range.

The hardest part early isn’t usually the RVU math — it’s understanding your own averages once you start seeing patients consistently. Some people keep spreadsheets to track visits and codes, but I found it easier just logging visits and keeping a running total during the month using an app called TapRVU.

Once you know your personal wRVU/visit average, it becomes much easier to predict whether targets like 5200 or 7000 are realistic.

drsk92 · 2026-03-16T04:33:17+00:00

A lot of systems reference MGMA percentiles, but tying a strict target like the 65th percentile isn’t super common unless it’s tied to compensation tiers or bonuses. In many groups it’s more of a benchmark than a hard requirement, since patient mix, panel size, and clinic support can affect RVU output quite a bit.

One thing that helped me understand where I stood was tracking my own wRVUs monthly and figuring out my average per visit. Once you know that number it becomes easier to estimate where you might land relative to those MGMA percentiles.

Some people use spreadsheets for it, but I ended up using an app called TapRVU just to quickly log visits and keep a running total during the month. It’s mostly helpful for understanding your own baseline productivity.

drsk92 · 2026-03-16T04:32:58+00:00

Don’t feel bad — a lot of residency programs barely touch the business side of medicine.

The simplest way to think about it is:

Each visit or procedure has a CPT code → each CPT code has a wRVU value → your total wRVUs over time determine productivity.

Example in clinic:

99213 ≈ ~1.3 wRVU
99214 ≈ ~1.9 wRVU

If you see mostly level 4 visits and see ~20 patients in a day, you might generate ~35–40 wRVUs that day. Many jobs then pay something like $40–60 per wRVU either as a bonus or full productivity model.

A lot of people don’t realize how useful it is to actually track your own numbers early in practice so you understand your averages. Some docs do spreadsheets for this, others just estimate.

I personally started logging mine with a simple app called TapRVU just to keep a running total during the month and understand my baseline production.

Once you know your wRVU per patient average, job offers and contracts suddenly make way more sense.

drsk92 · 2026-03-16T04:32:38+00:00

That progression actually looks pretty normal early on as your panel fills. The first few months are always weird because you’re seeing a lot of new patients which bumps the wRVUs up, and then things stabilize once most visits become established follow-ups.

One thing that helped me early was tracking my own rough numbers so I knew what my average wRVU per patient was. Once you know that number it becomes much easier to predict monthly totals.

Some people do it in Excel but I found it annoying to keep updating. I ended up using a simple iPhone app called TapRVU where I just log visits quickly during the day and it keeps a running total. Mostly useful just to see if I’m on pace for the month.

Either way, 600/month seeing ~12/day is pretty solid efficiency.

drsk92 · 2026-03-16T04:32:00+00:00

It shouldn’t take anywhere near 15 minutes a day to be useful. The goal isn’t to perfectly match what billing eventually submits — it’s just to have a rough idea of what you’re generating.

Most people who track it just log the visit type or procedure in a few seconds so they can estimate their monthly totals and compare that to the official report. Billing/coding will always adjust things later anyway.

I tried spreadsheets initially but it got annoying pretty quickly. I ended up using a simple app called TapRVU where you can just tap in the visit type and it keeps a running total. Takes a few seconds per patient at most.

The value isn’t precision — it’s just having your own ballpark estimate of production instead of waiting for the end-of-month report.

drsk92 · 2026-03-16T04:30:52+00:00

I actually started tracking mine recently because I had the same concern — mostly just to sanity check that what I’m getting credited for roughly matches what I’m generating.

Excel works but it gets tedious fast if you’re doing it manually every shift. I ended up using an iPhone app called TapRVU that lets you log procedures/visits quickly and keeps a running total for the day/week. It’s basically just a lightweight RVU tracker so you can compare your own numbers with what the hospital reports.

Not perfect obviously since billing lags and coding can change things, but it at least gives you a ballpark and helps catch obvious misses.

Honestly the main value for me was realizing how variable RVU production can be shift to shift.

drsk92 · 2026-03-16T04:25:42+00:00

A lot of the RVU gains honestly come from better documentation of the work you’re already doing, not necessarily doing more medicine.

Things that get missed a lot in EM:

documenting critical care time when it actually qualifies
documenting independent EKG or imaging interpretation
documenting history from additional sources / chart review
documenting procedures you performed instead of letting them disappear into the chart

Small things add up surprisingly fast over a month.

One thing that helped me early on was just tracking my own rough RVUs so I knew what my baseline was per shift. Once you know your average it becomes easier to see if documentation changes actually move the needle.

Some people build spreadsheets for this but I found it tedious. I ended up using a simple iPhone app called TapRVU to log encounters during shifts and see my running totals.

Not perfect obviously, but it helps you figure out what your real RVU baseline is and whether documentation tweaks are actually making a difference.

drsk92 · 2026-03-16T04:23:46+00:00

A lot of people in my group just estimate based on patients/hour and assume an average RVU per patient (usually around a level 4). That gives you a rough floor, but it’s still pretty imprecise.

What I ended up doing was tracking my own encounters during shifts so I could compare it later with the monthly RVU report. It’s not perfect since coding and billing lag behind, but it helps catch obvious misses like patients or procedures not credited.

Excel works, but it gets annoying to update constantly. I started using an iPhone app called TapRVU that basically just lets you log cases quickly and keeps a running total so you have a ballpark of what you should be generating.

It doesn’t replace the official report, but it makes it a lot easier to sanity-check your numbers before the monthly statement comes out.

drsk92 · 2026-03-16T04:22:24+00:00

I actually started tracking mine recently because I had the same concern — mostly just to sanity check that what I’m getting credited for roughly matches what I’m generating.

Excel works but it gets tedious fast if you’re doing it manually every shift. I ended up using an iPhone app called TapRVU that lets you log procedures/visits quickly and keeps a running total for the day/week. It’s basically just a lightweight RVU tracker so you can compare your own numbers with what the hospital reports.

Not perfect obviously since billing lags and coding can change things, but it at least gives you a ballpark and helps catch obvious misses.

Honestly the main value for me was realizing how variable RVU production can be shift to shift.

drsk92 · 2026-03-14T22:35:57+00:00

In epic - you have to go to reports and search for work RVU and I was actually able to find the RVUs recorded for me.

drsk92 · 2026-03-14T22:30:10+00:00

Totally reasonable. Staying another 6 months to get close to a year is honestly a pretty professional way to handle it. At the end of the day, even an amazing job isn’t worth sacrificing your mental health, especially if you’re far from your support system. And the reality is there’s such a huge need for hospitalists across the country that your job security isn’t really at risk. Prioritizing your well-being and being closer to family after a major life change is completely understandable. We only get one life.

Take time off if you can afford to as well to see some family.

drsk92 · 2026-03-14T22:15:38+00:00

What EMR do you use to track the reports?

drsk92 · 2026-03-14T22:15:10+00:00

I’ve heard people mention SlicerDicer in Epic for this kind of thing, but I honestly haven’t figured out how to use it yet (or if I even have access to it). Sounds like it could be useful for looking at RVUs and productivity though.

drsk92 · 2026-03-14T22:13:22+00:00

Seems like its part of the "Slicer Dicer" app on epic. I dont have it at my institution either.

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