This calculator applies the CMS Medicare Physician Fee Schedule formula to compute the payment allowable for any CPT-coded service. You enter the three RVU components and their GPCI adjustments, and the calculator multiplies by the annual conversion factor.
Work RVU (wRVU): Represents physician time, effort, technical skill, and mental stress. Typically the largest component.
Practice Expense RVU (peRVU): Covers non-physician overhead: staff wages, equipment, supplies, and office costs.
Malpractice RVU (mpRVU): Reflects the malpractice insurance premium associated with the service. Usually the smallest component.
Who Is This Calculator For?
This tool is built for physicians, practice managers, and billing professionals who need to estimate Medicare reimbursement without opening a full billing system.
Physicians
Evaluate fair compensation relative to wRVU productivity in employment contracts.
Practice Managers
Model revenue by service line and identify high-value CPT codes.
Hospital Administrators
Benchmark physician productivity and payer mix against national norms.
Billing Specialists
Verify expected reimbursement before claims are submitted to Medicare.
Contract Negotiators
Use per-wRVU payment rates to negotiate commercial payer contracts.
Medical Students
Understand how physician income connects to clinical activity volume.
When Should You Use It?
Before signing a physician employment contract to understand the per-wRVU compensation value
When modeling annual revenue for a new service line or practice expansion
To estimate the payment impact of switching CPT codes or adding modifiers
During commercial payer contract negotiations using Medicare as a benchmark
How to Use This Calculator
1
Look up your CPT code RVU values
Go to the CMS Medicare Physician Fee Schedule Look-Up Tool and search by CPT code to find the wRVU, peRVU, and mpRVU values for your service.
2
Find your GPCI values
GPCI values are published by CMS by locality. Search for your state or county to find the three separate GPCI values (work, practice expense, malpractice).
3
Enter the conversion factor
The 2025 CMS conversion factor is $33.89. Enter a different value if your payer uses a custom multiplier of the Medicare CF.
4
Enter annual volume for revenue modeling
Enter how many times per year you bill this code to see projected annual revenue. Leave blank for per-claim calculation only.
5
Interpret the results
The total payment is the pre-adjustment Medicare allowable. Your actual payment may differ based on payer contracts, modifiers, and site-of-service rules.
Example Calculation
Dr. Nguyen bills CPT 99214 (office visit, moderate complexity) from a non-facility office in Chicago. She sees this code approximately 3,000 times per year.
wRVU = 1.92, wGPCI = 1.030 (Chicago)
peRVU = 1.53, peGPCI = 1.080
mpRVU = 0.10, mpGPCI = 0.920
Adjusted RVUs = [1.978 + 1.652 + 0.092] = 3.722
Payment = 3.722 × $33.89$126.12
Annual revenue at 3,000 claims$378,360
Disclaimer: This calculator shows the Medicare allowable, not the actual remittance. Medicare pays 80% of the allowable after deductible. Verify with your payer contract for actual reimbursement.
Common Mistakes to Avoid
!
Using the wrong facility/non-facility RVU
CMS publishes separate peRVU values for facility and non-facility settings. Using the wrong value can result in significant over- or under-estimation.
!
Ignoring GPCI adjustments
High-cost localities (Manhattan, San Francisco) have GPCI values above 1.0. Skipping GPCI gives national average rates, not what Medicare actually pays in your area.
!
Confusing Medicare allowable with payment
Medicare pays 80% of the allowable after the patient's deductible. This calculator shows the total allowable, not what Medicare remits directly.
!
Assuming commercial payers mirror Medicare rates
Commercial contracts are often expressed as a percentage of the Medicare fee schedule. Multiply this calculator's output by your contract's Medicare multiplier.
!
Using last year's conversion factor
CMS updates the CF annually, sometimes mid-year. Always confirm you are using the current-year published value.
Frequently Asked Questions
A Relative Value Unit is a measure of the resources required to perform a medical service. CMS divides it into three components: physician work (effort, time, training), practice expense (overhead), and malpractice insurance.
CMS Medicare Physician Fee Schedule Final Rule 2025
Establishes the 2025 conversion factor ($33.89), RVU values, and GPCI adjustments by locality.
2
CMS Medicare Physician Fee Schedule Look-Up Tool
Official database for searching RVU values by CPT code, year, and facility/non-facility setting.
3
MGMA Physician Compensation and Production Survey
Provides national benchmarks for wRVU productivity and per-wRVU compensation rates by specialty.
M
Marcus Rivera, MHA
Healthcare Finance Consultant, 14 years
Marcus specializes in physician compensation modeling and payer contract analysis for large health systems. He built this tool to help clinicians and administrators understand how the RVU system translates clinical work into reimbursement.
Reviewed: April 2025Last updated: April 2025
Common CPT Code RVUs (2025)
CPT
wRVU
Total
99213 (Level 3 OV)
1.30
2.35
99214 (Level 4 OV)
1.92
3.43
99215 (Level 5 OV)
2.80
4.73
99203 (New Pt L3)
1.60
3.36
99204 (New Pt L4)
2.60
5.40
99232 (Hosp Follow)
1.39
2.49
99233 (Hosp Follow)
2.00
3.53
Non-facility values. Verify at CMS MPFS.
Conversion Factor History
2025current
$33.89
2024
$32.74
2023
$33.06
2022
$34.61
2021
$34.89
Pro Tip
Divide your annual salary by projected wRVUs to find your per-wRVU rate. MGMA benchmarks for primary care average $52–$58 per wRVU. Compare this before signing an employment contract.