How to Check If You're Being Paid for All Your wRVUs

Why this check matters

If your compensation is tied to work relative value units (wRVUs), your paycheck depends on a long chain of steps you rarely see: your documentation becomes a CPT code, the CPT code maps to a wRVU value, your billing team submits it, a payer accepts or denies it, and your employer's system tallies the credited wRVUs onto a productivity report. A break anywhere in that chain quietly costs you money. Dropped charges, miscoded encounters, visits attributed to the wrong provider, denied claims that were never reworked, and reports that exclude certain encounter types are all common, and none of them announce themselves on your pay stub.

The good news: you do not need access to your employer's billing system to audit this. With your own encounter list and the published wRVU values, you can reconstruct what you should have been credited and compare it to what you were actually paid for. This guide walks through that reconciliation step by step.

First, get the vocabulary exactly right

Two numbers get confused constantly, and confusing them will make your math wrong. Keep them separate:

• A code's wRVU value comes from the CMS Physician Fee Schedule (PFS). It is a fixed, published measure of the physician work in a service. For example, an established-patient visit coded 99214 is worth about 1.92 work RVUs in the current schedule. This number is the same no matter who employs you.
• Your pay equals your credited wRVUs multiplied by your employer's negotiated dollars-per-wRVU rate. That rate is set in your contract and commonly lands roughly in the ~$45 to ~$90+ range depending on specialty, market, and percentile, with primary care often nearer the lower end and surgical or procedural subspecialties toward the top.

The number you must not use for your pay math is Medicare's conversion factor. That figure (about $33.40 per RVU for non-qualifying APM participants in 2026, or $33.57 for qualifying APM participants) is what Medicare multiplies by a code's total RVUs to decide what to reimburse a practice for a claim. It is a billing number, not a pay rate, and it has actually drifted downward over the years (roughly $36 in 2019 to about $33 today) even as employer pay-per-wRVU rates have risen. Your employer's $/wRVU rate is a separately negotiated compensation rate and is typically much higher than the Medicare conversion factor. Mixing the two up is the single most common error in self-audits.

The formula you are verifying

Expected productivity pay = (sum of the wRVU value of every service you personally performed and that should be credited) x (your contracted $/wRVU rate). Your job in this audit is to independently build the left side of that equation and confirm the report and paycheck agree.

Step 1: Track your own encounters and CPT codes

You cannot reconcile a report you cannot reproduce. Starting now, keep an independent log of what you do each clinical day. You do not need the billing system for this; you need a disciplined habit. Capture, per encounter:

• Date of service and patient identifier you can match later (initials plus visit date, or your own MRN shorthand, keeping it secure and HIPAA-appropriate)
• The primary service code you believe applies (E/M level, procedure, etc.)
• Any additional billable procedures or services performed the same visit (e.g., a joint injection, a skin biopsy, an unrelated significant E/M with a -25 modifier)
• Whether it was a new or established patient, and the site of service

A few practical notes that protect your count:

• Separately billable procedures are easy to lose. If you did an E/M and a procedure, both can carry wRVUs. Confirm both show up later.
• Modifier-25 and -59 visits are frequent points of leakage. If a payer or coder strips the modifier, you can lose the wRVUs for one of the two services.
• Inpatient, after-hours, telehealth, and cross-coverage encounters sometimes route to a different attribution and silently fall off your individual report.

Even a simple spreadsheet maintained in near-real-time is enough. The point is to have a source of truth that does not depend on the department you are auditing.

Step 2: Look up the wRVU value of each code

Assign the published work RVU to each service from the current CMS Physician Fee Schedule. Use the work RVU column specifically, not the total RVU and not the facility/non-facility payment amount. The wRVU is the portion that reflects physician work and is what virtually all productivity-comp plans credit.

For the high-volume outpatient E/M codes, keep current values handy. Office-visit work RVUs were substantially increased effective January 1, 2021, so any older cheat sheet will undercount you. For context on the magnitude of that change:

Established-patient office codes (99212-99215) rose by roughly 28% on average in that overhaul, alongside the documentation simplification that let you bill on medical decision-making or total time. Always confirm the exact figure for the year you are auditing against, since values are updated annually.

One important consequence of the 2021 change worth understanding: because the wRVU values jumped, many physicians saw their measured productivity rise for the same clinical work, and a number of employers responded by re-basing their $/wRVU rates downward that year to keep total pay roughly neutral. So when you compare years, verify both the wRVU values and the contracted rate that applied in each period.

Step 3: Compute your expected wRVUs

Now total it up. For the period you are checking (a pay period, a month, or a quarter), sum the work RVU of every service in your log. A worked example for a single day of established-visit codes:

• 6 x 99213 at ~1.30 = 7.80 wRVU
• 8 x 99214 at ~1.92 = 15.36 wRVU
• 1 x joint injection (add its own published work RVU)

That gives roughly 23.16 wRVUs for the office visits alone that day, before the procedure. Extend the same arithmetic across the full period to get your expected credited wRVUs.

Then translate to dollars only to sanity-check against your pay: multiply your expected wRVUs by your contracted $/wRVU rate. If your contract pays, say, $55/wRVU, the example day's office visits represent about 23.16 x $55 = $1,273.80 in productivity compensation. Keep this dollar figure as a reference, but remember the cleaner comparison in the next step is wRVU-to-wRVU, because that isolates whether the credit is right before any rate question enters.

Step 4: Reconcile against the productivity report

Request your detailed, line-level productivity report from your group or finance office, not just the summary total. You want the version that lists encounters or CPT codes with the wRVUs credited to each, ideally with dates of service. Then reconcile in two passes:

1. Count match. Does the number of encounters on the report match your log for the same dates? Missing encounters are the clearest sign of leakage, often from claims that denied, posted to the wrong provider, or were never charged.
2. Value match. For the encounters that are present, does the credited wRVU per code match the published value you looked up? A 99214 credited as a 99213, or credited at an outdated wRVU value, shortchanges you on every instance.

Watch specifically for these recurring problems:

• Down-coding: the level billed is lower than what you documented and performed.
• Dropped procedures: the same-day procedure or the second service behind a -25/-59 modifier never appears.
• Attribution errors: shared-visit, locum, or resident/APP-involved encounters credited to the wrong clinician.
• Denied-and-abandoned claims: a denial that was never reworked may also mean no wRVU credit, depending on your plan's rules, so confirm how your contract treats denials.
• Excluded encounter types: some reports omit telehealth, certain payers, or no-charge visits entirely.

Then check the report against your paycheck

The report and the pay stub are two different documents and can disagree. Confirm: total credited wRVUs on the report x your contracted rate = the productivity dollars on your pay. Reconcile your contract's mechanics too: the rate tier you fall in, any wRVU threshold or draw/guarantee structure, and the lag (many groups pay wRVUs a month or a quarter in arrears, so align the periods before concluding anything is missing).

Step 5: What to do about a discrepancy

If the numbers do not line up, work from documentation rather than frustration. A short, specific, evidence-backed inquiry gets fixed faster than a general complaint.

1. Isolate the gap. Decide whether it is a credit problem (encounters or wRVU values missing or wrong on the report) or a payment problem (report is right, paycheck does not match). They go to different people.
2. Build the line-item list. Identify the specific dates of service and codes that are missing or undervalued, with your log and the published wRVU value next to each.
3. Route credit problems to coding/billing. Ask them to trace each missing encounter: was it charged, did it deny, was it attributed elsewhere, was a modifier stripped? Ask for the corrected wRVU credit once resolved.
4. Route payment problems to finance/comp administration. Reference your contract's rate, tier, and timing language explicitly, and show the arithmetic.
5. Confirm the lookback window. Ask how far back corrections can be made and request retroactive adjustment for verified errors. Get the resolution in writing.
6. Re-audit next period. If a systemic issue caused it (a report that excludes a payer, a coding pattern, an attribution rule), verify the fix held rather than assuming it did.

None of this requires an adversarial posture. Most discrepancies are honest pipeline errors, and a clinician who tracks their own wRVUs accurately is simply the most reliable check the system has.

A simple ongoing habit

The hard part of this audit is not the math, it is having an independent record to compare against. If you log encounters and codes as you go, look up the current work RVU for each, and reconcile every pay period, you will catch leakage in weeks instead of discovering it at a year-end true-up that may already be closed. Treat it as a standing process, not a one-time investigation, and the report stops being a black box.