Physician RVU Calculator 2025
* The 2025 proposed conversion factor is approximately $32.35 (Subject to final CMS rule).
2025 Calculation Results
Understanding the 2025 RVU System
The Relative Value Unit (RVU) system is the standard method used by Medicare (CMS) and private insurers to determine physician compensation. As we move into 2025, understanding the components of your reimbursement is critical for practice management and financial forecasting.
The Three Components of an RVU
- Work RVU (wRVU): Accounts for the physician's time, technical skill, and mental effort required to perform a specific procedure or service.
- Practice Expense RVU (peRVU): Covers the overhead costs of running a medical practice, including rent, non-physician staff salaries, and medical supplies.
- Malpractice RVU (mpRVU): Represents the cost of professional liability insurance premiums associated with the specific CPT code.
What is GPCI?
The Geographic Practice Cost Index (GPCI) adjusts the three components of the RVU based on the local cost of living and doing business in a specific area of the United States. A GPCI of 1.00 represents the national average. If you practice in a high-cost area like Manhattan or San Francisco, your GPCI will likely be higher than 1.00.
The 2025 RVU Formula
To calculate the total reimbursement for a CPT code, use the following standardized formula:
2025 Conversion Factor Update
The Conversion Factor (CF) is the dollar amount assigned to a single RVU. For 2025, the proposed conversion factor has faced adjustments to account for budget neutrality and the expiration of temporary legislative increases. As of the latest updates, the 2025 CF is projected at approximately $32.35, representing a decrease from the 2024 rate of $33.28. This makes maximizing coding accuracy more important than ever.
Example Calculation
Let's look at a hypothetical office visit (CPT 99213) in an area with average costs (GPCI 1.0):
| Component | RVU Value | GPCI |
|---|---|---|
| Work (wRVU) | 1.30 | 1.000 |
| Practice Expense | 1.00 | 1.000 |
| Malpractice | 0.07 | 1.000 |
Total RVU: 2.37
2025 Payment: 2.37 × $32.35 = $76.67
Frequently Asked Questions
CMS typically updates RVU values and GPCIs annually in the Physician Fee Schedule (PFS) Final Rule, usually released in November for the following calendar year.
The conversion factor often decreases due to the "Budget Neutrality" requirement, where increases in one area of Medicare spending must be offset by cuts elsewhere, combined with the expiration of temporary funding from Congress.
This calculator allows you to input specific PE RVUs. Note that PE RVUs differ significantly between "Facility" (Hospital) and "Non-Facility" (Private Office) settings. Always ensure you are using the correct PE RVU for your site of service.