What Is an RVU?
An RVU, or relative value unit, is the standard Medicare uses to measure how much a physician service is worth compared to every other service. Each CPT code gets an RVU value, and that value, multiplied by a dollar conversion factor, sets what Medicare pays.
RVU definition in plain English
RVUs put every medical service on one shared scale. A routine office visit might be worth about 3 total RVUs and a total knee replacement about 35, so the knee replacement is valued roughly ten times higher. The number itself is not dollars. It only becomes money once it is multiplied by a conversion factor.
The system behind RVUs is called the Resource-Based Relative Value Scale (RBRVS). Medicare adopted it in 1992, and today most commercial insurers and employers use it too, either to set fees or to measure physician productivity.
The three parts of an RVU
Every CPT code has three separate RVU values. Added together, they make the total RVU.
| Component | What it pays for | Share of total (approx.) |
|---|---|---|
| Work RVU (wRVU) | The physician's time, skill, mental effort, and stress | About half |
| Practice expense RVU (PE) | Staff, equipment, supplies, and office overhead | About 45% |
| Malpractice RVU (MP) | Professional liability insurance | About 4% |
Practice expense has two versions. Non-facility PE applies to services done in an office. Facility PE applies in a hospital or surgery center, where the facility covers the overhead, so it is usually lower. Work RVUs are the same in both settings. To learn more about the work component, read What is a wRVU?.
How RVUs turn into payment
Medicare adjusts each component for your location using a Geographic Practice Cost Index (GPCI), adds them up, and multiplies by the conversion factor:
Payment = [(Work RVU × Work GPCI) + (PE RVU × PE GPCI) + (MP RVU × MP GPCI)] × Conversion factor
For 2026, CMS set two conversion factors: $33.4009 for most physicians and $33.5675 for qualifying participants in alternative payment models. You can look up your local adjustment on the GPCI by state page.
Example: a 99214 office visit
CPT 99214, an established patient visit of moderate complexity, has 4.06 total RVUs in 2026 (non-facility). Using the national rate with no geographic adjustment:
4.06 total RVUs × $33.4009 = about $135.61
Of those 4.06 RVUs, 1.92 are work RVUs. That smaller number is the one most employed physicians are paid on. Compare it with the next level up in 99214 vs 99215.
Who sets RVU values?
- The AMA/Specialty Society RVS Update Committee (the RUC) surveys physicians and recommends values for new and revised codes.
- CMS reviews those recommendations and publishes final values each year in the Medicare Physician Fee Schedule.
- New values take effect on January 1. Changes in a given year can raise or lower the RVUs for codes you bill every day. See what changed in 2026 RVU changes.
Why RVUs matter to physicians
- Pay: many employment contracts pay a set amount per work RVU or add a bonus above a yearly wRVU target.
- Productivity: health systems compare your RVUs with specialty benchmarks. See benchmarks by specialty.
- Negotiation: knowing your real RVU volume gives you leverage when a contract is renewed.
- Accuracy: tracking your own RVUs lets you catch missed charges or under-credited work before payroll does.
Common questions
What does RVU stand for?
RVU stands for relative value unit. It is the measure Medicare uses to rank the value of physician services against each other.
What is the difference between an RVU and a wRVU?
An RVU usually means the total RVU, which combines work, practice expense, and malpractice. A wRVU is only the work part, which reflects the physician's own effort and is the number most often used for physician pay.
How much is one RVU worth in 2026?
Under Medicare, one RVU is worth the conversion factor: $33.4009 in 2026 for most physicians, before geographic adjustment. Employers who pay per work RVU set their own rate, which is usually much higher.
Do RVUs change every year?
Yes. CMS updates RVU values and the conversion factor every year in the Physician Fee Schedule, effective January 1.
Where can I find the RVU value for a CPT code?
Search any code in the free CPT code lookup on wRVU Tracker. It shows work, practice expense, malpractice, and total RVUs from official CMS data.
Keep learning
- What is a wRVU? — The work RVU and how it drives physician pay
- How to calculate RVUs — Step-by-step formulas with real examples
- CPT code lookup — RVU values for every code from CMS data
- GPCI by state — Geographic adjustments for your location
- 2026 RVU changes — Which codes went up or down this year
- Most common CPT codes — Top-billed codes by specialty