---
title: "Why is my wRVU production bonus lower in 2026?"
canonical: "https://www.joinandwise.com/answers/wrvu-cut-2026"
checked: "2026-10-22"
claim: "andwise:answer/wrvu-cut-2026@2026-10-22"
license: "CC BY 4.0"
---

# Why is my wRVU production bonus lower in 2026?

CMS cut work RVUs by 2.5% for non-time-based services starting in 2026, so the same patient volume credits fewer wRVUs. At benchmark volume that is about $6,380 a year for neurosurgery, $5,745 for orthopedic surgery, $4,543 for general surgery and $167 for psychiatry. If your contract sets a wRVU target and a rate per wRVU, the cut lands on you unless the contract restates to prior-year values or adjusts the rate.

## The rule

The CY2026 Physician Fee Schedule applied a −2.5% efficiency adjustment to work RVUs for about 7,700 codes that are not time-based. E/M and other time-based codes are exempt. The non-APM conversion factor for 2026 is $33.4009, up from $32.35 in 2025, and CMS plans to revisit the adjustment every three years.

The loss scales with how procedural your practice is. At benchmark volume, psychiatry loses about 5 wRVUs a year because only 5% of its work is procedural; neurosurgery loses about 191 because 85% is. That is why two physicians on the same contract template can see very different bonus changes.

The contract decides whether you absorb it. If pay is a target plus a rate per wRVU, fewer credited RVUs means a smaller bonus for identical work. A contract that restates 2026 wRVUs at 2025 values, raises the rate per wRVU, or uses a hybrid model passes the cut back to the employer. No public source counts how many employers have restated.

Read three numbers before the next contract: the wRVU definition, the rate per wRVU, and whether the target moves with the RVU schedule. A target that stays fixed while credited RVUs fall is the version that costs you the most.

The dollar figures are the value of lost RVUs at the Medicare rate, at benchmark volume. A commercial payer mix or a rate above Medicare scales them; a lower volume scales them down.

## Numbers

- Neurosurgery: ≈$6,380 (191 wRVUs lost at 85% procedural share)
- Orthopedic surgery: ≈$5,745 (172 wRVUs at 88% procedural share)
- General surgery: ≈$4,543 (136 wRVUs at 80% procedural share)
- Dermatology: ≈$3,808 (114 wRVUs at 70% procedural share)
- Psychiatry: ≈$167 (5 wRVUs at 5% procedural share)

## Actions

- Find the wRVU definition, rate and target in your contract. — https://www.joinandwise.com/contracts/check
- Ask for 2026 wRVUs to be restated at 2025 values, or for the rate per wRVU to be adjusted. — https://www.joinandwise.com/contracts/model-clauses
- Model the cut across two offers before you compare base salaries. — https://www.joinandwise.com/contracts/compare
- Get any rate or target change in the contract, not the offer letter.

## What could change this

- Your contract already restates to prior-year values or adjusts the rate — the cut does not reach your pay.
- Your work is mostly time-based E/M — those codes are exempt, so the loss is small.
- Your volume runs well above benchmark — the dollar loss scales up with it.
- Your employer lowers the wRVU target at the same time — the two changes can offset or compound.

## When the numbers aren't enough

- Your contract does not define which year's wRVU values apply.
- Your employer restated the rate without changing the target.
- You are negotiating a production model for the first time.

## Sources

- [CMS: CY 2026 Physician Fee Schedule final rule](https://www.cms.gov/newsroom/fact-sheets/calendar-year-cy-2026-medicare-physician-fee-schedule-final-rule-cms-1832-f)
- [Andwise: specialty malpractice and wRVU benchmarks](/data/specialty-benchmarks.json)

Checked 2026-10-22. General information, not legal, tax or financial advice. The site describes what the law and rules say; it does not say whether a clause is enforceable or what you should do.