97%
Will the CY2027 Medicare Physician Fee Schedule final rule set the conversion factor for clinicians outside a qualifying APM below 2026's $33.4009?
Forecast 2026-10-21 · resolves by 2026-12-31
Contracts · Clause library
Compensation and wRVU clause
How you are paid: a guaranteed base salary, a productivity formula (often per wRVU, the work relative value unit), bonuses, or a mix. The formula and when the guarantee ends matter as much as the starting number.
Physician's compensation will be determined annually by the Employer based on productivity and other factors at the Employer's discretion.
Physician will receive a guaranteed base salary of $[X] per year for the first two years, plus $[Y] per wRVU above [Z] wRVUs per year, paid quarterly.
Sample wording written by Andwise for illustration. It is not model contract language.
Questions to ask
- How long is the base salary guaranteed, and what replaces it afterward?
- Which year's CMS RVU values does the contract use, and what happens to your threshold when CMS revalues codes?
- What is the dollar rate per wRVU, and can the employer change it during the contract?
- Who decides which bonus targets were met, and is that decision written into the contract?
How wRVU pay works
Under a productivity model, pay is the number of work RVUs (wRVUs) you generate multiplied by a dollar rate per wRVU, often only above a threshold and sometimes on top of a guaranteed base. Each service's wRVU value comes from Medicare's Physician Fee Schedule, which CMS revises every year.
That makes three numbers matter: the rate per wRVU, the threshold, and which year's fee schedule assigns the wRVU values.
The 2026 Medicare change
For 2026, CMS reduced work RVUs by 2.5% for services that are not time-based, calling it an efficiency adjustment. Evaluation and management visits, care management, behavioral health services, services on the Medicare telehealth list and codes new for 2026 are exempt. CMS says it will apply the adjustment every three years.
If a contract credits wRVUs from the current fee schedule, the same procedures can earn fewer wRVUs in 2026 than in 2025, and a physician near a threshold can see lower productivity pay with no change in work.
Sources: CMS fact sheet: CY 2026 Physician Fee Schedule final rule (CMS-1832-F) · Final rule, 90 FR 49266 (Nov. 5, 2025)
Which year's values the contract uses
Contracts handle this in different ways. Many use the most recent fee schedule; others fix the values from a specific year, such as the year the contract was signed, and some organizations kept paying on 2025 values after the 2026 change. Look for the clause that names the schedule year, whether the threshold and rate are adjusted when CMS revalues codes, how often wRVUs are reconciled, and whether payments above a guarantee can be taken back.
For pay benchmarks, published surveys such as Doximity's annual physician compensation report and MGMA's data are the usual references. This site does not reproduce them.
Sources: Hall Render: CMS wRVU updates will impact physician compensation models (2020) · Holland & Hart: wRVU compensation formulas, time to review (2020) · PYA: 2026 wRVU changes and physician compensation planning (2026)
In the contract guide
Outlook
Dated forecasts, scored when they resolve. All forecasts and the track record →
40%
Will Congress enact a law by March 31, 2027 that raises 2027 Medicare physician payment above the conversion factor in the CY2027 final rule?
Forecast 2026-10-21 · resolves by 2027-03-31
Not legal advice. How a clause works in your contract depends on its exact wording and your state's law. Have an attorney licensed in your state review it before you sign.