RVU Tracking for Nurse Practitioners
More nurse practitioners are paid on productivity, and that productivity is measured in work RVUs. Here is how wRVUs work for NPs, how the Medicare 85% rule fits in, and how to keep your own record so you can check every paycheck.
How wRVU pay works for nurse practitioners
Hospitals, health systems, and large groups increasingly pay NPs the same way they pay physicians: on production. Every CPT code you bill carries a work RVU set by CMS, and your employer adds up your wRVUs and multiplies them by a dollar rate. If you are new to the idea, start with what a wRVU is.
The most common NP productivity setups are:
- A base salary plus a bonus for every wRVU above a yearly threshold
- A straight dollar amount per wRVU, with or without a guaranteed minimum
- Tiered rates, where each wRVU pays more once you pass a set volume
- A productivity score that counts toward a quality or incentive bonus
Your codes carry the same wRVUs as a physician's
The work RVU on a CPT code does not change based on who performs the service. In 2026, a 99214 office visit is 1.92 wRVUs whether a physician or a nurse practitioner sees the patient. What can differ is what Medicare pays for the visit and how your employer credits it to you.
The Medicare 85% rule and your wRVUs
When an NP bills Medicare under their own NPI, Medicare pays 85% of the physician fee schedule amount. That is a payment rule, not a change to the wRVU. Some employers still credit you with the full wRVU, some count 85% of it, and some build the difference into a lower dollar rate.
| Billing route | What Medicare pays | Where it applies |
|---|---|---|
| Under your own NPI | 85% of the fee schedule | Any setting |
| Incident-to | 100%, billed under the physician | Office visits for established patients on a physician's plan of care, with a physician in the office suite |
| Split/shared visit | 100%, billed by whoever did the substantive portion | Hospital and other facility settings |
With incident-to and split/shared billing, the claim may go out under the physician's name, so the wRVUs may be credited to them instead of you. Ask your employer how visits are attributed. That one answer often explains most of the gap between your own count and their report.
Setting your rate in wRVU Tracker
wRVU Tracker logs every code at its full CMS wRVU value, then multiplies your total by the rate you enter for each job. You stay in control: enter the dollar amount from your contract, and if your employer credits you at 85%, enter the adjusted rate so the estimate matches your paycheck.
Effective rate = contract rate × 0.85 (example: $50.00 × 0.85 = $42.50 per wRVU)
Work at more than one place? Add each employer or setting as its own job with its own rate, and your totals and pay estimates are kept separate.
Nurse practitioner wRVU benchmarks
| Role | 25th | Median | 75th | 90th | Median pay |
|---|---|---|---|---|---|
| NP, primary care | 3,200 | 4,100 | 5,000 | 5,900 | $125,000 |
| NP, specialty | 3,400 | 4,300 | 5,300 | 6,300 | $135,000 |
Yearly wRVUs. These ranges are composite estimates drawn from public sources (2024), not primary survey data, so use them for orientation rather than contract negotiation. Choose Nurse Practitioner as your specialty in wRVU Tracker to compare your own pace. Benchmarks for physician specialties are in the specialty directory.
Common codes nurse practitioners log
| Code | Service | 2026 wRVU |
|---|---|---|
| 99213 | Office visit, established patient, low complexity | 1.30 |
| 99214 | Office visit, established patient, moderate complexity | 1.92 |
| 99215 | Office visit, established patient, high complexity | 2.80 |
| 99204 | Office visit, new patient, moderate complexity | 2.60 |
| G2211 | Visit complexity add-on for ongoing care | 0.33 |
| 99396 | Preventive visit, established patient, age 40–64 | 1.90 |
| 99232 | Subsequent hospital care, moderate complexity | 1.59 |
Values come from the CMS 2026 Medicare Physician Fee Schedule. Look up any other code in the CPT code lookup or add up a full day in the RVU calculator.
Common questions
Do nurse practitioners get paid on wRVUs?
Many do. Employed NPs at hospitals, health systems, and large groups are often paid a base salary plus a wRVU bonus, or a set dollar amount per wRVU. Others are paid salary only but still have their wRVUs tracked for productivity reviews.
Do NPs get the same wRVUs as physicians for the same code?
Yes. CMS assigns one work RVU value to each CPT code no matter who performs the service. A 99214 is 1.92 wRVUs in 2026 for both. Medicare pays NPs 85% of the fee when they bill under their own NPI, but that affects payment, not the wRVU value.
Does the 85% Medicare rule reduce my wRVUs?
Not by itself. It reduces what Medicare pays. Your employer decides whether to credit you the full wRVU, 85% of it, or a lower rate per wRVU. Check your contract, then set your dollar per wRVU in wRVU Tracker to match.
How many wRVUs does a nurse practitioner generate per year?
Composite public estimates put the median around 4,100 wRVUs a year in primary care and 4,300 in specialty roles, with most NPs between roughly 3,200 and 5,900. Your number depends on schedule, setting, and how visits are attributed.
Can nurse practitioners use wRVU Tracker?
Yes. wRVU Tracker was built by a physician, and it works for any clinician who bills CPT or HCPCS codes. Log your codes, set the rate from your contract for each job, and compare your pace against NP benchmarks.
Keep learning
- RVU tracking for PAs — wRVU pay, benchmarks, and codes for physician assistants
- What is a wRVU? — How work RVUs drive productivity pay
- RVU calculator — Add up wRVUs and estimated pay for any codes
- RVU logger — Track your wRVUs shift by shift
- Specialty benchmarks — Typical wRVU volume by specialty
- How to calculate RVUs — Formulas and worked examples