RVU Tracking for Physician Assistants
Physician assistants in clinics, hospitals, emergency departments, and operating rooms are often measured on work RVUs. Here is how wRVUs work for PAs, what the Medicare 85% rule changes, and how to keep your own record so you can check every paycheck.
How wRVU pay works for physician assistants
Many employers pay PAs on production the same way they pay physicians. 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 PA 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
- Shift pay plus a productivity bonus, common in emergency and hospital medicine
- A share of the wRVUs from procedures you assist on, common in surgical roles
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 99284 emergency visit is 2.74 wRVUs whether a physician or a physician assistant sees the patient. Since 2022, PAs can also receive Medicare payment directly. What can differ is what Medicare pays and how your employer credits the work to you.
The Medicare 85% rule and your wRVUs
When a PA 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, emergency department, and other facility settings |
| Assistant at surgery (modifier AS) | A small share of the surgeon's fee | Operating room |
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.
Logging cases you assist on
When a PA assists in surgery, the claim usually carries modifier AS, and the assistant is credited with a fraction of the procedure's value instead of the full amount. In wRVU Tracker, add modifier AS when you log the case and the wRVUs are reduced to the assistant share (16% of the code's wRVU). If your employer credits assists differently, adjust your rate to match.
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 shifts 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.
Physician assistant wRVU benchmarks
| Role | 25th | Median | 75th | 90th | Median pay |
|---|---|---|---|---|---|
| PA, primary care | 3,300 | 4,200 | 5,100 | 6,000 | $128,000 |
| PA, specialty | 3,600 | 4,600 | 5,600 | 6,600 | $145,000 |
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 Physician Assistant as your specialty in wRVU Tracker to compare your own pace. Benchmarks for physician specialties are in the specialty directory.
Common codes physician assistants log
| Code | Service | 2026 wRVU |
|---|---|---|
| 99213 | Office visit, established patient, low complexity | 1.30 |
| 99214 | Office visit, established patient, moderate complexity | 1.92 |
| 99284 | Emergency visit, moderate complexity | 2.74 |
| 99285 | Emergency visit, high complexity | 4.00 |
| 99233 | Subsequent hospital care, high complexity | 2.40 |
| 20610 | Joint injection or aspiration, major joint | 0.77 |
| 12002 | Simple wound repair, 2.6 to 7.5 cm | 1.11 |
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 shift in the RVU calculator.
Common questions
Do physician assistants get paid on wRVUs?
Many do. Employed PAs are often paid a base salary or shift rate 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 PAs 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 99284 is 2.74 wRVUs in 2026 for both. Medicare pays PAs 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 physician assistant generate per year?
Composite public estimates put the median around 4,200 wRVUs a year in primary care and 4,600 in specialty roles, with most PAs between roughly 3,300 and 6,600. Your number depends on schedule, setting, and how visits are attributed.
How do I log surgical cases I assisted on?
Log the procedure code and add modifier AS. wRVU Tracker reduces the wRVUs to the assistant share automatically. If your employer credits assists differently, adjust your rate per wRVU to match your contract.
Can physician assistants 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 PA benchmarks.
Keep learning
- RVU tracking for NPs — wRVU pay, benchmarks, and codes for nurse practitioners
- 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