What are the most common physician compensation models?

The four you will encounter most are straight salary, base salary plus bonus, wRVU based productivity, and percentage of net collections. Blends dominate: in 2024, 60.8 percent of physicians were paid through two or more methods, most often a salary paired with productivity pay or a bonus [1].

What is the difference between RVU and net collections compensation?

wRVU pay is based on the work you document, regardless of whether the practice gets paid; net collections pay is based on dollars the practice actually receives. Under collections models, denials, write-downs, and bad debt reduce your income, while under wRVU models that risk stays with the employer [5].

What percentage of collections do physicians typically receive?

Published attorney and industry commentary describes pure net collections arrangements commonly in the 30 to 40 percent range (occasionally up to 45 percent), and hybrid arrangements paying roughly 15 to 25 percent of collections above a base salary threshold [8]. Actual percentages vary by specialty, overhead, and market. [MARKET BOARD DATA: 32% - 38% for Primary Care; 35% - 42% for Surgical Specialties, as of July 27, 2026]

Is salary or productivity pay better for a new attending?

Most new attendings benefit from a guaranteed base or a defined guarantee period, because credentialing delays and panel ramp-up suppress early productivity. What matters most is understanding exactly when and how the contract converts to productivity pay, and whether the thresholds are achievable at your realistic volume.

How do physician bonuses usually work?

Bonuses are typically tied to wRVUs above a threshold, quality metrics, patient satisfaction, or call coverage. They are increasingly common (39 percent of physicians received one in 2024) but modest in size, averaging about 4.4 percent of total compensation [1]. In recruiting data, 65 percent of production bonuses in 2024 to 2025 contracts included an RVU component [3].

Can my pay change without my contract changing under a wRVU model?

Yes. If CMS revalues the RVUs behind your codes, as the 2026 efficiency adjustment does for many services, your measured productivity can fall even at constant volume [7]. Well drafted contracts specify which calendar year's RVU values govern the compensation calculation.

Physician Compensation Models Explained: Salary vs RVU vs Collections

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