In this guide
Three pieces behind one code
The same service can have different total RVUs in an office and a facility because the practice-expense component can change. The example below lets you see that difference without changing the code.
Code 99214 · live CMS example
RVU26D · Effective 2026-10-01
Work RVUs
1.92
Total RVUs · before geography
4.06
These are the component RVUs from the selected CMS release. The bar shows their shares of the unadjusted total; it does not show clinician pay.
- Work
- The clinician’s relative time, effort, skill and intensity associated with the service.
- Practice expense
- The resources involved in providing the service, including staff, equipment, supplies and overhead.
- Malpractice expense
- The relative professional-liability expense associated with the service.
Work RVUs and total RVUs answer different questions
Work RVUs describe the work component alone. Total RVUs combine work, practice expense and malpractice. Using a work-RVU number as though it were the total leaves out two parts of the Medicare calculation.
When someone says “this code is worth two RVUs,” ask which RVUs they mean, which release they are using, and—if they mean the total—which setting applies. Two different numbers can both be correct for the same code.
RVUs are also not a shortcut for selecting a billing code. Code selection follows the service performed and the applicable documentation and coding requirements.
How RVUs become Medicare dollars
Multiply each component by its own geographic practice cost index (GPCI), add those three adjusted values, then multiply by the applicable Medicare conversion factor. A single multiplier applied to total RVUs cannot reproduce every locality’s result.
99214 in Chicago · Office / nonfacility · 2026-10-05
- Work
- 1.92 × 1.007 = 1.93344
- Practice expense
- 2 × 1.005 = 2.01
- Malpractice
- 0.14 × 2.295 = 0.3213
4.26474 adjusted RVUs × $33.4009
$142.45
Non-QP, participating-physician base PFS amount. Rounded to cents after the component calculation; before claim adjustments and patient cost sharing.
Why work RVUs do not tell you take-home pay
A compensation arrangement may assign its own dollar value to a work RVU. That contract rate is not the Medicare conversion factor, and multiplying it by work RVUs does not calculate the practice’s reimbursement.
Hypothetical example: 100 work RVUs × $50 per work RVU = $5,000 before any other contract terms. The $50 is an illustrative input, not a market benchmark or CMS rate.
Thresholds, guarantees, bonuses, attribution rules and other terms can change compensation. Use the values defined in the actual agreement when exploring the arithmetic.
Follow the example back to its source
The displayed code example uses FeeBase’s accepted CMS dataset and the same rate calculation used by the lookup. Its release and effective date are shown above, so the numbers can change when a new accepted release becomes effective.