Hospitalist work RVUs by code
See the work RVU for the E/M codes you bill on the wards.
When a contract pays for production, it counts work RVUs, so that’s the column to read. The values are CMS’s, from the release named above the tables.
Sources & methodologyCMS fee schedule · RVU26D
Work RVUs for the hospital E/M codes
17 codes from the CMS 2026 Physician Fee Schedule relative value file. The RVUs are CMS’s. The five-digit codes are CPT® codes, which belong to the AMA; G0316 is a CMS HCPCS code. The labels beside them are ours, not the AMA’s descriptions.
CPT® copyright 2026 American Medical Association. All rights reserved. CPT is a registered trademark of the American Medical Association. Fee schedules, relative value units, conversion factors and/or related components are not assigned by the AMA, are not part of CPT, and the AMA is not recommending their use. The AMA does not directly or indirectly practice medicine or dispense medical services. The AMA assumes no liability for data contained or not contained herein.
Initial hospital or observation care
The admission visit. Level it by MDM or by total time on the date.
| Code | What it covers | Work RVU | Total RVU (facility) | Medicare national rate (facility) |
|---|---|---|---|---|
| 99221 | Initial hospital care, level 1 | 1.63 | 2.23 | $74.48 |
| 99222 | Initial hospital care, level 2 | 2.60 | 3.50 | $116.90 |
| 99223 | Initial hospital care, level 3 | 3.50 | 4.68 | $156.32 |
Subsequent hospital or observation care
Your daily follow-up visits. Same three levels as the admission.
| Code | What it covers | Work RVU | Total RVU (facility) | Medicare national rate (facility) |
|---|---|---|---|---|
| 99231 | Subsequent hospital care, level 1 | 1.00 | 1.32 | $44.09 |
| 99232 | Subsequent hospital care, level 2 | 1.59 | 2.11 | $70.48 |
| 99233 | Subsequent hospital care, level 3 | 2.40 | 3.20 | $106.88 |
Admission and discharge on the same day
One code for a patient admitted and sent home on the same calendar date. Medicare pays it only when the stay ran eight hours or more. Under eight hours, Medicare pays the admission code only.
| Code | What it covers | Work RVU | Total RVU (facility) | Medicare national rate (facility) |
|---|---|---|---|---|
| 99234 | Same-day admission and discharge, level 1 | 2.00 | 2.64 | $88.18 |
| 99235 | Same-day admission and discharge, level 2 | 3.24 | 4.28 | $142.96 |
| 99236 | Same-day admission and discharge, level 3 | 4.30 | 5.68 | $189.72 |
Discharge day
The discharge visit. The two codes split at 30 minutes of discharge work on the date.
Critical care
Timed, not leveled. Medicare doesn’t pay 99292 until 104 minutes of critical care on the date. CPT’s own table starts it at 75.
Prolonged inpatient or observation care
Add-ons for time past the threshold of a level 3 visit leveled by time (99223, 99233 or 99236), in 15-minute blocks. Medicare pays its own G code for this, not the CPT add-on.
| Code | What it covers | Work RVU | Total RVU (facility) | Medicare national rate (facility) |
|---|---|---|---|---|
| G0316 | Prolonged inpatient or observation care, each additional 15 minutes (Medicare add-on) | 0.61 | 0.83 | $27.72 |
| 99418 | Prolonged inpatient or observation care, each additional 15 minutes (CPT add-on)Status I in the CMS file: a code Medicare doesn’t use for payment. | 0.81 | 1.04 | Not paid by Medicare |
Advance care planning
The goals-of-care conversation, timed.
Medicare national rate (facility) = total RVU (facility) × 33.4009, CMS’s general conversion factor. It is a fee schedule figure before geographic adjustment, the 2% sequestration cut and any payer’s own rules, not pay.
Example
- 2 admissions at 99223
- 2 × 3.50 = 7.00
- 12 follow-ups at 99232
- 12 × 1.59 = 19.08
- 2 discharges at 99239
- 2 × 2.15 = 4.30
30.38 work RVUs for the day
A made-up day: 2 admissions at 99223, 12 follow-ups at 99232 and 2 discharges at 99239 come to 30.38 work RVUs. Swap in your own counts and levels.
Source: CMS relative value file RVU26D. Sources and methodology
Three notes make the report
Most of a hospitalist’s production report is three notes: the H&P, the daily follow-up, and the discharge summary. The other tables are same-day admission and discharge, critical care, prolonged care, and advance care planning.
A rounding day in wRVUs
The made-up day under the tables is the napkin math for what a target takes in a day. Put your own counts and levels in it, run a month of those days, and divide by shifts.
See what that means per shiftWhich year’s table
If the admission wRVU you remember is higher than the one here, you’re remembering a table from before 2023. CMS reweighted the hospital codes that year and moved value from admissions to follow-ups and discharges, and old forum threads still carry the old values. Total RVUs and the Medicare rate did fall again in 2026, when CMS cut the practice expense it credits for hospital work, but work RVUs didn’t move. Some groups lock the wRVU table to a contract year on purpose, and on a pre-2023 table an admitter earns more per 99223, so check which release your contract names before you set a target against these rows.
Check your pace against your targetWhy a night looks thin on this table
Nocturnists admit, and an admit posts under your name like anyone’s. What doesn’t post is routine cross-cover: one E/M per patient per date, and the day note usually takes it. So a night of admits reads fine here and a night of cross-cover reads as nothing, whichever was harder. Nights are mostly paid per shift rather than against a day target, so put night pay next to day pay per hour before you read anything into the report.
Compare night and day pay per hourCommon questions
Is 99233 worth more than 99223?
No. In the current file, 99223 carries 3.50 work RVUs and 99233 carries 2.40. A level 3 follow-up still sits above a level 1 admission at 1.63.
Why does Medicare pay G0316 rather than 99418?
Medicare didn’t adopt the CPT add-on because it starts the clock later than CPT does: G0316 is billable once you reach 105 minutes on a 99223, 80 on a 99233, or 125 on a 99236. The file marks G0316 status A (a code CMS pays under the fee schedule) and 99418 status I (a code Medicare doesn’t use for payment). Both carry a work RVU, 0.61 and 0.81, but Medicare pays only G0316. Commercial payers set their own rules on 99418, and some don’t pay it separately.
Do these values change during the year?
Yes, they can. CMS updates the relative value file quarterly and can correct a value between releases. This page reads RVU26D, and the label above the tables changes when the file does.
Sources & methodology
Source file
Release RVU26D (CY 2026 Physician Fee Schedule relative value file, October update), downloaded Oct 7, 2026. The download link, the member file and the zip’s SHA-256 are in the source block below.
Medicare national rate
- Medicare national rate (facility)
- equals total RVU (facility) × conversion factor
33.4009 is CMS’s general conversion factor. Doctors who qualify through an Advanced APM are paid on a slightly higher one, which this table doesn’t use. Your billing office knows whether you qualify.
CY 2026 Physician Fee Schedule relative value file, October update. CMS updates the file quarterly, and each release carries its own label.
RVU26D · Member file PPRRVU2026_Oct_nonQPP.csv · Downloaded Oct 7, 2026
Source file and columns used
Release: RVU26D, CY 2026 Physician Fee Schedule relative value file, October update. Source: https://www.cms.gov/files/zip/rvu26d.zip. Member file read: PPRRVU2026_Oct_nonQPP.csv. Downloaded Oct 7, 2026; CMS last modified it Aug 26, 2026.
Source SHA-256: 521ff0f4ecbf13b5d99dc1dc04d9f82e5361e55c6b4b6b3033043598bf8406e6
Columns used: HCPCS, MOD, STATUS CODE, WORK RVU, FACILITY PE RVU, MP RVU, FACILITY TOTAL, NON-FACILITY TOTAL, GLOB DAYS, CONV FACTOR. Rows with a modifier are left out. The labels on this page are ours, and no descriptions from the file are used.
Also from Aclera
Work through your next admission with Casey
Casey is the assistant in CasePanel, Aclera’s note-writing app for hospitalists. You paste or upload the chart, nothing connects to your EHR, and Casey reads all of it before you write, then drafts the HPI and A&P for you to edit.
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More calculators
wRVU target
See what your wRVU target means per shift.
Enter a month of wRVUs and shifts, the shifts you plan to work, and your annual target. You get the year at that pace and the gap to the target per shift.
RVU bonus
See what your RVU bonus would pay.
Enter base, threshold, bonus rate, and the wRVUs you expect this year. You get the bonus, the year’s pay, and the effective $/wRVU.
wRVUs per shift
See your wRVUs per shift and per scheduled hour.
Enter the wRVUs, shifts, and shift length from one period of your report. You get wRVUs per shift and per scheduled hour.
Nocturnist salary
Does the night job pay more per hour?
Enter annual pay, shifts, and hours for a day job and a night job. You get each one per shift and per scheduled hour, and the night premium.
Medicare data
See what Medicare paid for hospitalist care in 2024.
Medians and quartiles for Original Medicare payments, services and patients per hospitalist in 2024, nationally and by state. Payment for billed care, not salary.