~4,200
Median wRVUs / yr
Admits, daily rounds, observation, and discharge — the codes that make up a hospitalist's shift, with 2026 CMS wRVU values and a tracker designed for shift-based productivity.
Compensation and productivity benchmarks pulled from public physician surveys and the 2026 Medicare Physician Fee Schedule.
The codes that drive the bulk of hospital medicine billing, with current Work RVU values from the 2026 Medicare Physician Fee Schedule. Use these as a baseline — locality (GPCI) and modifiers adjust the final payment.
| Code | Description | wRVU | Type |
|---|---|---|---|
| 99221 | Initial hospital care, low complexity | 1.63 | E&M |
| 99222 | Initial hospital care, moderate complexity | 2.60 | E&M |
| 99223 | Initial hospital care, high complexity | 3.50 | E&M |
| 99231 | Subsequent hospital care, low (15 min) | 1.00 | E&M |
| 99232 | Subsequent hospital care, moderate (25 min) | 1.59 | E&M |
| 99233 | Subsequent hospital care, high (35 min) | 2.40 | E&M |
| 99238 | Hospital discharge, 30 min or less | 1.50 | E&M |
| 99239 | Hospital discharge, more than 30 min | 2.15 | E&M |
| 99291 | Critical care, first 30-74 min | 4.50 | E&M |
| 99292 | Critical care, additional 30 min | 2.25 | E&M |
| 99234 | Same-day admit + discharge, low complexity | 2.00 | E&M |
| 99235 | Same-day admit + discharge, moderate complexity | 3.24 | E&M |
| 99236 | Same-day admit + discharge, high complexity | 4.30 | E&M |
Source: 2026 Medicare Physician Fee Schedule (CMS). Values reflect the national, unadjusted Work RVU.
Where hospital medicine productivity falls across the percentile distribution. Most RVU-based contracts target the median (50th percentile); high-volume practices push into the 75th-90th range.
MGMA-aligned 2024 estimates. Verify with your group's data source for contract negotiations.
Typical total compensation ranges across a hospital medicine career. Numbers blend salary, RVU productivity, and bonus components reported in physician surveys.
First 1-3 years out of training. Base-heavy contracts; productivity bonuses begin to ramp.
Years 4-10. RVU-based comp dominates as case volume settles into a steady pattern.
10+ years, partnership track, ASC ownership, or high-volume practice settings.
Ranges synthesized from Doximity 2024 and AMGA / MGMA-aligned compensation reports. Actual offers vary by region, practice setting, and case mix.
Most RVU tools were built for one type of day. RVU Tracker handles the mix of clinic, procedures, and inpatient work that actually shows up on a hospital medicine schedule.
Save your most-used codes as quick-add buttons. Log a visit in seconds between patients.
Add multiple codes per encounter; the tracker sums correctly with MPPR awareness when relevant.
Tag clinic vs. procedure days and see productivity per session. Decide where to add capacity.
Every code ships with current Work RVU values. Year-over-year updates roll out automatically.
Set your wRVU threshold. The tracker shows monthly pace and projects year-end totals.
Plug in your conversion factor and see real-time earnings. Compare offers during contract review.
A few high-leverage details that quietly cost RVUs (and revenue) when missed.
CMS deleted the 99217-99220 / 99224-99226 observation codes in 2023. Observation stays now bill under the standard hospital admit (99221-99223), subsequent (99231-99233), and discharge (99238/99239) codes — same as full inpatient. Place of service distinguishes the two.
99238 (≤30 min) vs. 99239 (>30 min) is time-based. Document precise time spent on discharge management; many hospitalists default to 99238 and undercode complex discharges that genuinely exceed 30 minutes.
On any given hospital day, you can bill 99291/99292 (critical care) instead of — not in addition to — 99231-99233. Document precise critical care minutes and exclude time spent on separately billable procedures.
Same-day admit and discharge uses 99234-99236 (combined) instead of separate admit + discharge codes. The combined code pays better than 99221 + 99238 separately and is the correct code for short-stay scenarios.
2026 CMS data pre-loaded for every code. Designed for the cadence of a real hospital medicine day.