Clinical Scenario RVU Simulator
Scenario simulator that converts selected CPT bundle presets into work RVU, total RVU, Medicare payment, and monthly run-rate estimates with visible CMS provenance.
Scenario presets
Choose an editable CPT bundle example, then model total wRVU and Medicare payment by locality and conversion factor.
4.02 work RVU per bundle; $6,733.62 estimated monthly payment at entered volume.
- Planning only: scenario presets are not coding advice.
- Hold assumptions fixed: compare the same CPT bundle, locality, and conversion factor before changing volume.
- Before relying on it: confirm documentation, modifiers, payer rules, and the actual clinical mix.
| CPT | Line | Setting | Qty | wRVU | Total RVU | Payment |
|---|---|---|---|---|---|---|
| 99204 | New patient visit | Office | 1 | 2.60 | 5.31 | $177.36 |
| 93306 | Complete transthoracic echo | Office | 1 | 1.42 | 5.89 | $196.73 |
2026/rvu26b
2026-03-10
CPT or HCPCS code, Work RVU, Practice expense RVU, Malpractice RVU, GPCI locality, Conversion factor
Cardiology new patient + transthoracic echo scenario provenance. The calculation uses CMS April 2026 RVU records, GPCI localities, and conversion factors. Verify official CMS and payer rules before billing or contract decisions.
- CPT or HCPCS code: CMS PFS Relative Value Files RVU record and descriptor fields
- Work RVU: CMS PFS Relative Value Files work RVU component
- Practice expense RVU: CMS PFS Relative Value Files facility and non-facility PE RVU fields
- Malpractice RVU: CMS PFS Relative Value Files malpractice RVU component
- Preset
- Cardiology new patient + transthoracic echo
- Specialty
- Cardiology
- Locality
- National: National Average
- Monthly volume
- 18
- Source basis
- CMS 2026 CPT RVU records for 99204 and 93306 with selected GPCI locality and conversion factor.
Scenario presets are CPT bundle examples for financial modeling; they are not coding advice. Use this workflow to estimate a financial scenario after coding and documentation choices are already known.
Related workflows
Use these tools when the current result needs payment, geography, compensation, or productivity context.
Uses the CMS April 2026 Physician Fee Schedule RVU files, GPCI localities, and 2026 conversion factors. Estimates should be verified against official CMS files for billing decisions.
For calculator workflows, calculator inputs are processed in the browser. Contact, lead forms and PDF download forms are separate submissions.
Can a scenario preset choose the correct CPT codes?
No. Presets are editable financial modeling examples. Use documentation, payer policy, modifiers, and coding review before relying on CPT selections.
What should stay fixed when comparing scenarios?
Keep the same CPT bundle, setting, locality, conversion factor, and volume when isolating one assumption at a time.
When should I use bulk instead?
Use the bulk calculator when you have an actual spreadsheet or exported CPT list instead of a preset clinical scenario.
Use note: Scenario presets are planning bundles, not coding advice.