Orthopedic Surgeon wRVU Calculator

Most hospital-employed and health-system orthopedic surgeons are compensated on a work RVU (wRVU) model. This calculator takes your expected production volume and offered conversion factor, estimates your annual compensation, and shows where your offer falls against MGMA 2025 benchmarks — so you can evaluate an offer before signing.

MGMA 2025 Benchmarks — Orthopedic Surgery

These figures are from the MGMA 2025 DataDive report (reflecting 2024 production data) for physician compensation and productivity, orthopedic surgery category.¹ They primarily reflect hospital-employed and health-system surgeons — private practice partners typically have higher effective rates through profit-sharing and ASC distributions that don't appear in wRVU tables.

Percentile	wRVU Production	Conversion Factor	Estimated Comp (wRVU-based only)
25th percentile	~6,800	~$48/wRVU	~$326K
50th (median)	~9,200	~$55/wRVU	~$506K
75th percentile	~12,000	~$65/wRVU	~$780K
90th percentile	~14,500	~$75/wRVU	~$1.09M

Why wRVU-based comp shows lower than total compensation surveys: MGMA total compensation surveys include private practice surgeons, ASC distributions, call pay, and productivity bonuses — categories that often aren't tracked in wRVU compensation tables. The MGMA median total comp for orthopedic surgery is typically reported in the $650K–$800K range; the difference between that and the ~$506K above is largely ASC income, call stipends, and private practice earnings above the wRVU model.²

How Many wRVUs Do Common Ortho Procedures Generate?

CMS sets work RVU values for each CPT code under the annual Physician Fee Schedule. Most employer compensation systems credit the same wRVU values for production tracking. Values below reflect the CMS 2026 Physician Fee Schedule; the 2026 rule applied a 2.5% efficiency adjustment to many non-time-based procedural codes, reducing wRVU values from prior years.³

Procedure	CPT	2026 wRVU	Notes
Total knee arthroplasty	27447	19.11	Confirmed CMS 2026³
Total hip arthroplasty	27130	19.11	Confirmed CMS 2026³
Posterior lumbar interbody fusion, 1 level	22630	25.70	Confirmed CMS 2026³
ACDF, 1 level (anterior approach)	22551	~16.5	Approximate; verify at CMS PFS⁴
Arthroscopic rotator cuff repair, large/massive	29827	~12.5	Approximate; verify at CMS PFS⁴
Arthroscopic ACL reconstruction	29888	~12.0	Approximate; verify at CMS PFS⁴
Total shoulder arthroplasty	23472	~15.5	Approximate; verify at CMS PFS⁴
ORIF distal radius, ≥3 fragments	25609	~11.0	Approximate; verify at CMS PFS⁴

CMS 2026 conversion factor for Medicare payment calculations: $33.40/wRVU (non-APM participants).³ Employer compensation conversion factors are separate and substantially higher — typically $48–$75+/wRVU — reflecting overhead models that differ from Medicare payment rates.

5 Red Flags in wRVU Job Offers

A guarantee that functions as a ceiling, not a floor. If your guarantee is $600K but the threshold for earning above it requires producing more than ~10,900 wRVUs at $55/wRVU, the guarantee may structure your comp so you rarely exceed it. Ask: "At what wRVU production level do I start earning above the guarantee?" The answer should be achievable in year one or two.
A conversion factor that doesn't renegotiate. If the contract locks in a $48/wRVU rate for 3 years with no inflation adjustment, you're accepting a real pay cut annually. Ask for annual renegotiation rights or an indexed escalator. A conversion factor below the 25th percentile (~$48/wRVU) that isn't expected to grow is a material red flag.
No quality bonus structure. Most health systems now offer a 5–15% quality and value-based bonus on top of wRVU production comp. If none exists, ask why — and whether one can be added. Quality payments increasingly represent $50K–$100K+ annually at high-volume systems and are being missed by surgeons who don't negotiate for them.
Administrative time that doesn't earn wRVUs. Program director responsibilities, department leadership, resident supervision, and committee work can consume 5–15% of your time without generating a single wRVU. If you'll carry any of these roles, they must either earn a flat stipend or be excluded from the denominator used to calculate your productivity thresholds. "Protected time" that quietly reduces your production credit is unpaid labor.
No call stipend in a high-volume trauma environment. Call burden for orthopedic surgery is one of the heaviest in medicine. Emergency cases often generate lower effective wRVU rates (night/weekend cases with dictation overhead, longer procedures per case, lower-complexity reimbursement relative to elective work). A dedicated call stipend of $10K–$40K/year is standard in competitive markets; absence at a Level I trauma center is a clear negotiating point.

What wRVU Compensation Doesn't Capture

A wRVU offer is only one part of the full economic picture. Critical items outside the model:

ASC distributions. Hospital employment typically excludes ASC ownership. A private practice partner with an ambulatory surgery center stake can generate $300K–$800K/year in distributions — income that never appears in any wRVU compensation table. See ASC Investment ROI Calculator.
Retirement plan contributions. Hospital employers often contribute $20K–$60K/year to your 403(b) or 401(k) before you contribute a dollar. Private practice owners running a solo 401(k) plus cash balance plan can shelter $200K–$400K/year in pre-tax contributions at peak career. The after-tax comparison is radically different from the gross comp comparison. See Cash Balance Plans for Ortho Surgeons.
Malpractice tail on departure. Hospital employment includes tail coverage; private practice does not. If you later transition, a tail policy can cost $80K–$150K+ out of pocket. This is effectively deferred compensation that comes due at exit. See Malpractice Tail Coverage.
Partnership equity and exit value. A 5% equity stake in a private ortho group with $10M EBITDA, sold to a PE buyer at an 8x multiple, returns $4M. No hospital employment arrangement has a comparable exit value. The wRVU model captures income; it captures nothing about equity. See Selling Your Practice to PE.
Non-compete scope. A restrictive non-compete that makes you leave the metro if you resign can have a six-figure NPV impact. Negotiate geography and duration before signing. See Contract Negotiation Guide.

Related tools and guides

Sources

MGMA 2025 Provider Compensation and Productivity Data Report — orthopedic surgery wRVU production and conversion factor benchmarks (reflecting 2024 survey data). Median ~9,200 wRVU/yr; median compensation rate ~$55/wRVU.
Marit Health — 2025 wRVUs and $/wRVU by Specialty, citing MGMA 2025 DataDive. Total orthopedic surgery compensation benchmarks including private practice and subspecialty differentials.
FastRVU — Orthopedic Surgery RVU Guide 2026. CPT 27447 (total knee, 19.11 wRVU), CPT 27130 (total hip, 19.11 wRVU), CPT 22630 (PLIF single-level, 25.70 wRVU); citing CMS 2026 Physician Fee Schedule with 2.5% efficiency adjustment. CMS 2026 conversion factor $33.40/wRVU (non-APM).
CMS — Physician Fee Schedule. Authoritative source for all CPT code wRVU values by calendar year. Values for CPT 22551, 29827, 29888, 23472, and 25609 shown in the table above are 2026 approximations — confirm exact values for billing and compensation purposes using the CMS PFS search tool.

Benchmark values verified May 2026 against MGMA 2025 DataDive and CMS CY2026 Physician Fee Schedule. wRVU values may differ from prior years due to the 2.5% efficiency adjustment applied in the 2026 final rule.