Education article

How Medicare allowable payment works

Medicare offers the most transparent public framework for translating a surgical service into dollars. This article explains how RVUs, GPCI adjustments, and the conversion factor become an allowable payment.

The core formula

The Medicare allowable starts with physician work, practice expense, and malpractice RVUs. Each component is adjusted by its geographic practice cost index, then multiplied by the annual conversion factor.

Why surgeons should care

Commercial contracts, employed compensation models, and practice revenue forecasts often reference Medicare directly or indirectly. Understanding the baseline makes payer and contract terms easier to evaluate.