Understanding RVUs, Base Salary, and Incentives in 2026

Compensation models can feel confusing, especially if you have been in the same role for years.

In the United States, most employed physicians and many advanced practice providers are paid using some combination of base salary and productivity incentives. The most common productivity measure is the Relative Value Unit, or RVU.

A base salary provides predictable income. It is typically guaranteed for a set period, often one to three years for new hires.

Productivity incentives reward output. In RVU-based models, clinicians earn additional compensation after exceeding a defined threshold. The conversion factor, or dollar amount per RVU, varies by specialty and region.

Some contracts include quality bonuses tied to patient satisfaction, documentation accuracy, or value-based care metrics.

Understanding your total compensation requires looking at all components together. A high base salary with a high RVU threshold may limit upside. A lower base with a strong conversion factor may reward high productivity.