Pay per wRVU by Specialty in 2026: $33.83 to $99.97

Median physician pay per work RVU ran from $50.52 in general pediatrics to $99.97 in hematology and medical oncology in 2025, according to AMGA's 2026 Medical Group Compensation and Productivity Survey. Family medicine sat at $52.61 and internal medicine at $55.62, so hematology/oncology paid 1.9 times the family medicine rate for each unit of work.

AMGA took the figures from 451 medical groups and health systems, covering nearly 188,000 providers in more than 190 specialties. The pay ratio below is median total clinical compensation per work RVU (wRVU) for 2025.

What AMGA reported, and primary care rates

AMGA released the survey on June 24, 2026. Overall median total clinical compensation rose 4.3% in 2025, and median wRVUs rose 2.4%, per AMGA. Patient visit volume rose 2.0%. AMGA says productivity funded roughly half of the pay growth.

The pay-per-wRVU ratio moved by group as follows. Primary care rose 1.7%, surgical specialties rose 1.8%, medical specialties rose 2.6%, and nurse practitioners and physician assistants (APCs) rose 2.6%. Pay grew faster than output in every group.

The earlier survey editions show the same direction. Overall median pay rose 4.9% in the 2025 edition, 5.3% in 2024, 3.5% in 2023 and 3.7% in 2022. Median wRVUs in the 2026 edition rose 2.0% in primary care, 2.0% in medical specialties, 2.4% in surgical specialties and 3.1% in radiology, anesthesiology and pathology.

The respondents are medical groups and health systems. The chart document does not split results by group size, so a small independent practice has no matching row.

Family medicine had a median pay of $342,411 on 6,505 wRVUs, a ratio of $52.61. A year earlier the ratio was $51.66, so it rose 1.8%. Pay rose 3.7% and wRVUs rose 2.6%.

Internal medicine paid $361,426 on 6,390 wRVUs, a ratio of $55.62. That ratio did not change from 2024, though pay rose 3.9% and wRVUs rose 3.1%. General pediatrics paid $305,435 on 5,996 wRVUs, a ratio of $50.52, up 1.6% from $49.72. Pediatric wRVUs fell 0.7% while pay rose 3.5%.

Primary care visits fell 2.2% in 2025, which AMGA puts at 60 to 90 fewer visits per physician. Primary care wRVUs still rose 2.0%, because wRVUs per visit went from 1.86 to 1.94. Each visit carried more coded work, so output rose while the visit count dropped.

Specialty rates, rate gaps and volume gaps

The table lists ten physician specialties from AMGA's 2026 chart document, sorted by 2026 pay per wRVU.

Specialty	Median pay	Median wRVUs	Pay per wRVU, 2026	Pay per wRVU, 2025	Change
General pediatrics	$305,435	5,996	$50.52	$49.72	1.6%
Family medicine	$342,411	6,505	$52.61	$51.66	1.8%
Internal medicine	$361,426	6,390	$55.62	$55.62	0.0%
OB/GYN, general	$419,021	7,681	$57.88	$55.84	3.7%
Cardiology, non-invasive	$648,852	9,415	$68.79	$66.80	2.9%
Neurology	$391,148	5,391	$71.03	$68.42	3.8%
Gastroenterology	$656,500	9,052	$72.28	$70.47	2.6%
General surgery	$530,000	7,140	$74.48	$73.82	0.9%
Orthopedic surgery	$751,350	10,007	$78.94	$78.00	1.2%
Hematology and medical oncology	$591,080	6,146	$99.97	$97.32	2.7%

Source: AMGA, 2026 Medical Group Compensation and Productivity Survey: Selected Data, June 2026 (451 groups, 2025 data).

Orthopedic surgery has the highest median pay in the table at $751,350, yet its rate of $78.94 is below hematology/oncology at $99.97. Orthopedic surgeons log 10,007 wRVUs, or 62.8% more than the 6,146 for hematology/oncology. Hematology/oncology pay is $591,080, which is 21.3% below orthopedic pay.

Neurology shows the reverse pattern. Its rate of $71.03 beats cardiology at $68.79, but neurology pay of $391,148 is 39.7% below the $648,852 for cardiology. Cardiology produces 9,415 wRVUs and neurology produces 5,391.

Family medicine against cardiology gives a plain comparison. Cardiology pays a rate 30.8% higher, and it also logs 44.7% more wRVUs, so total pay is 89.5% higher. The rate gap is 30.8%, the volume gap is 44.7%, and together they produce the 89.5% pay gap.

Pay per wRVU for NPs and PAs, and your own ratio

AMGA reports six APC roles. Primary care APCs sit near $34 per wRVU, and surgical APCs sit far above that.

• Nurse practitioner, primary care: $149,178 on 4,647 wRVUs, $33.83 per wRVU, up 5.1%.
• Physician assistant, primary care: $156,894 on 4,868 wRVUs, $34.00 per wRVU, up 6.8%.
• Nurse practitioner, medical specialty: $147,269 on 2,676 wRVUs, $54.82 per wRVU.
• Physician assistant, medical: $146,873 on 2,881 wRVUs, $53.06 per wRVU.
• Nurse practitioner, surgical specialty: $149,614 on 2,177 wRVUs, $67.17 per wRVU.
• Physician assistant, surgical: $159,659 on 1,827 wRVUs, $85.35 per wRVU, down 0.4%.

A primary care nurse practitioner earns $149,178 and a surgical nurse practitioner earns $149,614, a gap of $436. The primary care nurse practitioner logs 2.1 times the wRVUs, which is why the rate is half as high. Overall APC pay rose 4.1% in 2025 and APC wRVUs rose 3.0%.

Multiplying the family medicine rate by its wRVUs gives $342,223, within $188 of the reported median pay of $342,411. Not every row reconciles that closely. For primary care physician assistants, $156,894 divided by 4,868 gives $32.23, while AMGA reports $34.00. AMGA's chart document does not say how it computes the ratio, so use its published rate when comparing.

The same ratio can be worked out from practice records. Take each clinician's annual pay and annual wRVUs from the billing system, then divide. A family physician paid $342,411 on 6,505 wRVUs would match the AMGA median pay level. One paid $300,000 on the same wRVUs sits at $46.12 per wRVU, which is $6.49 below the AMGA family medicine rate.

AMGA data shows the median rate moved 0.0% to 3.8% across the ten physician specialties in 2025. Internal medicine was the only one with no change.

Sources

• AMGA, 2026 Medical Group Compensation and Productivity Survey: Selected Data, June 2026
• AMGA, press release on the 2026 compensation and productivity survey results, June 24, 2026