Name: 什麼是 RVUs？醫生是這樣獲得報酬的💸 (What Are RVUs? This is How Doctors Are Paid💸)
Uploaded: 2025-10-24T18:11:30.000Z
Duration: 11 min 17 s

Have you ever wondered how doctors make their money or why some doctors make more than others?

你是否曾經好奇過醫師是怎麼賺錢的，或是為什麼有些醫師收入比別人高？

The answer is relative value units or RVUs.

答案就是相對價值單位，也就是 RVUs。

Jubbal medschoolinsiders.com let's break down what RVUs are and how they are calculated to determine how much doctors and hospitals make.

Jubbal 醫師 medschoolinsiders.com 讓我們來解析 RVUs 是什麼，以及它們是如何計算來決定醫師和醫院的收入。

RVUs, or relative value Units, are used by Medicare and insurance companies to determine how much a physician should be paid for their services and based on time spent with the patient.

RVUs，也就是相對價值單位，是聯邦醫療保險和保險公司用來決定醫師的服務費用，並根據與病患共度的時間來支付。

There are both benefits and drawbacks to this model of medical pay, which we will outline later in this video.

這種醫療支付模式有好有壞，我們稍後會在影片中說明。

First is work RVUs, or WRVUs, which represent the relative amount of physician work required to perform a particular service or procedure.

第一種是工作相對價值單位，也就是 WRVUs，它代表執行特定服務或程序所需的醫師工作的相對量。

If you found that extremely vague, well, it's supposed to be work.

如果你覺得這很模糊，嗯，這就是它的本意。

RVUs can include everything from a 20 minute office visit with a new patient to a major operation such as inserting a deep brain stimulator.

RVUs 的範圍很廣，從為新病患看診 20 分鐘的門診，到像植入腦深層刺激器這樣的重大手術都包含在內。

A multitude of factors determine how much physician work is required for each service and procedure, including how long it takes for the doctor to perform the service, how much effort and technical skill it requires, and

有很多因素決定了每項服務和程序所需的醫師工作量，包括醫師執行服務所需的時間、所需的努力和技術技巧，以及

The second type of RVU is practice expense RVUs.

第二種 RVU 是執業費用相對價值單位。

These are designed to cover the cost of running a clinic or hospital, dealing with expenses like rent, utilities, medical supplies, equipment and support staff salaries.

這些是為了支付經營診所或醫院的費用而設計的，處理像是租金、水電、醫療用品、設備和支援人員薪資等開銷。

Without these RVUs, most clinics cannot afford to keep the lights on.

沒有這些 RVUs，大多數診所都無法負擔維持營運。

The third and last type of RVU is malpractice RVUs.

第三種也是最後一種 RVU 是醫療疏失相對價值單位。

Malpractice RVUs account for the relative cost of malpractice insurance associated with providing a specific service.

醫療疏失 RVUs 佔了提供特定服務相關的醫療疏失保險的相對成本。

For example, inserting a deep brain stimulator is much riskier than a 20 minute appointment with a new patient.

例如，植入腦深層刺激器比為新病患看診 20 分鐘的門診風險高得多。

Because a neurosurgeon is taking on more risk than a family medicine physician, their malpractice RVUs are higher.

因為神經外科醫師承擔的風險比家庭醫學醫師大，所以他們的醫療疏失 RVUs 也比較高。

When you combine work RVUs, production malpractice expense RVUs, and malpractice RVUs, you get total RVUs.

當你把工作相對價值單位、生產醫療疏失費用相對價值單位，以及醫療疏失相對價值單位加起來，就能得到總相對價值單位。

Medicare because of the current setup of the American healthcare system, what Medicare decides to do is what many commercial insurance companies follow.

聯邦醫療保險，因為美國醫療保健系統目前的架構，聯邦醫療保險的決定會影響許多商業保險公司。

Although the US Healthcare system is anything but simple, healthcare payments run more smoothly because everyone uses RVUs.

雖然美國的醫療保健系統一點都不簡單，但因為大家都在使用 RVUs，所以醫療支付流程會更順暢。

The Relative Value Scale Update Committee, or RUC, determines RVUs.

相對價值量表更新委員會，或稱 RUC，負責決定 RVUs。

Technically, the RUC is a private committee that gives recommendations to Medicare, but

技術上來說，RUC 是一個私人委員會，會向聯邦醫療保險提出建議，但是

these recommendations are almost always accepted in their entirety.

這些建議幾乎總是會被完整接受。

The AMA leads this committee, which includes representatives from every medical specialty.

美國醫學會領導這個委員會，成員包含各個醫學專科的代表。

The committee looks at survey data from each specialty to see how long it takes doctors to perform a certain CPT code.

委員會會檢視各專科的調查數據，瞭解醫師執行特定 CPT 代碼需要花費多久時間。

CPT stands for current Procedural Terminology, which is a standard vocabulary for classifying different types of physician tasks and procedures.

CPT 是目前程序術語的縮寫，這是用來分類不同類型醫師任務和程序的標準詞彙。

Then the committee votes to determine whether the RVUs for each CPT are fair or need to be adjusted.

接著委員會會投票決定每個 CPT 的 RVUs 是否公平或需要調整。

Now that we have a basic understanding of RVUs, we can calculate how much Medicare pays for a particular service.

既然我們對 RVUs 有了基本瞭解，就可以計算聯邦醫療保險會為特定服務支付多少費用。

We will work through two calculations, one for a routine primary care visit and one for intensive surgery.

我們會進行兩項計算，一項是例行的初級照護門診，另一項是密集手術。

However, before we do the math, this is what you need to know about Medical Codes and reimbursement Rates if you've ever seen a medical bill, you might have noticed a string of random numbers attached to each service, and

不過，在我們開始計算之前，如果你看過醫療帳單，可能會注意到每項服務後面都有一串隨機數字，關於醫療代碼和報銷費率，你需要知道這些。

Each code is attached to a different number of RVUs based on how much work it takes to perform the service called work rvus, how much it costs the facility to offer that service called practice expense RVUs, and

每個代碼都對應不同數量的 RVUs，這取決於執行該服務需要多少工作量，稱為工作相對價值單位；機構提供該服務的成本，稱為執業費用 RVUs；以及

how much liability the physician takes on to perform that service called malpractice RVUs.

醫師執行該服務所承擔的風險，稱為醫療疏失 RVUs。

These are the dollar value for each billed RVU, meaning how each RVU is converted into money.

這是每筆已開帳單 RVU 的美元價值，也就是每個 RVU 如何轉換成金錢。

At the time of this video, Medicare set the RVU to dollar conversion rate at $33.2875 per RVU.

在本影片發布時，聯邦醫療保險將 RVU 的美元轉換率設定為每 RVU 33.2875 美元。

Insurance companies have their own conversion rates, often in the range of $45 to $75 per RVU.

保險公司有自己的轉換率，通常在每 RVU 45 到 75 美元之間。

The first example is an established patient office visit that lasts between 20 to 29 minutes.

第一個例子是看診時間在 20 到 29 分鐘之間的舊病患門診。

The Centers for Medicare and Medicaid Services determined this code receives 1.3 work RVUs, 0.56 practice expense RVUs, and

聯邦醫療保險與醫療補助服務中心（Centers for Medicare and Medicaid Services）判定此代碼可獲得 1.3 個工作相對價值單位、0.56 個執業費用相對價值單位，以及

Adding these together gives a total of 1.96 RVUs.

將這些加起來總共是 1.96 個 RVUs。

With a reimbursement rate of 33.2875, the physician should expect $65.24 every time they enter a 99213 code.

以 33.2875 的報銷費率計算，醫師每次輸入 99213 代碼時，預期會收到 65.24 美元。

Many encounters often involve multiple services.

許多就診情況常包含多項服務。

For example, the doctor could check your ear for an ear infection medical code 99203 consult the patient on smoking cessation and perform a mental health assessment code 90791 all in one visit.

例如，醫師可以檢查你的耳朵，使用醫療代碼 99203 處理耳部感染，就抽菸戒斷問題諮詢病患，並進行心理健康評估，代碼為 90791，這些都可以在一次就診中完成。

This means for a 20 to 29 minute appointment, the physician is likely to make more than $65.24 for their services as they are getting RVUs from each CPT code simultaneously.

這表示對於 20 到 29 分鐘的預約，醫師很可能會從每項 CPT 代碼同時獲得 RVUs，是以收入會比 65.24 美元來得多。

If you're trying to choose a specialty or subspecialty, check out our so youo Want to Be series, which provides insight into what it's like to pursue different specialties.

如果你正在考慮選擇一個專科或次專科，可以看看我們的「你想要成為…」系列，裡面有關於不同專科的深入介紹。

If you don't see a specialty you're interested in, leave a comment below to make the request.

如果你沒有看到你感興趣的專科，請在下方留言告訴我們。

The second example is the resection of an apical lung tumor.

第二個例子是肺尖腫瘤的切除。

The medical code for this is 32503 CMS determined.

這個醫療代碼是 32503，由 CMS 決定。

This code receives 31.74 work RVUs, 13.42 practice expense RVUs and and 7.8 for malpractice RVUs.

這個代碼包含 31.74 個工作相對價值單位，13.42 個執業費用相對價值單位，以及 7.8 個醫療疏失相對價值單位。

These high numbers account for the skilled work required for the surgery, the high OR costs, and

這些高數字反映了手術所需的精湛技術、高昂的手術室成本，以及

This results in a total of 53 RVUs, or $1,764.23 for performing the surgery needed to remove a particular type of lung tumor.

這意味著進行切除特定類型肺腫瘤所需的手術，總共可獲得 53 個 RVUs，或 1,764.23 美元。

This means if you're a primary care physician and you spend one hour with a patient, you might earn 3.5 RVUs.

這表示如果你是基層醫師，與病患共度一小時，你可能會賺取 3.5 個 RVUs。

If you're a surgeon performing an operation that lasts an hour, you could earn 10 RVUs.

如果你是外科醫師，進行一個小時的手術，你可能會賺取 10 個 RVUs。

However, physicians don't pocket the entire 100% of the RVUs they make.

不過，醫師們並不能將他們賺取的 RVUs 全額 100% 收入囊中。

If the physician is in private practice, they keep everything, but

如果醫師是自己開業，他們會保留全部收入，但

they also need to pay for a number of expenses involved in running the practice.

他們也需要支付經營診所的許多開銷。

And keep in mind, running an OR is much pricier than the overhead for a simple clinic visit.

而且要記住，經營一個手術室比單純的門診開銷貴多了。

For example, if they work at a hospital, the hospital keeps the RVUs and pays the doctor a predetermined salary.

舉例來說，如果他們在醫院工作，醫院會保留 RVUs 並支付醫師預定的薪水。

This salary is often created based on the average RVUs they generate per month.

這份薪水通常是根據他們每月平均產生的 RVUs 所訂定的。

Minimums need to be hit and often if a physician goes above their set monthly goals, bonuses are added to their pay.

必須達到最低標準，而且如果醫師超過他們設定的每月目標，通常會額外獲得獎金。

Bonuses are often noted as other reportable compensation.

獎金通常會被記錄為其他可申報的報酬。

If you have a medical bill lying around and want to see how much the physician was paid for the service you received, go to the US Government's Search the Physician Fee Schedule website linked in the description.

如果你手邊有醫療帳單，想知道醫師從你接受的服務中獲得多少報酬，可以到美國政府的「搜尋醫師費用表」網站，連結在說明裡。

Lastly, let's discuss the pros and cons of using a pay for service system.

最後，我們來討論一下論質計價系統的優缺點。

The main benefits are standardization, transparency, and incentivizing efficiency.

主要的好處是標準化、透明化，以及鼓勵效率。

Since both Medicare and insurance companies use RVUs to determine how much to reimburse, the entire billing process is smoother.

由於聯邦醫療保險和保險公司都會使用 RVUs 來決定給付金額，所以整個計費流程會更順暢。

If the government and commercial insurance companies were using completely different tools to determine how much physicians should be paid, things would get messy fast.

如果政府和商業保險公司使用完全不同的工具來決定醫師的薪資，事情很快就會變得一團亂。

The system is transparent because the number of RVUs associated with each medical code is public information.

這個系統之所以透明，是因為每個醫療代碼的 RVUs 數量都是公開資訊。

Anyone can search it and the system helps ensure physicians are fairly compensated for their work.

任何人都可以查詢，這個系統有助於確保醫師的工作獲得公平的報酬。

Because RVUs are the main method of payment for physicians, many physicians optimize their practices to generate as many RVUs as possible.

由於 RVUs 是醫師的主要支付方式，許多醫師會優化他們的執業方式，以產生盡可能多的 RVUs。

This promotes efficiency but presents larger challenges of maintaining quality of care.

這能提升效率，但也帶來了維持照護品質的更大挑戰。

The three main Drawbacks of the Fee for service system are variability of reimbursement rates, complexity and quality of care.

論質計價系統的三個主要缺點是給付費率的變異性、複雜性以及照護品質。

If if you've ever worked as a scribe or medical assistant, you may have heard physicians complaining about reducing reimbursement rates because RVUs are converted to dollars.

如果你曾擔任過抄寫員或醫療助理，你可能聽過醫師抱怨給付費率降低，因為 RVUs 會轉換成美元。

If the conversion rate is low, doctors will make less money across the board for the same amount of work this year to year.

如果轉換率很低，醫師今年的總收入就會比去年減少，即使工作量相同。

Variability can make it difficult for hospitals and clinics to make long term plans as they may not have the same cash flow the following year.

費率的變異性讓醫院和診所難以做長期規劃，因為下一年的現金流可能不如預期。

Complexity is another serious problem for the RVU system.

複雜性是 RVU 系統的另一個嚴重問題。

Many pre meds and even medical students don't have a full understanding of how RVUs work and how they will be paid as doctors.

許多醫學院預科生甚至醫學院學生，都無法完全理解 RVUs 的運作方式，以及他們未來當醫師時會如何獲得支付。

The last and most serious drawback to the RVU system is the potential for lower quality of care for patients.

RVU 系統最後一個也是最嚴重的缺點，就是可能影響病患的照護品質。

Critics of this healthcare model often argue that fee for service care unethically incentivizes physicians to focus on quantity over quality.

這種醫療模式的批評者常認為，論質計價的照護不道德地鼓勵醫師注重數量而非品質。

Since the RVU system prioritizes the number of patients a physician sees, the number of services provided and the complexity of those services, it can undermine the quality of patient care.

由於 RVU 系統優先考量醫師看診的病患人數、提供的服務數量以及這些服務的複雜度，這可能會損害病患的照護品質。

Fraud can and frequently does occur as there is a financial motive to perform as many tests and procedures as possible even if those tests are not medically necessary.

詐欺行為確實會發生，而且頻繁發生，因為存在著盡可能多做檢查和程序的財務動機，即使這些檢查並非醫療上必要。

This has undeniably negative consequences for patient care, hospital resources, and taxpayer dollars.

這對病患照護、醫院資源和納稅人的錢，都無疑會造成負面影響。

Physicians shouldn't be incentivized to act like pushy car mechanics.

醫師不應該被鼓勵像推銷的汽車技師一樣。

They should be seen as trusted advisors who always act in the best interest of their patients.

他們應該被視為值得信賴的顧問，永遠以病患的最佳利益為重。

Since the 1960s, there has been a movement to focus on the quality of medical care, paving the path for value based care.

自 1960 年代以來，一直有個運動強調醫療照護的品質，為價值導向照護鋪平道路。

Instead of reimbursing physicians for each individual service they render, Value based care ties reimbursement to the quality and effectiveness of the care provided.

價值導向照護不以支付醫師提供的個別服務來支付費用，而是將支付與照護的品質和有效性連結。

But how hospitals and Medicare determine quality and effectiveness is where value based care gets complex.

但醫院和聯邦醫療保險如何決定品質和有效性，就是價值導向照護變得複雜的地方。

There are countless measures hospitals can use to objectively determine the quality of a physician's care.

醫院有數不清的指標可以客觀地決定醫師照護的品質。

If you'd like us to cover how value based care is determined and the benefits of this payment system in another video, leave us a comment.

如果你希望我們在另一支影片中探討價值導向照護是如何確定的，以及這個支付系統的好處，請在下方留言告訴我們。

While the current system can encourage medical students to pursue specialties that generate higher RVUs, it's essential to note that a lack of passion and enthusiasm for your work means you're very likely to experience unhappiness and depression and burnout at the end of the day, no amount of money is worth that.

雖然目前的系統可能會鼓勵醫學院學生追求能產生較高 RVUs 的專科，但必須注意的是，缺乏對工作的熱情和投入，意味著你很有可能會感到不快樂、沮喪並最終心力交瘁，沒有任何金錢值得你這樣做。

Choose the specialty that will give you the most personal satisfaction based on a number of factors rather than solely looking at how to maximize your income.

選擇一個能給你最多個人滿足感的專科，並考量多項因素，而不是隻看如何最大化你的收入。

No matter the specialty you choose Research will play a huge role in your success.

無論你選擇哪個專科，研究都會在你的成功中扮演重要角色。

Elevating your research skills while building your list of publications will open doors and give you the option to choose the specialty you most align with.

提升你的研究技能，同時建立你的出版品清單，將為你開啟機會，讓你選擇最符合你志向的專科。

The Med school Insiders Ultimate Research Course distills the tactics and lessons Dr.

medschoolinsiders.com 的終極研究課程提煉了醫師

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什麼是 RVUs？醫生是這樣獲得報酬的💸 (What Are RVUs? This is How Doctors Are Paid💸)

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