Medicare Clinical Revenue Proxy
Data-derived proxyFree
Proxy· ▲ Higher is better
What it is
Medicare fee-for-service clinical activity over sector-attributed codes, weighted by work RVUs and shown alongside Medicare allowed amounts.
What it is not
Not income, salary, or total collections. Medicare FFS is one slice of a practice and excludes commercial, Medicaid, facility fees, and salaried support.
- Latent target (what we wish we could measure)
- Clinical professional revenue capacity.
- Proxy (what we actually use)
- wRVU-weighted Medicare FFS volume and Medicare allowed-amount sum over sector-attributed codes, shown side by side.
- Computation
- Aggregate per-NPI service counts x wRVU (and allowed amounts) over the verified code crosswalk, roll up to sector x geography, suppress small cells.
- Confidence inputs
- Coverage is low where Medicare exposure is sparse; mapping certainty is gated by the unverified CPT crosswalk.
Known biases
- Medicare FFS Part B only; excludes Medicare Advantage, commercial payers, facility/technical fees, and salaried structures.
- Only the Medicare subset of each surgeon's volume is observed; total volume requires an explicit payer-mix assumption.
- Systematically understates sectors with younger / commercially insured patients (especially pediatrics).
Requires verification
Requires verification- CPT/HCPCS -> sector crosswalk (licensed coder).
- Target-year conversion factor and wRVU file release.
- Whether to apply any payer-mix scaling (default: none).