How we value your work

The simple version of the math

Every number you see in FairPay-Rx traces back to a CMS Physician Fee Schedule rule and the document you uploaded. Here's the pipeline, in plain terms.

Reconciliation pipeline
Six stages from extraction to dollar variance.
  1. 1 · Performed procedures

    Extracted from your uploaded productivity reports. Each line is normalized to a numeric CPT code, modifier set, units, and date of service. Low-confidence extractions are quarantined for review before they enter reconciliation.

  2. 2 · Earned dollars (CMS PFS)

    Each performed line is priced against the CMS Physician Fee Schedule national payment amount for the service date's effective rule (the published Final Rule plus any in-year corrections). FairPay-Rx tracks PFS releases (RVU{yy}A–D) and refreshes its reference store on each publication.

  3. 3 · Credited wRVUs

    Read from your compensation statement. Credited wRVU per line is compared to the work-RVU expected for the performed procedure under the value vintage you configure (current-year or frozen anchor-year).

  4. 4 · Paid dollars

    Credited wRVU × the $/wRVU rate configured in Settings. This is what your contract turned into actual pay for that line.

  5. 5 · Variance

    Variance = Earned − Paid. Positive variance indicates the performed work would have been worth more under CMS PFS than the comp model paid. FairPay-Rx surfaces and explains the gap; it does not file, appeal, or recommend action.

  6. 6 · Confidence flags

    Each line carries High / Medium / Low confidence reflecting extraction certainty and rule-matching ambiguity. Low-confidence lines should be reviewed before being trusted.

References & limitations

Sources. CMS Physician Fee Schedule (PPRRVU / GPCI files), the employer compensation statement you upload, and your performed-procedure records.

Limitations. FairPay-Rx does not parse payer 835/ERA remittances; the "reimbursement vs CMS" lens is a deferred milestone. Comp-vs-hours productivity analysis is out of scope.

Disclaimer. Informational only. Not legal, billing, or compensation advice. CPT codes shown numerically only — descriptors are AMA-licensed and not displayed in this preview.