Radiology the top specialty in compensation per hour, new AMA survey says

Radiology is the top specialty in compensation per hour, according to new survey data from the American Medical Association. 

The profession led the way with average hourly pay of about $281.27, based on answers from 2,653 rads across 78 departments. This finding comes from the AMA’s newest Physician Practice Information Survey, conducted to help ensure Medicare calculates doc pay based on accurate cost estimates. 

Radiologist Michael Booker, MD, MBA, recently examined the survey findings, sharing his thoughts in a guest column published March 6 in the American College of Radiology’s Bulletin publication. 

“Despite ever-downward pressure on radiology reimbursement, many trends seem to be countering this pressure,” wrote Booker, the college’s alternate advisor on the RVS Update Committee, which advises Medicare on how to value physicians’ work. “Some of the factors with the greatest impact include the radiology labor shortage, ever increasing work RVU requirements (leading to ever increasing burnout) and a shift from small radiology practices performing their own billing to employed and supplemented models.”

The federal payment program has relied on outdated practice expense information dating to 2006 to help calculate physician payments. AMA contracted consultancy Mathematica and worked with over 100 healthcare organizations on this new poll with the goal of creating an accurate representation of business costs. Booker noted that the results could have “substantial implications” on how money is divided among different specialties and between components of the relative value unit. 

Mathematica shared the data with the Centers for Medicare & Medicaid Services in January, and CMS can choose whether to accept it. If so, Booker said to expect shifts in payment rates “across all of medicine.” Multiple specialties were grouped together to obtain an accurate sample size. This resulted in both diagnostic and interventional radiology being lumped together, alongside radiation oncology and nuclear medicine. 

Booker also highlighted practice-expense funding as another key component of the survey’s findings. This element is “particularly important” in radiology, since it makes up a large portion of total imaging reimbursement. The AMA has now calculated new practice-expense-per-physician-hour rates as part of the survey process. Booker noted that these rates are directly responsible for setting indirect practice-expense funding—an amount comprising 70% of total practice-expense funs in imaging. 

Diagnostic radiology’s figure is roughly $134.84 total PE/hr, while IR is at $101.55. But it will ultimately be up to CMS to decide how to use this information. 

“Many specialty surveys saw an increase in PE/hr compared to 2006. Diagnostic radiology experienced a rise in both direct and indirect rates,” Booker noted. “However, because additional funding has not been committed to fund these increases, changes to practice-expense reimbursement will rely on how that specialty performed relative to all other specialties. Due to the way practice expense is calculated, the indirect PE/hr has a particularly large impact as it informs the only specialty-specific budget neutrality adjustment, the Indirect Practice Cost Index.” 

CMS is likely to provide comment on the findings in the 2026 physician fee schedule proposed rule, expected to arrive in July. You can find more about the PPI survey results on the AMA website.