How Fair is the Fair Market Value for Cardiac Electrophysiology Physician Reimbursement?

November 10, 2025 — The Heart Rhythm Society (HRS) released How Fair is the Fair Market Value for Cardiac Electrophysiology Physician Reimbursement?, examining the current application of fair market value (FMV) regulations and their impact on physician compensation in cardiac electrophysiology.

Originally designed to prevent fraud and conflicts of interest, FMV frameworks are intended to ensure that physician compensation reflects the value of services provided. However, this document highlights how current FMV methodologies may be applied restrictively, particularly for subspecialists such as electrophysiologists, whose work involves complex procedures, extensive training, and significant contributions to health system revenue.

The statement reviews the historical and regulatory foundations of FMV, as well as the common approaches used to determine compensation, including reliance on survey-based percentile benchmarks. It outlines key limitations of these models, noting that they often fail to account for procedural complexity, cognitive workload, and non-revenue-generating activities such as education, administration, and research.

Key issues explored in the document include:

• Limitations of survey-based FMV methodologies and percentile-based compensation caps
• Misalignment between physician productivity and compensation
• The impact of hospital employment consolidation on negotiating power
• Consequences for workforce sustainability, including burnout and reduced pipeline of specialists
• The disconnect between physician compensation and overall economic value generated within health systems

The document also proposes a path forward, emphasizing the need for specialty-specific FMV frameworks that better reflect the unique contributions of electrophysiologists. It calls for a multistakeholder approach involving professional societies, health systems, and policymakers to improve transparency, data collection, and compensation models.

Overall, the statement highlights the importance of aligning compensation structures with the realities of modern electrophysiology practice to support physician well-being, workforce sustainability, and patient access to high-quality care.