J, G.S., Rohit, M., Rahul, C., Renick, P., Arash, A., Suneet, M., Sammy, K., Chirag, S., Ashish, S., Jodie, H., M, A.K.S., Aashish, K., Justin, B., Amit, S., Luigi, D.B., A, E.K., Andrea, N., K, C.M., & Dhanunjaya, L. (2026). How fair is the fair market value for cardiac electrophysiology physician reimbursement?. Heart rhythm. https://doi.org/10.1016/j.hrthm.2025.10.061
J GS, Rohit M, Rahul C, Renick P, Arash A, Suneet M, et al. How fair is the fair market value for cardiac electrophysiology physician reimbursement?. Heart rhythm. 2026; doi: 10.1016/j.hrthm.2025.10.061
J GS, Rohit M, Rahul C, et al. How fair is the fair market value for cardiac electrophysiology physician reimbursement?[J]. Heart rhythm. 2026. DOI: 10.1016/j.hrthm.2025.10.061.
@article{j2026,
author = {Greenberg Scott J and Mehta Rohit and Chaudhary Rahul and Perry Renick and Aryana Arash and Mittal Suneet and Khatib Sammy and Sandesara Chirag and Sadhu Ashish and Hurwitz Jodie and Al-Khatib Sana M and Katapadi Aashish and Beland Justin and Shanker Amit and Di Biase Luigi and Ellenbogen Kenneth A and Natale Andrea and Chung Mina K and Lakkireddy Dhanunjaya},
title = {How fair is the fair market value for cardiac electrophysiology physician reimbursement?},
journal = {Heart rhythm},
year = {2026},
doi = {10.1016/j.hrthm.2025.10.061},
note = {PMID: 41224166},
}
TY - JOUR AU - Greenberg Scott J AU - Mehta Rohit AU - Chaudhary Rahul AU - Perry Renick AU - Aryana Arash AU - Mittal Suneet AU - Khatib Sammy AU - Sandesara Chirag AU - Sadhu Ashish AU - Hurwitz Jodie AU - Al-Khatib Sana M AU - Katapadi Aashish AU - Beland Justin AU - Shanker Amit AU - Di Biase Luigi AU - Ellenbogen Kenneth A AU - Natale Andrea AU - Chung Mina K AU - Lakkireddy Dhanunjaya TI - How fair is the fair market value for cardiac electrophysiology physician reimbursement? T2 - Heart rhythm PY - 2026 DO - 10.1016/j.hrthm.2025.10.061 AN - PMID:41224166 ER -
Fair market value (FMV) regulations were established in health care to prevent fraud and eliminate conflicts of interest by ensuring that physician compensation reflects the value of services rendered, independent of referrals or business volume. The current application of FMV is restrictive, particularly disadvantaging subspecialists including cardiac electrophysiologists. We critically examine the historical context, legal underpinnings, methodologies, and limitations of current FMV models-focused on electrophysiology. FMV determinations rely on compensation surveys (eg, Medical Group Management Association, American Medical Group Association, MedAxiom) that apply percentile-based thresholds, which fail to account for procedural complexity, extended training, and exceptional productivity, thereby undervaluing highly skilled physicians. Electrophysiologists are uniquely affected owing to their labor-intensive procedures, cognitive demands, and role in generating substantial facility revenues-factors largely unrecognized by existing work relative value unit-centric frameworks. Trends toward hospital employment/consolidation have exacerbated the problem. This has created a "monopsony"-a market with a single dominant buyer, where they wield disproportionate power over wages and contract terms owing to the lack of competing employers-allowing hospitals to exert downward pressure on physician compensation. This misalignment contributes to physician burnout, deters entry into demanding specialties, threatens workforce sustainability, and limits patient access to care. We propose a multistakeholder reform strategy, emphasizing the need for the Heart Rhythm Society to spearhead the development of a specialty-specific FMV framework. Through enhanced data collection, regional benchmarks, and novel compensation tools, FMV can be restructured to reflect market realities, support physician well-being, and promote excellence in high-skill, high-value care.