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Radiology Contract — Sample Analysis
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Contract Analysis · Radiology — Diagnostic
sample-radiology-contract.pdf
Moderate Risk
0 = physician-favorable · 100 = extreme risk
Income Snapshot
Four numbers: the total revenue your work generates, what you take home, what your group collects in professional fees, and what the hospital captures. Estimates, not promises. We do not estimate employer cost — if the group wants to argue cost, they can provide their data to you.
Total revenue you generate
Coming soon
Revenue breakdown is rolling out specialty by specialty — live now for emergency medicine and hospital medicine.
Your estimated take-home
$339,743 – $349,751
Mid-range: $339,743
Gross $485,000 – $499,288 minus your share of insurance, retirement, malpractice tail, and tax.
Professional fees collected
Coming soon
Specialty-specific revenue ranges are rolling out — live now for emergency medicine and hospital medicine.
Hospital revenue captured
N/A
Hospital facility-fee math is currently scoped to emergency medicine.
After a combined 30% effective rate covering federal income tax, employee payroll taxes, and the 4.95% Illinois flat tax, this contract produces an estimated $339,700 in annual take-home at P25 and median production, rising to approximately $349,800 at P75 production. The low and mid scenarios are identical because the 11,500-unit bonus threshold sits above the median production of 11,399 wRVUs — at median volume the contract pays base only. Employer-funded tail would remove a $15,000–$30,000 contingent liability at exit.
Executive Summary
This contract presents a base salary of $485,000 with a marginal wRVU rate of $4.50 above an 11,500-unit threshold. The 2025 national diagnostic radiology data puts the median compensation rate at $55.11 per wRVU and median production at 11,399 wRVUs per year — so the bonus threshold sits above median production, and a median-productivity radiologist in this structure earns base only. At 1,500 wRVUs above the threshold, the $4.50 rate produces $6,750 in bonus against roughly $82,700 at the median rate — an effective gap of approximately $76,000 a year on incremental work. Total compensation of $485,000–$499,000 under this structure lands below the P25 total compensation of $509,685 for diagnostic radiology, against a median of $603,897.
The partnership track is the second structural problem. Section 8.1 references "partnership consideration" but specifies no timeline, no buy-in formula, no equity percentage, and no criteria. In private radiology groups, partnership is the largest single financial element of the physician's career with this group — buy-in multiples, equity distributions, and profit-sharing typically represent $200,000–$500,000 in cumulative value over a partnership lifetime. A track without specifics is a promise with no enforcement mechanism.
The non-compete runs 24 months and 30 miles from any Lakeshore facility, and adds a separate prohibition on engaging with any teleradiology platform operating in the United States — a restriction that reaches every market where teleradiology is read, far beyond the group's local referral area. The state-law breakdown, including the radius and duration ranges Illinois courts have upheld, is in the Non-Compete section below.
Three changes are required before this contract reaches fair-market terms: defining the partnership track in writing, increasing the marginal wRVU rate, and removing the teleradiology platform language. Any one of those changes alone is material; together they determine whether this is a career-building position or a multi-year income shortfall.
Key Red Flags
- Marginal wRVU rate $4.50/unit vs. the 2025 national median of $55.11/unit — approximately $76,000/year gap on 1,500 incremental wRVUs
- Partnership track undefined — no timeline, no buy-in formula, no criteria, no equity percentage in Section 8.1
- Non-compete runs 24 months and 30 miles, plus a separate ban on all teleradiology platforms operating in the United States — forecloses a growing segment of post-separation radiology work
- No night or weekend differential on call coverage — 25–50% premium is industry standard
- No subspecialty premium for neuro, breast, or IR reads despite higher wRVU values and technical complexity
Key Strengths
- Base salary of $485,000 sits within 1% of the P50 base compensation of $490,006 for diagnostic radiology — a solid income floor even though the bonus structure underdelivers
- Private group structure with partnership track creates long-term equity upside if track is defined in writing
- Quarterly bonus reconciliation in arrears with no advance draws — eliminates the year-end clawback exposure common in wRVU advance structures
Compensation Analysis
HIGHYour $/wRVU vs the market
Your effective rate of $42.55/wRVU sits at the 24th percentile for this specialty. The shaded band is the national middle 50% (P25–P75).
What you earn at each production level
Annual compensation at your contract rate versus the specialty-median rate, across P25 / median / P75 production. The gap is the cost of the rate, and it grows with volume.
Model
Base Salary + wRVU Bonus
Base Rate
$485,000 / year
Shift differentials: No night or weekend differential — call reads compensated at standard wRVU rate
wRVU Rate vs Benchmark
Contract rate of $4.50/wRVU above the 11,500 threshold is approximately 8% of the 2025 national median rate of $55.11/wRVU. At 1,500 wRVUs above the threshold, the gap against the median rate is approximately $76,000/year. Even at the P25 rate of $44.42/wRVU, the underpayment on incremental work is roughly $60,000/year.
Multiplier: $4.50/wRVU · work RVU
Sign-on Bonus
$25,000
2-year pro-rated clawback on sign-on — $12,500 owed if departure before year 1, $6,250 before year 2
CME Coverage
$3,500/year CME allowance, 5 CME days — in line with professional-society guidance
Productivity Bonus
$4.50/wRVU on all wRVUs above 11,500 annually (quarterly reconciliation)
Net Take-Home
Gross (P25 – P75)
$485,000 – $499,288
Mid: $485,000
Classification
W-2
Drives the expense math
Estimated take-home
$339,743 – $349,751
Mid: $339,743
| Expense line | Annual range | Note |
|---|---|---|
| Estimated taxes (federal + payroll + state) | $145,258 – $149,537 | W-2: federal + employee payroll + IL (30% effective). |
Assumptions
- Production scenarios anchored to the 2025 national diagnostic radiology wRVU percentiles: 8,952 (P25), 11,399 (P50), 14,675 (P75)
- No bonus is earned at P25 or median production — the 11,500-unit threshold sits above the P50 of 11,399 wRVUs; the high scenario includes $14,288 in bonus at P75 production
- Combined 30% effective tax rate: 25% federal + employee payroll baseline plus the 4.95% Illinois flat state rate
- Tail reserve and health-plan employee share are not deducted here — tail is a contingent exit cost detailed in the Malpractice section
Revenue Breakdown (rolling out)
Revenue breakdown is rolling out specialty by specialty. Emergency medicine is live first; other specialties follow as we tune collected-revenue ranges per specialty and practice setting.
Missing Protections
Written partnership track with defined timeline, criteria, and buy-in formula
Section 8.1 references partnership but commits to nothing. In a private radiology group, partnership is the primary wealth-building event — buy-in, equity distributions, and profit-sharing typically represent $200,000–$500,000+ in cumulative value. A verbal partnership track is not an enforceable obligation.
"Add an exhibit to the contract specifying: (a) the partnership timeline — 24–36 months from start date; (b) the criteria — productivity, quality, collegial assessment; (c) the buy-in formula — a defined multiple of trailing 12-month distributions; and (d) the equity percentage — not less than an equal per-partner share."
Night and weekend read differential
After-hours and weekend reads involve after-hours acuity, call-back disruption, and time-opportunity cost. Industry standard in private radiology is a 25–50% per-read premium or flat per-shift differential. Without this language, complex trauma CTs read at 2 AM compensate at the same rate as routine chest X-rays read at 9 AM.
"Add a 30% differential for all reads initiated between 10:00 PM and 7:00 AM and on weekends, or a flat $200/shift premium for overnight coverage."
Subspecialty read premium for neuro, breast, and IR
Subspecialty reads carry higher wRVU values per case and command premium rates in market contracts because of training requirements and billing complexity. Treating all reads identically understates the value delivered for subspecialty work.
"Add a 15% premium on neuro, breast, and IR wRVUs above standard diagnostic reads, or a separate subspecialty fee schedule applied to board-eligible subspecialty cases."
Turnaround time metric with case-complexity adjustment
Section 9.3 ties compensation to turnaround time without case-mix adjustment. A single turnaround metric that treats multi-organ trauma CT the same as a routine chest X-ray creates perverse incentives to prioritize volume over complex reads.
"Tier the turnaround targets by modality and complexity: routine X-ray ≤ 4 hours, CT standard ≤ 2 hours, CT/MRI cross-sectional complex ≤ 4 hours, IR procedures documented separately."
Clause Analysis
"Physician shall receive $4.50 per qualifying work RVU generated above the annual threshold of 11,500 wRVUs."
The $4.50/wRVU marginal rate is approximately 8% of the 2025 national median rate of $55.11/wRVU. The threshold of 11,500 wRVUs sits above the P50 productivity of 11,399 wRVUs/year — a median-productivity radiologist earns no bonus at all, and every unit of above-median production pays $4.50 against a $55.11 median market rate. At 1,500 wRVUs above the threshold, the gap between the contract rate and the median rate is approximately $76,000/year. This structure makes above-median production nearly compensation-neutral, which removes the incentive to read efficiently.
Negotiate the marginal rate to at least $40/wRVU above the threshold — still below the $55.11 median but a substantial improvement in incentive value. Alternatively, lower the threshold from 11,500 to 10,000 wRVUs, which would put it below median production and make the marginal rate apply to realistic volume.
"Physician shall be considered for partnership in Lakeshore Radiology Group upon demonstrating satisfactory performance during the employed period, subject to partnership approval."
"Considered for partnership" is not a commitment — it is an invitation to be evaluated by criteria that are not defined, on a timeline that is not specified, for equity that is not quantified. Every element of the partnership track — timeline, buy-in amount, criteria, vote threshold, equity share — is discretionary under this language. A physician who performs well for three years can be denied partnership with no contractual remedy.
Add a partnership exhibit specifying: (a) timeline of 24–36 months, (b) criteria defined and objective (productivity ≥ P50, quality metrics met, collegial assessment passed), (c) buy-in formula tied to a multiple of trailing distributions with a cap, (d) equity percentage of not less than equal per-partner share. Without a written exhibit, walk away from any partnership promise.
"The Group may modify wRVU compensation rates and annual thresholds by majority vote of the partnership, with sixty (60) days written notice to employed physicians."
The $4.50 marginal rate and the 11,500-unit threshold are not fixed terms — the partnership can change both on 60 days notice, and employed physicians have no vote. Any rate improvement negotiated at signing can be revised away during the employed period, before the physician reaches a partnership vote. This provision converts the productivity plan from a contractual term into a policy the employer controls.
Lock the negotiated economics for the employed period: add language that the marginal wRVU rate may not be reduced, and the annual threshold may not be raised, before the first partnership vote date without the physician's written consent.
"Physician shall participate in after-hours and weekend call coverage as part of the standard rotation. Compensation for call coverage is included in the base compensation structure."
"Included in base compensation" is the contractual language for zero differential. Industry standard for radiology night and weekend reads — particularly for cross-sectional and trauma cases — is a 25–50% per-read premium or flat shift differential. The absence of a differential means a Saturday overnight trauma read rotation generates the same compensation as a Tuesday routine read session, despite materially different acuity and lifestyle impact.
Add a 30% differential for reads between 10:00 PM and 7:00 AM and on weekends/holidays, or a flat $200/shift premium for overnight or holiday coverage. Frame as standard — professional-society practice economics data supports this structure.
"Employer shall provide claims-made professional liability insurance during employment. Extended reporting period coverage is Physician's responsibility upon separation."
Illinois diagnostic radiology tail premiums typically run $15,000–$30,000 for general diagnostic reads; higher for interventional. The employer shifts this cost entirely to the physician. Combined with the sign-on clawback, the effective out-of-pocket cost to leave this contract in the first two years includes the clawback balance plus the full tail premium.
Request employer-funded tail on any separation. If employer will not provide full tail, negotiate a tail allowance of $20,000 escrowed at hire and vesting pro-rata over 3 years.
"Either party may terminate this Agreement upon 90 days written notice. All rights to partnership consideration under this Agreement shall terminate immediately upon separation for any reason."
90 days is appropriate for radiology. The partnership forfeiture clause is the more significant issue: separation for any reason — including employer-initiated termination without cause — forfeits all partnership rights. A physician who performs well for 30 months and is then terminated without cause loses any claim to the partnership track they were promised.
Add a survival clause: if employer terminates without cause after the physician has been employed for 18+ months, the physician retains a right to purchase a proportional equity interest at the defined buy-in formula. This protects the physician in the termination-during-the-track-period scenario.
"Physician shall maintain average turnaround time of 60 minutes for all studies. Failure to meet turnaround targets may result in compensation adjustment."
A single 60-minute turnaround target applied to all studies creates a structural conflict with thorough complex reads. A multi-organ trauma CT, a complex neuroimaging case, or an interventional procedure cannot responsibly be completed in 60 minutes with the documentation required. This standard will penalize radiologists who prioritize complex cases and could indirectly reduce quality.
Request tiered turnaround targets by modality: routine X-ray 45 minutes, standard CT 60 minutes, complex cross-sectional CT/MRI 90 minutes, IR procedures excluded from turnaround metrics entirely.
Non-Compete
HIGHExists
Yes
Radius
30 miles
Duration
24 months
Governing State
Illinois
Enforceability
Moderately Enforceable
Landmark cases: Prairie Rheumatology Associates, S.C. v. Francis (2014, Illinois Appellate Court, Third District): Physician's non-compete unenforceable for inadequate consideration where she resigned after roughly 19 months, short of the two-year continued-employment threshold and with little additional benefit conferred.
Illinois enforces reasonable physician non-competes (Enforceable — common-law reasonableness). Treat this as binding and negotiate the scope down now. Your 30-mile radius exceeds what Illinois courts typically uphold (2–25 miles) — push it into that range. Governing law: 820 ILCS 90 (Illinois Freedom to Work Act).
Malpractice Insurance
MODERATEType
claims-made
Coverage Limits
$1,000,000 per occurrence / $3,000,000 aggregate
Tail Coverage
Not provided — physician responsibility on separation
Tail Cost Estimate
$15,000–$30,000 (Illinois diagnostic radiology, major carriers, 2025 pricing)
Request employer-funded tail. Also negotiate a consent-to-settle clause protecting NPDB record — particularly important given the partnership track context.
Termination Provisions
MODERATEWithout-Cause Notice
90 days written notice by either party
With-Cause Provisions
Immediate termination for: (1) loss of medical license, (2) DEA registration suspension, (3) felony conviction, (4) material breach not cured within 10 days, (5) exclusion from federal healthcare programs, (6) loss of hospital radiology privileges.
Physician Rights
90 days written notice to terminate without cause. No physician right to terminate for cause against employer. Partnership forfeiture on any separation — including employer-initiated without cause — is the most punitive element of the termination provisions.
Add a provision that partnership rights survive employer-initiated termination without cause after 18 months of employment. Also add a physician right to terminate immediately for cause if employer fails to pay compensation within 15 days of the due date.
Benefits & Leave
LOWHealth Insurance
Group health plan available — employee contribution deducted from pay; employer contribution not specified
CME
$3,500/year CME allowance and 5 paid CME days — consistent with the professional-society recommended range
PTO
20 days PTO per year — below the median vacation allotment of 180 hours (22.5 days) in the 2025 national radiology data; does not include CME days
Retirement
Profit-sharing 401(k) available at partnership; 401(k) for employed physicians with employer match not specified
Disability
Short-term disability provided; long-term disability not addressed
Malpractice
Claims-made coverage provided during employment; tail not included (see Malpractice section)
Negotiation Approach
The partnership track is the highest-value item in any private radiology group contract — it must be defined in writing before signing. The marginal wRVU rate and the non-compete scope are the two other material issues. Sequence: (1) partnership exhibit — this is a deal condition, not a negotiating ask; (2) wRVU rate increase or threshold reduction; (3) teleradiology language removal and geographic radius reduction; (4) night/weekend differential. The teleradiology platform ban reaches every U.S. market — its removal is a scope-narrowing ask the group can grant without touching its local referral protection.
Opening Move
"I am interested in this position and the partnership potential, but Section 8.1 does not give me enough specificity to evaluate the real value of the track. Before I can finalize any terms, I need a partnership exhibit that specifies the timeline, criteria, and buy-in formula. I am happy to discuss the employment terms in parallel, but the partnership definition is a condition of my signing."
Key Principles
- Partnership definition is a condition, not an ask. Do not accept "we will work it out" — get it in writing or walk.
- Use the 2025 national diagnostic radiology data for the wRVU rate. A $4.50/unit marginal rate against the $55.11 median is a number no employer can defend — bring the percentile figures, not feelings.
- The teleradiology platform ban reaches every U.S. market. Frame its removal as scope-narrowing, and anchor the geographic ask to the 2–25 mile range Illinois courts have upheld (see the Non-Compete section).
- Night/weekend differential is widely granted in private radiology. Frame as standard practice.
- Do not let the sign-on clawback and tail cost compound your exit exposure — negotiate tail funding early.
Sequencing
- 1Make partnership exhibit a pre-signature condition — communicate this in writing before the formal counter-proposal
- 2Submit written counter-proposal on wRVU rate (target $40+/wRVU above threshold) as the second item
- 3Address the non-compete in the third phase — removal of the teleradiology platform language plus a radius reduction into the 2–25 mile range Illinois courts have upheld
- 4Bundle night/weekend differential and subspecialty premium as final redline additions
- 5Tail funding is the last financial item — often granted by private groups that want to retain the physician beyond year 2
Negotiation Priorities
Financial Impact
Partnership equity distributions and profit-sharing typically add $100,000+ per year over employed compensation once admitted — $300,000+ over the first 3 partnership years, and $200,000–$500,000 in cumulative career value. An undefined track is worth $0 contractually.
Current Terms
"Consideration for partnership" with no timeline, criteria, buy-in, or equity specification
The Ask
Partnership exhibit: 24–36 months, defined criteria, buy-in formula at trailing distribution multiple, equal per-partner equity share
Fallback
If the full exhibit is refused at signing, a binding addendum committing to a partnership vote no later than 36 months from start date, with the buy-in defined as a capped multiple of trailing 12-month distributions and equity of not less than an equal per-partner share
Walk-Away Point
Walk away if partnership is not defined in a written exhibit. A verbal promise on partnership is not enforceable.
Say this
“Section 8.1 offers consideration for partnership but no timeline, no criteria, no buy-in formula, and no equity percentage. At a private radiology group, partnership represents $200,000–$500,000 in cumulative value, and I need that defined before I sign. I am asking for a partnership exhibit specifying a 24–36 month timeline, objective criteria, a buy-in formula tied to trailing 12-month distributions, and an equal per-partner equity share. I am glad to negotiate the employment terms in parallel, but the written exhibit is a condition of my signature.”
Financial Impact
The teleradiology ban forecloses roughly $100,000+/year in post-separation teleradiology income — $200,000+ over the 24-month restriction, with the full exposure falling inside any 3-year horizon.
Current Terms
30-mile radius plus a ban on all teleradiology platforms operating in the United States, for 24 months
The Ask
Teleradiology platform language removed entirely; geographic radius reduced into the 2–25 mile range Illinois courts have upheld
Fallback
If full removal is refused, replace the platform ban with a narrow restriction limited to reads on patient populations with an active encounter at a Lakeshore-affiliated facility, and reduce the geographic radius from 30 to 20 miles
Walk-Away Point
Teleradiology platform language must be removed, and the geographic radius must come down into the 2–25 mile range Illinois courts have upheld.
Say this
“The 24-month ban on every teleradiology platform operating in the United States reaches far beyond the group's local referral market, and the 30-mile radius sits above the 2–25 mile range Illinois courts have typically upheld. At $500–$700 per teleradiology shift, the platform ban forecloses more than $100,000 a year in post-separation income. I am asking for the teleradiology platform language to be removed and the radius reduced to 20 miles — the group's local referral relationships are fully protected at that scope.”
Financial Impact
At 1,500 wRVUs above threshold, increasing from $4.50 to $40/unit adds $53,250/year — $159,750 over 3 years. At the $55.11 median rate, the gain is $75,915/year and $227,745 over 3 years.
Current Terms
$4.50/wRVU above 11,500 wRVUs annually
The Ask
$40/wRVU above 11,500 wRVUs (below P25 but substantially more rational)
Fallback
$25/wRVU above the threshold combined with lowering the threshold from 11,500 to 10,000 wRVUs, so the higher rate applies to more of the actual production
Walk-Away Point
$25/wRVU minimum above threshold. Below this, above-median production generates a de minimis bonus.
Say this
“The 2025 national diagnostic radiology data shows a median of $55.11 per wRVU, and this contract pays $4.50 on units above the threshold — roughly 8% of the median. At 1,500 wRVUs above 11,500, that is a gap of about $76,000 a year. I am asking for $40 per wRVU above the threshold, which is still below the median but restores a rational productivity incentive.”
Financial Impact
At 1 overnight shift per week, a $200/shift differential adds $10,400/year — $31,200 over 3 years. A 30% read premium on overnight cross-sectional reads adds a similar or higher figure depending on volume.
Current Terms
Night and weekend reads included in base compensation — no differential
The Ask
30% differential on reads between 10:00 PM and 7:00 AM and on weekends, or $200/shift flat
Fallback
A 25% per-read differential on overnight reads, or a flat $200/shift premium limited to overnight coverage with weekend reads revisited at the next annual rate review
Walk-Away Point
$150/shift minimum, or 20% per-read differential. Below this, overnight coverage is significantly undercompensated.
Say this
“Industry standard in private radiology is a 25–50% premium on night and weekend reads, and this contract folds that coverage into base with no differential at all. I am asking for a 30% differential on reads between 10:00 PM and 7:00 AM and on weekends, or a flat $200 per shift. At one overnight shift per week that is roughly $10,400 a year — a modest cost to the group, and standard market practice.”
Financial Impact
One-time $15,000–$30,000 tail liability at exit. Combined with the sign-on clawback, departure within the first 3 years can cost $25,000–$55,000 out of pocket.
Current Terms
Physician responsible for all tail costs on separation
The Ask
Employer provides tail coverage on any separation, or $20,000 tail allowance vesting over 3 years
Fallback
A $20,000 tail allowance escrowed at hire and vesting pro-rata over 3 years, or employer-funded tail triggered on any employer-initiated termination without cause
Walk-Away Point
$20,000 escrowed tail allowance, vesting over 3 years minimum.
Say this
“Tail on an Illinois diagnostic radiology claims-made policy runs $15,000 to $30,000, and as written that entire cost falls on me at separation. Combined with the sign-on clawback, an early exit could cost $25,000 to $55,000 out of pocket. I am asking the group to fund tail coverage on any separation, or alternatively to escrow a $20,000 tail allowance vesting pro-rata over 3 years.”
Generate Counter-Proposal
What this section does
- Generates a full counter-proposal letter in your chosen tone (warm or firm), addressed to the employer, citing specific specialty benchmarks and your negotiation priorities.
- Lets you select which priorities to include, and supports both new-offer and renegotiation letter types with an optional contract start date.
- Output is editable, copyable, and prints to PDF alongside the report — ready to send, or revise it first.
Unlimited Q&A
Example question
Unlimited Q&A — ask follow-up questions about your analysis
Ask about any clause, negotiate strategy, what specific language to request, or what a term means in practice. Answers are grounded in your actual contract text and benchmarks for your specialty. Yours forever — come back any time.
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