The Hospital Math Says Build. The Physician Math Says Do Not. That Gap Is The wRVU Trap.

Most rad onc programs sitting on soft Q2 numbers are looking outside the building for offsetting revenue. The infrastructure for radioligand therapy is already inside the building, and a Jefferson-authored paper accepted by Practical Radiation Oncology in May 2026 puts the 340B-eligible hospital gross margin at roughly $101,000 per Pluvicto patient over a full course. The same paper names why programs stall. The rad onc on a dollars-per-wRVU comp model takes a 26-wRVU haircut against EBRT for picking up RPT. The credential map is already in the department. The comp model discussion is in the way. The operator move is to renegotiate the comp model with the 340B margin as the leverage before the service line gets approved.medsolvedynamics.com | [email protected]