r/CRNA • u/1290_money • 15d ago
1099 Contract Thoughts
My team is currently all w2. 300k base plus call and bonus ends up around 425-450 gross plus retirement matching and full healthcare paid. Currently 12 weeks vacation.
Thoughts on this 1099 contract for new hires:
Base- $275/hr with 8hr minimum daily when working
Overtime- $350/hr after 5PM when not on call.
Weekday Call- $2,000 Daily (covers 5:00 p.m. to 7:00 a.m., whether working or not)
Weekend Call- $3,000 Weekend Day
Thanks in advance.
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u/Bropofol_27 CRNA 13d ago
I feel like Iām being rage baited lol where are you located?
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u/1290_money 13d ago
Oregon. Definitely not rage bait. But I can oblige if you'd like ha ha.
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u/Bropofol_27 CRNA 13d ago
Eugene?
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u/1290_money 13d ago
Eastern. Where the wind blows. This is a preliminary package that I haven't gotten approved yet but hoping to get the green light this week.
I feel like it's pretty aggressive but if you want to hire people this is where you need to be at these days.
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u/DeepHouse1337 13d ago
Any chance of two weeks on two weeks off type gig!?
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u/1290_money 13d ago
Yes. The issue that I'm trying to avoid is having locum providers come through that are not committed members of the team. I need people who are here regularly and plan on being here long term.
The difference between your core team and those who are going to be there for 3 to 6 months it's just so night and day. I need people who are going to make sure that the medication labels stay updated ha ha. That's kind of my litness test.
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u/Nrt33507 13d ago
Are you hiringā¦
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u/1290_money 13d ago
Yup.
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u/Nrt33507 13d ago
What state?
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u/1290_money 13d ago
Oregon. Area is not super desirable but I've been here 12 years and quite like it.
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u/Narrow-Garlic-4606 12d ago
Damn. Iām not being paid my worth at allllll but I really like my job š
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u/Janeway123 13d ago edited 13d ago
Pharmacist here. $275/hr?!?! PLUS OT pay that's even higher?!?! God do I wish I had made different choices when I was younger... If you're working full-time and picking up some of the even-higher paying "undesirable" shifts, this is potentially a $600k/year job. Rural Oregon? For that compensation I'd work in rural Afghanistan.
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u/Timbo558922 CRNA 13d ago
How is this even sustainable? Do you have a humongous stipend from the hospital? Even the W2 gross is way larger than normal.
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u/1290_money 13d ago
The market is crazy right now. I'm close to Yakima Washington and they just put a ad out paying $300 an hour....... Nuts.....
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u/jed0802 13d ago
Tim they make a lot more off anesthesia than they would have you led to believe buddy. I have made over 400k every year as locums and I keep being told no way it keeps up but it just actually keeps going higher lol. Florida is now well over 400k for locums I remember when the pay here was 125 an hour.
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u/Timbo558922 CRNA 13d ago
Oh Iām a locums too and make well over 400k, but these are for staff positions
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u/jed0802 13d ago
We are both 1099. Locums is just a title for traveling 1099. My buddy pays 300k a year for 26 weeks 1099. Actually itās like 310 but still. Trust me a commercial insurer depending on units and asa score for a 60-90 min anesthesia case pays up to 1500+ per case. I do a min 4 of those a day so Iām creating 6000 and being paid 2200
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u/Timbo558922 CRNA 13d ago
Nice. What Iām saying is this compensation is not the normal for our profession.
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u/jed0802 13d ago
You can go to New Mexico right now and make 450-500k lol
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u/Timbo558922 CRNA 13d ago
Yea but who the hell wants to go there? Thereās plenty of local jobs near me where I can sleep in my own bed and make whatever I want depending on how much I want to work.
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u/MacKinnon911 13d ago
Well, not really. What people are getting paid and what anesthesia professional billing actually generates are two different things.
It depends heavily on payer mix, case volume, units generated, and commercial contract rates. Medicare anesthesia reimbursement has not kept up with inflation, Medicaid is generally worse, and commercial rates vary all over the place.
Letās use the contract in this thread and do some basic math.$275/hr, 8-hour minimum, 4 days a week, 42 weeks a year.
That CRNA costs $369,600 a year in base pay before a single dollar of call or overtime.
Now letās give the facility a pretty favorable payer mix of 60% Medicare/Medicaid and 40% commercial. To make it even more favorable, letās pretend all of that Medicare/Medicaid business pays at the Medicare rate instead of discounting Medicaid.
Use about 50 ASA units per provider per day, which is a reasonable national productivity number, and a commercial conversion factor around $82/unit.
That gives you a blended collection rate of about $45/unit.50 units x 168 working days = 8,400 units.
8,400 x $45 is roughly $380,000 in anesthesia professional collections.
Now letās really help the numbers and say this CRNA also bills 3 separately reimbursable procedures every single day they work. Blocks, lines, whatever. Call it $65 collected per procedure.That adds another roughly $33,000.
So now we are at about $413,000 gross.
Take out 6% billing and another 3% administration, which is pretty conservative, and youāre left with about $376,000.The CRNA costs $369,600.
You have basically $6,000 left for the entire year before malpractice, credentialing, recruiting, scheduling costs, cancellations, unproductive time, bad debt, or anything else.Now add just one weekday call per week at the $2,000 rate in this contract.
Thatās another $84,000 a year.
Now the position is about $78,000 underwater.Add one $3,000 weekend call day every 4 weeks and youāre over $100,000 underwater.
And we havenāt even touched the $350/hr after 5 PM rate. Or low volume OB / OR call where fee if any cases are done.
Now put that same CRNA in a 1:4 ACT with a physician anesthesiologist making $800,000 a year. Allocate 25% of that physician cost to each room and thatās another $200,000 in provider expense against the revenue generated by that room.
Now youāre roughly $194,000 underwater before call.
And Medicare doesnāt magically pay two anesthesia fees because you used an ACT. The allowed anesthesia payment gets divided between the physician anesthesiologist and CRNA when medical direction requirements are met.
Yes, CRNAs are making $400K plus in some desperate markets Absolutely. That does not mean the anesthesia professional fee revenue is generating enough money to pay everyone $400K plus.
I did fee for service anesthesia for about 14 years and negotiated facility contracts. There was a time when anesthesia billing itself was extremely lucrative. That has changed dramatically.
Where our economic value really exists now is in what we allow the hospital to do.
Surgery.We are basically the gas required to run the surgical engine. The hospital may lose $100K or $200K subsidizing anesthesia coverage and still be far better off than having ORs sitting empty because they donāt have anesthesia staff.
So yes, these salaries can continue. Hospitals may continue paying them because they have no choice if they want to keep the ORs running.
But thatās very different from saying anesthesia professional billing itself is generating enough revenue to support these salaries. In most places it isnāt.
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u/1290_money 13d ago
Yup this guy gets it. The hospital is recruiting an insane amount of new services -surgeons and procedurealists etc.... They need us to keep the wheels running.
The good thing for our department is that we have set up a super solid team, so they know we will deliver when called upon, so they come to the negotiation table ready when we tell them what we need.
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13d ago
[removed] ā view removed comment
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u/MacKinnon911 13d ago
Locums has and will always exist in my career. Itās where the locums will be thatās the change! If people are willing to goto undesirable locations Locums will be avaliable assuming they stay solvent. Many are closing over the last decade and more with the ābig beautiful billā.
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u/SillyMeringue4946 13d ago
In the northeast a W2 salary of $300k is not abnormal at all, $100k sign on bonus also not abnormal, plus $15-25k annual retention bonus afterwards.
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u/Timbo558922 CRNA 13d ago
The northeast is its own area compared to the rest of the country. Itās not abnormal in the Midwest for 300k with a sign on bonus of 100k for 3 years. But at 425-450k gross Iām sure youāre working a shit ton of call and overtime to get that number.
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u/ImportantPerformer24 13d ago
I think Iād want it know what a typical work week was like. Iām in Portland OR, full-time 1099 and grossed 465k in 2025 with minimal call or weekends, 8 weeks off but the occasional extra shift - usually 10-20 hours extra per month. At your $2200 min daily rate, if I worked 4 days per week and had 12 weeks off, thatād be $352k minimum without call, weekends or staying late. To make up that 113k gap, thatād be a lot of OT, call or weekends. I would expect a better compensation package for a rural area, as they usually need to pay more than big cities to draw great job candidates there.
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u/FreeSprungSpirit 12d ago
That's solid for rural Indy practice, definitely on the better side, really depends what call is like, you're looking at around 4200/day for 24 hr call essentially which isn't anything special but if it's on the lighter side then it's pretty good, all relative, I have sites that pay me 7k/day for 24 HR call but I'm WORKING for it, I'd take 4.5-5k all day if it was chill.
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u/1290_money 11d ago
We have two providers on call for the hospital at all times. One covers OB the other covers the operating room and the rest of the hospital so it's very manageable.
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u/SouthernFloss 13d ago
Make sure you have an S-corp LLC. 1099 needs to be 20-25% above W2 rates to be competitive.
Otherwise, looks good. Where at?
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u/Working-Bike5600 13d ago