Practice Breakeven Calculator

Every practice owner — and every clinician thinking about opening a practice — needs to know one number: how many patients do we need to see to cover our costs? And then the more important one: how many to pay me what I want? This calculator answers both.

What this calculator does

Enter your fixed monthly costs, average collections per visit, variable cost per visit, your target owner pay, clinic days per month and the most visits you can handle in a day. It shows:

• visits per day needed to hit your pay target,
• breakeven visits per month and per day (with owner pay at zero),
• your contribution margin per visit, and
• how much of your daily capacity your target requires.

The chart shows yearly owner profit at different daily volumes.

The formula in plain English

Contribution margin = collections per visit − variable cost per visit. This is what each visit contributes toward fixed costs and profit.

Breakeven visits per month = fixed monthly costs ÷ contribution margin.

Target visits per month = (fixed monthly costs + owner pay ÷ 12) ÷ contribution margin.

Per day = monthly visits ÷ clinic days per month.

Capacity used = target visits per day ÷ maximum visits per day. If this is over 100%, your target isn't reachable with your current pricing, costs and schedule.

A worked example

Dr. Washington is planning a family medicine practice. Her fixed costs — rent, two medical assistants, a front-desk person, EHR, insurance and a startup loan — total $45,000 a month. She expects to collect $145 per visit, with $22 in variable costs. She plans to work 20 days a month and can see up to 28 patients a day. Her pay target is $250,000.

• Contribution margin: $123 per visit.
• Breakeven: about 366 visits a month, or 18.3 a day.
• To pay herself $250,000, she needs about 26.8 visits a day — 96% of her capacity.

That's a thin margin. A few no-shows a day would push her below target. Her best levers are improving collections (payer contracts, coding, collecting copays at the visit), reducing fixed costs, or adding an NP or PA to raise capacity.

Why it matters at each career stage

If you're: Employed

Thinking about leaving employment to start a practice? Run this with realistic numbers from your specialty before you sign a lease. Ask practice owners in your area about collections per visit and staffing levels.

If you're: Practice owner

Revisit your breakeven whenever costs change — a new hire, a rent increase, a new payer contract. Track visits per day weekly; it's the earliest warning sign that something is off.

If you're: Resident / fellow

If you're interested in ownership, understanding contribution margin now will help you ask good questions when you interview with private groups and evaluate partnership offers.

Ways to improve your breakeven

Raise collections per visit. Review fee schedules, renegotiate payer contracts, reduce denials and collect patient balances at the visit.

Lower variable costs. Compare billing services and supply vendors.

Control fixed costs. Staff is the biggest fixed cost in most practices; match staffing to volume.

Increase capacity. Better scheduling, fewer no-shows and team-based care can raise visits per day without longer hours.

Consider cash-pay services. Services outside insurance can raise your average collection per visit.

Next, check how your costs compare with typical ranges using the overhead ratio calculator, and plan your taxes with the quarterly estimated tax calculator. Our guide to practice ownership numbers covers the rest.