{
  "slug": "medical-practice-cost-per-visit",
  "title": "Medical Practice Cost Per Visit Calculator",
  "heading": "Cost Per Patient Visit Calculator",
  "category": "financial",
  "url": "https://www.revenuelab.fyi/toolbox/medical-practice-cost-per-visit",
  "summary": "Break down fully-loaded overhead and staff cost per visit for a medical practice.",
  "description": "Practices routinely underprice their break-even point because they only think about the physician's time, not the front desk, MA, billing staff, rent, EHR subscription, and malpractice insurance sitting behind every appointment slot. This calculator divides total monthly fixed and variable practice overhead by monthly visit volume to produce a true fully-loaded cost per visit, then compares it against your average reimbursement to show margin per visit. It's the number that should drive decisions about panel size, no-show policy, and whether a payer contract at a given rate is even worth keeping. Many primary care practices find their true cost per visit is $110–$180 once overhead is properly allocated, well above what a quick mental estimate suggests, which is why payer mix and visit volume matter as much as the fee schedule itself.",
  "formula": "Cost per visit = (fixed monthly overhead + variable cost per visit × visits) ÷ visits; margin = avg reimbursement − cost per visit.",
  "dateModified": "2026-09-30",
  "run_url": "https://www.revenuelab.fyi/api/public/calc?tool=medical-practice-cost-per-visit",
  "inputs": [
    {
      "id": "rent",
      "label": "Monthly rent & utilities",
      "kind": "number",
      "hint": null,
      "default": 8000,
      "unit": "$",
      "min": 0,
      "max": null
    },
    {
      "id": "staffCost",
      "label": "Monthly non-provider staff cost",
      "kind": "number",
      "hint": null,
      "default": 22000,
      "unit": "$",
      "min": 0,
      "max": null
    },
    {
      "id": "otherFixed",
      "label": "Other fixed overhead (EHR, insurance, billing)",
      "kind": "number",
      "hint": null,
      "default": 6000,
      "unit": "$",
      "min": 0,
      "max": null
    },
    {
      "id": "variablePerVisit",
      "label": "Variable cost per visit (supplies, labs)",
      "kind": "number",
      "hint": null,
      "default": 12,
      "unit": "$",
      "min": 0,
      "max": null
    },
    {
      "id": "visitsMonth",
      "label": "Visits per month",
      "kind": "number",
      "hint": null,
      "default": 700,
      "unit": null,
      "min": 1,
      "max": null
    },
    {
      "id": "avgReimbursement",
      "label": "Average reimbursement per visit",
      "kind": "number",
      "hint": null,
      "default": 145,
      "unit": "$",
      "min": 0,
      "max": null
    }
  ],
  "outputs": [
    {
      "id": "costPerVisit",
      "label": "Fully-loaded cost per visit",
      "format": "currency",
      "hint": null,
      "primary": true
    },
    {
      "id": "margin",
      "label": "Margin per visit",
      "format": "currency",
      "hint": null,
      "primary": false
    },
    {
      "id": "marginTotal",
      "label": "Monthly profit at this volume",
      "format": "currency",
      "hint": null,
      "primary": false
    },
    {
      "id": "fixedPerVisit",
      "label": "Overhead share per visit",
      "format": "currency",
      "hint": null,
      "primary": false
    },
    {
      "id": "breakEvenVisits",
      "label": "Break-even visits per month",
      "format": "number",
      "hint": null,
      "primary": false
    }
  ],
  "worked_example": {
    "inputs": [
      "Monthly rent & utilities: 8000 $",
      "Monthly non-provider staff cost: 22000 $",
      "Other fixed overhead (EHR, insurance, billing): 6000 $",
      "Variable cost per visit (supplies, labs): 12 $",
      "Visits per month: 700",
      "Average reimbursement per visit: 145 $"
    ],
    "outputs": [
      "Fully-loaded cost per visit: $63.43",
      "Margin per visit: $81.57",
      "Monthly profit at this volume: $57,100",
      "Overhead share per visit: $51.43",
      "Break-even visits per month: 271"
    ]
  },
  "how_to": {
    "title": "How to use this",
    "steps": [
      "Enter monthly rent & utilities ($).",
      "Enter monthly non-provider staff cost ($).",
      "Enter other fixed overhead (ehr, insurance, billing) ($).",
      "Enter variable cost per visit (supplies, labs) ($).",
      "Enter visits per month.",
      "Enter average reimbursement per visit ($).",
      "Read your fully-loaded cost per visit on the right — it updates as you type.",
      "Hit Share to keep the scenario or send it to someone."
    ]
  },
  "scenarios": [
    {
      "name": "Conservative",
      "description": "Lower-end numbers — what if things land soft?",
      "values": {
        "rent": 4800,
        "staffCost": 13000,
        "otherFixed": 3600,
        "variablePerVisit": 7,
        "visitsMonth": 420,
        "avgReimbursement": 85
      }
    },
    {
      "name": "Typical",
      "description": "Defaults — the most common real-world setup.",
      "values": {
        "rent": 8000,
        "staffCost": 22000,
        "otherFixed": 6000,
        "variablePerVisit": 12,
        "visitsMonth": 700,
        "avgReimbursement": 145
      }
    },
    {
      "name": "Ambitious",
      "description": "Higher-end numbers — what if things really pop?",
      "values": {
        "rent": 12800,
        "staffCost": 35000,
        "otherFixed": 9600,
        "variablePerVisit": 19,
        "visitsMonth": 1120,
        "avgReimbursement": 230
      }
    }
  ],
  "limitations": [
    "Results are estimates before tax, fees, and inflation unless an input explicitly covers them.",
    "Rates are treated as fixed for the whole period — variable-rate products will drift from this projection.",
    "This is educational maths, not financial advice. Check anything contractual with the lender or your accountant."
  ],
  "faq": [
    {
      "q": "Why is overhead allocation the hardest part?",
      "a": "Multi-provider practices need to split shared costs (front desk, rent, EHR) across providers, usually by visit share or by FTE. Getting this wrong either overstates a struggling provider's losses or hides an underperforming one behind a busier colleague's volume."
    },
    {
      "q": "What's a healthy margin per visit in primary care?",
      "a": "Anywhere from $20 to $60 per visit is typical after full overhead allocation, depending on specialty and payer mix. Procedural specialties (dermatology, ortho) run higher; cognitive specialties with more time-per-visit and lower reimbursement run tighter."
    },
    {
      "q": "How does payer mix change this number?",
      "a": "Medicaid often reimburses 60-80% of Medicare rates, and Medicare reimburses roughly 80% of commercial rates for the same CPT code. A practice with 40% Medicaid patients needs meaningfully higher commercial rates or visit volume to hit the same margin as an all-commercial practice."
    },
    {
      "q": "Should I include physician compensation in the fixed cost?",
      "a": "Not if you're calculating margin available to pay the physician — that's the point of this number. If you're comparing to employed-physician economics, add physician salary and benefits to fixed overhead and compare the resulting cost per visit to reimbursement directly."
    }
  ],
  "related": [
    "https://www.revenuelab.fyi/toolbox/rvu-physician-compensation",
    "https://www.revenuelab.fyi/toolbox/no-show-cost-calculator"
  ],
  "license": "CC-BY-4.0",
  "citation": "RevenueLab — Medical Practice Cost Per Visit Calculator (https://www.revenuelab.fyi/toolbox/medical-practice-cost-per-visit)"
}