Mechanical Circulatory Support Break-Even: $163K Monthly Revenue

Fixed costs $133.2K/mo Payroll and overhead

Contribution margin 52.5% After variable costs

Break-even revenue $253.4K/mo Needed monthly sales

Break-even timing Month 1 Model break-even point

Break-even calculator

Use this to test whether monthly revenue covers direct costs and fixed overhead in a cardiac support program.

Lean Base Full

Monthly revenue Use monthly collections or billing; more revenue gives more room to cover overhead. $ Lower volume Higher volume Variable expenses Include direct costs that rise with each case, like consumables, commissions, and travel support. $ Lower direct Higher direct

Money available to cover fixed costs $1,371,641 $1,625,167 revenue - $253,526 variable expenses

Margin ratio

84%

Covers fixed costs

Yes

Fixed monthly costs This is the monthly overhead that stays on even when case volume dips. $ Lower overhead Higher overhead

Break-even chart Revenue Total costs

Which expenses stay fixed, and which move with case volume?

Cost classification

Break-even is reliable only when fixed overhead, revenue-linked costs, and staffing steps are separated. This model reaches break-even in Month 1, but that depends on treating payroll capacity differently from case-level spend.

Expense	Cost	Break-Even Treatment	Common Mistake
Headquarters fixed overhead	Fixed	Use $42,200 per month for rent, software, legal, IT, marketing, and office supplies from Month 1 to Month 60.	Spreading office overhead as a revenue percentage.
Salaried leadership and admin payroll	Semi-fixed	Use about $91,000 per month in the first year, then step up as full-time equivalent staffing rises.	Treating coverage payroll as purely variable.
Medical Consumables and Sterile Kits	Variable	Apply 4.5% of revenue in the first year, declining to 3.5% by the mature year.	Modeling sterile kits as a flat monthly line.
Malpractice Insurance Premium Allocation	Variable	Apply 6.5% of revenue in the first year, declining to 5.2% by the mature year.	Ignoring the case-volume link in the allocation.
Business Development Commissions	Variable	Apply 3.5% of revenue in the first year, declining to 2.2% as the program scales.	Leaving commissions inside fixed sales payroll.
Travel and Clinical Site Support	Variable	Apply 4.0% of revenue in the first year, declining to 2.0% by the mature year.	Treating device support and site visits as fixed.

How does break-even change from a lean launch to base and full scale?

Scenario table

Same cost stack, different volume. The base case clears the roughly $163K monthly break-even line, while a lean start sits right on the edge and full scale gives a much wider cushion.

Planning assumptions only, not guarantees; the $1.44M capex total affects cash, not contribution margin.

Scenario	Monthly Revenue	Variable Costs	Fixed Costs	CM Ratio	Operating Profit	Break-Even Signal
Lean launch floor	$163.4K	$30.2K	$133.2K	81.5%	$0	At the floor, any softer ramp turns negative.
Base Year 1 plan	$363.0K	$67.2K	$133.2K	81.5%	$162.6K	Month 1 clears break-even with a healthy cushion.
Full Year 5 scale	$4.5M	$584.0K	$232.6K	87.1%	$3.7M	Wide cushion; fixed cost pressure is easy to absorb.

What breaks the break-even plan for this cardiac support service?

Stress test

The base plan clears break-even with about $200K of monthly cushion. It gets tight fast if revenue slips below $163K or if fixed and variable costs rise together.

Stress Case	Changed Assumption	Break-Even Revenue	Revenue Gap	Risk Signal
Current plan	No change.	$163K	$200K cushion	Strong Month 1 headroom, but payroll keeps burn high.
Revenue shortfall	Monthly revenue falls to $150K.	$163K	$13K gap	Revenue drops below break-even, so cash burn resumes.
Fixed-cost pressure	Fixed costs rise by $10K a month to $143K.	$175K	$188K cushion	Overhead rises, but the plan still clears break-even.
Margin pressure	Variable expenses rise by $36K a month.	$186K	$177K cushion	Contribution shrinks, so break-even moves up fast.
Combined pressure	Revenue falls to $160K, fixed costs add $10K, and variable expenses rise by $36K.	$200K	$40K gap	Break-even moves above revenue, so Month 5 cash need gets tight.

Can you prove the cardiac support program clears break-even before you commit to the build?

Founder checklist

Check that signed referrals can support at least $163K in monthly revenue, the Year 1 plan can reach about $363K a month, and cash stays above the $704K low in Month 5. If any of those break, delay the device buy, staffing ramp, and referral spend.

1Demand Proof$163K/mo

Verify signed referral capacity can support at least this monthly revenue before you lock the build.

2Launch Pace$363K/mo

Confirm the first operating year can reach this monthly revenue pace so the launch plan matches the model.

3Unit Economics$42.2K/mo

Keep fixed overhead at this level and hold contribution near 81.5% so the program can cover payroll and capex.

4Staff Coverage$91K/mo

Lock coverage for the cardiac surgeon, heart failure cardiologist, VAD coordinator, perfusionist, and clinical data specialist roles before you hire to Year 5 scale.

5Cash Floor$704K Month 5

Hold cash above the Month 5 low so the $1.44M build and payroll run-up do not force a stall.

6Launch Systems$4.5K/mo

Test billing and coding first, then confirm registry and compliance software is live before go-live so claims and tracking do not slip.