Radiation Oncology Center Break-Even: About $191K Monthly Revenue

Fixed costs $59.0K Monthly overhead base

Contribution margin 82% After variable spend

Break-even revenue $72.0K Revenue needed monthly

Break-even timing Month 1 Launch month break-even

Break-even calculator

This calculator tests monthly revenue, variable expenses, and fixed costs against break-even for a radiation oncology center.

Lean Base Full

Monthly revenue Revenue is the pool that covers direct costs and overhead. $ Early ramp Mature scale Variable expenses Use costs that move with treatment volume, like supplies, software, marketing, and claims work. $ Low direct cost High direct cost

Money available to cover fixed costs $3,186,792 $3,753,583 revenue - $566,791 variable expenses

Margin ratio

85%

Covers fixed costs

Yes

Fixed monthly costs This is the monthly overhead the margin has to cover. $ Tight overhead Heavy overhead

Break-even chart Revenue Total costs

Which radiation oncology center expenses are fixed, and which move with treatment volume?

Cost classification

Break-even is only useful if fixed overhead, revenue-linked spend, and staffing steps stay separate. Here, Month 1 break-even depends on treating the $59,000 fixed monthly base differently from Year 1 variable percentages like supplies at 6% and billing at 4%.

Expense	Cost	Break-Even Treatment	Common Mistake
Facility Lease	Fixed	Include $25,000 per month in fixed overhead from Month 1 through Month 60.	Spreading lease only across treated patients and hiding the monthly cash floor.
Equipment Service Contracts	Fixed	Include $15,000 per month as recurring equipment overhead in operating break-even.	Treating service contracts as optional or fully volume-based forever.
Medical Supplies and Isotopes	Variable	Model as 6.0% of revenue in the first year, falling to 4.0% by Year 5.	Using one flat dollar amount even as treatment revenue scales.
Treatment Planning Software Fees	Variable	Model as 3.0% of revenue in the first year, declining to 2.0% by Year 5.	Classifying planning fees as fixed software overhead instead of treatment-linked spend.
Billing and Claims Processing	Variable	Model as 4.0% of revenue in the first year, easing to 3.2% by Year 5.	Treating billing support as fixed admin labor when claims volume rises with revenue.
Oncology Nurse Specialist	Semi-variable	Start with 2.0 FTE in Year 1 and step up to 5.0 FTE by Year 5 as capacity grows.	Holding nurse staffing flat while specialist count and utilization rise.
Utilities and Clinical Waste	Semi-fixed	Start with the $4,500 monthly run rate, but review when hours, treatments, or equipment use change.	Assuming utilities and waste stay fixed at every utilization level.
Facility Maintenance	Semi-fixed	Use $2,800 per month as the base, then add capacity checks as equipment hours increase.	Ignoring maintenance step-ups as treatment rooms run closer to capacity.

How does break-even change from lean ramp to full utilization at this radiation oncology center?

Scenario table

Lean volume sits close to the fixed load, so the first year is still tight. By Year 3 and Year 5, the higher contribution margin absorbs more overhead and the cushion gets much larger.

Planning cases only; actual results can move with payer mix, referral flow, and machine uptime.

Scenario	Monthly Revenue	Variable Costs	Fixed Costs	CM Ratio	Operating Profit	Break-Even Signal
Lean ramp, Year 1	$1.50M	$0.27M	$1.57M	82.0%	-$0.33M	Still below break-even, so coverage is thin.
Base case, Year 3	$3.75M	$0.57M	$1.95M	84.9%	$1.23M	Crosses break-even with a solid monthly cushion.
Full utilization, Year 5	$7.44M	$0.91M	$2.15M	87.8%	$4.38M	Fixed costs are well covered, so downside risk drops.

What breaks the Year 1 break-even plan for this radiation oncology center?

Stress test

Year 1 clears break-even, but the cushion depends on steady referrals and an 82% contribution margin, meaning 82 cents of each dollar stays after variable costs. Slower starts, payer denials, or a 15% jump in fixed overhead can shrink that cushion fast.

Stress Case	Changed Assumption	Break-Even Revenue	Revenue Gap	Risk Signal
Current plan	No change.	$191K	$1,077K cushion	Clear cushion, but volume has to stay on plan.
Revenue shortfall	Monthly revenue falls 20% from slower referrals and delayed starts.	$191K	$830K cushion	Still positive, but the buffer is thinner.
Fixed-cost increase	Fixed overhead rises 15%.	$220K	$1,054K cushion	More volume is needed to cover the higher load.
Margin pressure	Variable expenses rise 5 points to 23%, cutting contribution margin to 77%.	$203K	$1,002K cushion	Payer mix or supply costs can erode the spread.
Combined pressure	Revenue falls 20%, variable expenses rise to 23%, and fixed overhead rises 15%.	$234K	$747K cushion	The plan still clears break-even, but only if starts and collections hold.

Can this radiation oncology center support break-even before you sign the lease and start buildout?

Founder checklist

Use this check before you lock the lease, order the machine, or hire ahead of revenue. The model only works if Year 1 demand, payer rates, staffing, and cash all hold while you carry a Month 6 trough of -$942K.

1Referral load1,370 tx/mo

Confirm the referral pipeline can fill about 1,370 treatments a month at the Year 1 mix of 350 IMRT, 180 SBRT, 320 IGRT, 400 palliative care, and 120 brachytherapy.

2Payer rates$1.2K-$3.5K

Verify payer setup before you assume the Year 1 prices of $1,200 IMRT, $3,500 SBRT, $1,100 IGRT, $800 palliative care, and $2,800 brachytherapy.

3Contribution margin82% CM

Check that medical supplies, software, marketing, and claims still leave about 82% contribution margin, because that margin has to cover fixed costs and wages.

4Fixed burn$59.0K/mo

Lock the monthly fixed load at about $59.0K from lease, equipment service, liability coverage, utilities, IT, and maintenance before you commit to buildout.

5Staff ramp6 core roles

Confirm recruiting for the medical director, physicist, dosimetrist, oncology nurses, patient navigator, and administrator is tied to machine readiness, not hired early.

6Cash troughMonth 6: -$942K

Fund the Month 6 cash trough before launch, because the project can show profit later and still fail if buildout cash runs out first.