Radiology Service Break-Even Analysis: $73K Monthly Revenue

Fixed costs $59.3K/mo Overhead base

Contribution margin 81% Scan-level mix

Break-even revenue $73.1K/mo Revenue floor

Break-even timing Month 1 Launch break-even

Break-even calculator

Test monthly imaging revenue against direct costs and fixed overhead to see if the month clears break-even.

Lean Base Full

Monthly revenue Use total monthly imaging sales before direct costs. $ Low volume High volume Variable expenses Use direct supplies and consumables that rise with exam volume. $ Low direct cost High direct cost

Money available to cover fixed costs $894,507 $1,104,330 revenue - $209,823 variable expenses

Margin ratio

81%

Covers fixed costs

Yes

Fixed monthly costs Use the monthly overhead base the service must cover each month. $ Lean overhead Heavy overhead

Break-even chart Revenue Total costs

Which radiology service expenses are fixed and which move with scan volume?

Cost classification

Break-even only works if scan-level spend stays separate from monthly overhead and staffing steps. Misclassifying equipment purchases or payroll can make Month 1 break-even look safer than the cash runway really is.

Expense	Cost	Break-Even Treatment	Common Mistake
Facility Lease ($15,000/month)	Fixed	Include the full monthly lease in fixed overhead from Month 1 through Month 60.	Allocating rent per scan and hiding the downside of low early utilization.
Insurance Premiums ($3,000/month)	Fixed	Model as a recurring monthly overhead item that does not rise with each exam.	Treating coverage as variable because clinical risk rises with volume.
Software Licenses ($800/month)	Fixed	Keep the monthly license charge in fixed operating expense for break-even.	Moving it into technology usage fees without a usage-based assumption.
Medical Supplies (6% of revenue in first year)	Variable	Apply as a revenue-linked charge because it moves with completed imaging work.	Budgeting it as a flat monthly amount and overstating margin at higher volume.
Contrast Agents (4% of revenue in first year)	Variable	Tie directly to revenue because contrast use follows scan mix and patient volume.	Averaging it across all services and missing MRI and CT mix changes.
Disposables and Consumables (5% of revenue in first year)	Variable	Model as a percentage of revenue so contribution margin reflects each added exam.	Classifying consumables as fixed because they are purchased in bulk.
Administrative Assistant ($50,000/year; 1 FTE first year, 2 FTE from Year 3)	Semi-fixed	Add salary in staffing steps as front-desk and scheduling workload outgrows one FTE.	Spreading the second hire across scans before the actual staffing step occurs.
IT Support ($70,000/year; 0.5 FTE first year, 1.0 FTE from Year 2)	Semi-fixed	Model the first-year half FTE, then step up to a full FTE from Year 2.	Treating imaging system support like a per-scan expense instead of a staffing commitment.

How does break-even shift from a lean radiology setup to base and full scale?

Scenario table

Break-even improves as scan volume, payer mix, and staffing efficiency scale. The lean case clears fixed costs, and the full case spreads overhead across a much larger revenue base, so the cushion grows.

Planning assumptions only. These figures show break-even direction, not guaranteed results.

Scenario	Monthly Revenue	Variable Costs	Fixed Costs	CM Ratio	Operating Profit	Break-Even Signal
Lean radiology setup	$216,800	$41,192	$59,250	81%	$116,358	Revenue is above break-even, but the cushion is still tied to uptime.
Base radiology setup	$703,541	$119,602	$78,833	83%	$505,106	Strong throughput keeps fixed costs covered and leaves room for downtime.
Full radiology setup	$1,698,183	$254,727	$83,833	85%	$1,359,623	High volume creates the widest cushion, so reimbursement mix matters most.

What pushes the radiology break-even plan off track?

Stress test

The base plan has a strong cushion, but it tightens fast if referrals slow, reimbursement weakens, or overhead rises. Here’s the quick math: the first pressure points are volume, fixed rent and staffing, and scan-level margin.

Stress Case	Changed Assumption	Break-Even Revenue	Revenue Gap	Risk Signal
Current plan	No change.	$73,148	$143,652 cushion	Healthy cushion, but it depends on steady claims and referrals.
Revenue shortfall	Monthly revenue falls 10% to $195,120.	$73,148	$121,972 cushion	A small referral dip cuts room to absorb denials and overtime.
Fixed-cost pressure	Fixed costs rise 10% to $65,175.	$80,463	$136,337 cushion	Lease and staffing inflation bite fast because overhead is already heavy.
Margin pressure	Variable expenses rise and contribution margin falls from 81% to 76%.	$77,961	$138,839 cushion	Lower reimbursement weakens the model even if volume holds.
Combined pressure	Revenue falls 10%, fixed costs rise 10%, and variable expenses move to 24%.	$85,757	$109,363 cushion	The business stays above break-even, but the cushion shrinks quickly.

What should you verify before signing the lease and buying imaging equipment for a radiology service?

Founder checklist

Don't sign the lease or place the big equipment order until the referral flow, payer terms, and staffing line up with the Year 1 plan. The model shows about $365.5K in monthly revenue, $59.25K in fixed monthly costs, $3.275M in capex, and a Month 5 cash trough of -$1.587M.

1Referral flow$365.5K/mo

Verify enough physician referrals and scan orders to support the Year 1 volume behind about $365.5K in monthly revenue; without that flow, the lease becomes fixed cost before demand is real.

2Fixed burn$59.25K/mo

Check the full fixed load, including the $15,000 lease and core payroll, because Year 1 fixed costs run about $59.25K per month before any scan is done.

3Payer mix81% CM

Confirm payer contracts, prior auth, and claim cleanup keep contribution margin, the cash left after variable costs, near 81%; test it before you rely on billing help in Month 13.

4Coverage ramp1/1/1/2/1 FTE

Lock in coverage for radiology, MRI, CT, X-ray, and ultrasound at the Year 1 staffing plan of 1, 1, 1, 2, and 1 FTE so the opening month can actually run the booked cases.

5Capex stack$3.275M

Verify funding for MRI, CT, X-ray, ultrasound, installation, renovation, PACS and RIS software, computers, networking, furniture, and fixtures; the launch buildout totals $3.275M.

6Cash trough-$1.587M

Plan cash for the Month 5 trough of -$1.587M, because volume, billing, and collections do not arrive evenly after launch.