Short-Stay Surgical Center Break-Even Analysis: $213K/Month

Fixed costs $168.0K/mo Launch cost base

Contribution margin 79% After variable costs

Break-even revenue $212.7K/mo Monthly target

Break-even timing Month 1 First break-even month

Break-even calculator

Test monthly revenue against variable expenses and fixed monthly costs to see when this outpatient surgery center breaks even.

Lean Base Full

Monthly revenue Revenue is the cash in before direct costs and overhead. $ Low volume Full volume Variable expenses These direct costs rise with each procedure and cut contribution margin. $ Low cost High cost

Money available to cover fixed costs $2,254,568 $2,783,417 revenue - $528,849 variable expenses

Margin ratio

81%

Covers fixed costs

Yes

Fixed monthly costs This is the monthly overhead the center has to cover. $ Lean overhead Heavy overhead

Break-even chart Revenue Total costs

Which short-stay surgical center expenses are fixed and which move with case volume?

Cost classification

Break-even only holds if case-linked items stay variable and capacity items stay in bands. In Month 1, fixed lease, insurance, IT, and accreditation are live before case volume proves out.

Expense	Cost	Break-Even Treatment	Common Mistake
Facility Lease	Fixed	Include $28,000 per month in baseline overhead from Month 1.	Spreading rent across cases and hiding the occupancy risk.
Professional Liability Insurance	Fixed	Include $12,000 per month before contribution margin.	Modeling it as a case fee when coverage is required regardless of volume.
IT and EHR Support	Fixed	Include $5,000 per month as operating overhead.	Treating electronic health record support as optional until volume scales.
Accreditation and Licensing Fees	Fixed	Include $2,500 per month in the fixed monthly hurdle.	Leaving compliance spend out of break-even because it feels administrative.
Medical and Surgical Supplies	Variable	Apply 12.0% of revenue in the first year.	Using one flat monthly supply number despite procedure mix changes.
Sterilization and Laundry Services	Variable	Apply 3.0% of revenue in the first year.	Forgetting that more cases drive more instrument and linen turns.
Billing and Collection Fees	Variable	Apply 4.5% of revenue in the first year.	Counting gross revenue but missing collection friction.
Registered Nurse Staffing	Semi-fixed	Model in staffing bands, starting at 6.0 FTE in the first year and rising with capacity.	Assuming nurse labor flexes one-for-one with daily cases.

How does break-even change from a lean launch floor to Year 1 and a full Year 5 schedule for a short-stay surgical center?

Scenario table

Same-day surgery gets to break-even fast because fixed overhead is high, but each case brings strong contribution. Lean volume only covers the monthly bill, while Year 1 and Year 5 create much larger cushions.

Planning assumptions only; actual break-even will move with payer mix, case mix, staffing, and procedure throughput.

Scenario	Monthly Revenue	Variable Costs	Fixed Costs	CM Ratio	Operating Profit	Break-Even Signal
Lean launch floor	$213,000	$45,000	$168,000	79%	$0	Covers fixed costs only; no cushion.
Year 1 launch plan	$905,000	$190,000	$168,000	79%	$547,000	Break-even is passed with a wide operating cushion.
Year 5 full schedule	$5.9M	$1.0M	$271,000	83%	$4.6M	Higher volume absorbs payroll and expands cushion sharply.

What breaks the break-even plan for a short-stay surgical center?

Stress test

Base Year 1 still clears break-even by a wide margin, but the cushion shrinks fast if revenue falls, fixed overhead climbs, or procedure margin slips. The combined case still stays profitable, but it cuts the buffer hard.

Stress Case	Changed Assumption	Break-Even Revenue	Revenue Gap	Risk Signal
Current plan	No change.	$212,658	$692,342 cushion	Healthy cushion; break-even is not tight.
Revenue shortfall	Revenue falls 10% to $814,500.	$212,658	$601,842 cushion	Profit drops to about $475,455, but the center still clears break-even.
Fixed-cost pressure	Fixed costs rise 10% to $184,800.	$233,924	$671,076 cushion	Higher overhead lifts the break-even bar, so lease and staffing control matter.
Margin pressure	Variable burden rises from 21% to 26%.	$227,027	$677,973 cushion	Lower contribution margin pushes break-even up, so billing and supply spend matter.
Combined pressure	Revenue falls 10%, variable burden rises to 26%, and fixed costs rise 10%.	$249,730	$564,770 cushion	Profit falls to about $417,930, so the buffer shrinks fast under stacked pressure.

Can this center fill the schedule and cover fixed costs before you lock the lease and buildout?

Founder checklist

The model looks workable, but only if the 16-physician schedule and referral flow are locked before you sign anything. Year 1 revenue is modeled at $10.9M and EBITDA at $7.2M, but you still need $664K minimum cash in Month 1 to absorb launch timing.

1Surgeon Pipeline16 physicians / 310 cases

Verify those physician commitments can actually support 310 monthly cases before you spend the $8,000 monthly outreach budget, because empty room time breaks break-even fast.

2Lease Load$28K/mo

Check that the $28,000 lease fits inside the $69.7K monthly fixed-cost stack, because rent is the hardest cost to unwind if volume starts slow.

3Buildout Capex$2.335M

Confirm the $1.2M renovation plus $1.135M in equipment and software totals the $2.335M capex plan, because this is the cash you lock before case revenue starts.

4Launch Payroll$98.3K/mo

Verify the Year 1 staffing mix reaches about $98.3K in monthly payroll, because the center cannot run lean on care coverage and still keep the schedule open.

5Direct Cost15% + 4.5%

Keep supply, sterilization, and billing fees near the modeled 15% direct burden plus 4.5% billing fees, because that is what protects the cash left after variable costs.

6Cash Floor$664K

Hold at least the $664K Month 1 cash floor before launch, because the model's first-month gap is where a funding shortfall shows up.