Ultrasound Center Break-Even Analysis: $106K Monthly Revenue

Fixed costs $93.5K/mo Monthly cost base

Contribution margin 88% After variable spend

Break-even revenue $106.3K/mo Revenue at zero profit

Break-even timing Month 1 First breakeven month

Break-even calculator

Test whether monthly revenue can cover direct costs and the fixed monthly cost base for an ultrasound center.

Lean Base Full

Monthly revenue Revenue is the monthly cash coming in before direct costs. $ Low volume High volume Variable expenses These are direct costs that rise with each scan, like supplies, billing, referral fees, and contracted reading. $ Low direct cost High direct cost

Money available to cover fixed costs $228,624 $259,800 revenue - $31,176 variable expenses

Margin ratio

88%

Covers fixed costs

Yes

Fixed monthly costs This is the monthly cost base the margin has to cover, including rent, software, payroll, and support. $ Lean overhead Heavy overhead

Break-even chart Revenue Total costs

Which ultrasound center expenses are fixed, variable, or tied to scan volume?

Cost classification

Break-even is only reliable when scan-linked fees stay variable and capacity-driven staffing stays separate from flat overhead. Here’s the clean split: fixed monthly overhead is $20,800 before payroll, while Year 1 variable rates total 12.0% of revenue.

Expense	Cost	Break-Even Treatment	Common Mistake
Facility rent	Fixed	Use $10,000 per month in base overhead for every break-even month.	Spreading rent across scans and hiding occupancy risk.
Utilities, insurance, IT support, office supplies, and cleaning	Fixed	Use $4,500 per month as stable support overhead within the current operating range.	Cutting these too low when volume is still ramping.
RIS/PACS and EHR/billing software subscriptions	Semi-fixed	Use $3,800 per month until added workflow or capacity requires a higher subscription tier.	Modeling software as a per-scan fee from Month 1.
Equipment service contracts	Semi-fixed	Use $2,500 per month until another scanner or service obligation adds a step-up.	Treating maintenance as fully variable with each scan.
Medical supplies per scan	Variable	Apply 2.0% of revenue in the first year, then use the modeled annual rate.	Forgetting small percentages add up at higher scan volume.
Contracted radiologist fees, billing fees, and referral commissions	Variable	Apply 10.0% of first-year revenue: 3.0% contracted reads, 4.0% collections, and 3.0% referrals.	Counting revenue before the fees needed to earn and collect it.
Sonographer payroll	Semi-variable	Model FTE hiring with demand, rising from 3.0 FTE in the first year to 7.0 FTE in Year 5.	Treating all payroll as fixed when hiring follows scan volume.
Patient coordinator payroll	Semi-variable	Scale front-desk staffing from 1.0 FTE in the first year to 3.0 FTE in Year 5.	Leaving admin staffing flat while appointment volume grows.

How does break-even change from a lean launch to a full ultrasound center buildout?

Scenario table

Lean keeps fixed costs tighter, so the cushion is smaller. Base and full cases add more staff and overhead, but they also raise revenue enough to widen the gap above break-even.

These are planning assumptions, not guarantees, so actual results can move with payer mix, staffing, and scan volume.

Scenario	Monthly Revenue	Variable Costs	Fixed Costs	CM Ratio	Operating Profit	Break-Even Signal
Lean launch case	$153,960	$18,475	$93,508	88.0%	$41,977	Revenue clears the $106,259 break-even line, but the cushion is still modest.
Base operating case	$431,670	$46,620	$115,467	89.2%	$269,583	Revenue stays well above the $129,447 break-even line, so hiring can stay on plan.
Full-capacity case	$897,844	$86,193	$159,300	90.4%	$652,351	Revenue sits far above the $176,217 break-even line, which gives room for expansion timing.

What breaks the break-even plan for the ultrasound center?

Stress test

The base plan clears break-even with a $47,701 cushion, but that cushion shrinks fast if referrals slow, reimbursements soften, or overhead rises. In the combined case, only about $602 is left, so scheduling and collections have to stay tight.

Stress Case	Changed Assumption	Break-Even Revenue	Revenue Gap	Risk Signal
Current plan	No change.	$106,259	$47,701 cushion	The plan has room, but not much.
Revenue shortfall	Revenue drops 10% to $138,564.	$106,259	$28,428 cushion	Lower volume cuts the cushion by about $19k.
Fixed-cost pressure	Fixed costs rise 10% to $102,859.	$116,885	$37,075 cushion	Overhead growth eats into room fast.
Margin pressure	Variable expenses rise from 120% to 160%.	$111,319	$42,641 cushion	Reimbursement pressure pushes the target up.
Combined pressure	Revenue drops 20%, variable expenses rise to 160%, and fixed costs rise 10%.	$122,566	$602 cushion	One weak quarter nearly wipes out the cushion.

What should you verify before signing the lease and buying scanners for this ultrasound center?

Founder checklist

Verify the center can carry the lease, scanner buy, and first-year team while still surviving the Month 4 cash trough. If the referral funnel or staffing ramp falls short, break-even moves back fast and the fixed burn wins.

1Referral Volume780 scans/mo

Verify the referral funnel can fill the Year 1 model of 780 scans a month, or the new lease and hires will sit idle while cash burns.

2Lease Load$100K + $10K/mo

Confirm the site can handle $100,000 of leasehold work plus $10,000 a month in rent, because that commitment sits on top of about $20.8K in other monthly overhead.

3Contribution Margin88% CM

A Year 1 mix leaves about 88% contribution margin, so check that the 2% supplies, 3% contracted radiologist fees, 4% billing, and 3% referral commissions stay near plan.

4Year 1 Team8.5 FTE

Staff the opening plan first—center director, lead sonographer, 3.0 sonographer FTE, radiologist, patient coordinator, billing support, and 0.5 physician liaison—so Year 3 hires wait for real volume.

5Cash CushionMonth 4: $493K

Keep enough cash to reach the modeled low point of $493,000 in Month 4, because the build-out and staff ramp front-load the spend.

6Launch Stack$400K + $3.8K/mo

Lock the equipment and software setup before opening, because the $250,000 high-end scanner, $150,000 mid-range scanner, and $3,800 monthly software stack have to be ready to convert demand into revenue.