What Are Operating Costs For Preoperative Assessment Clinic?
Preoperative Assessment Clinic Running Costs
Running a Preoperative Assessment Clinic requires careful management of high fixed overhead and variable clinical expenses Based on 2026 projections, expect average monthly running costs to be around $152,000, driven primarily by support staff payroll and facility expenses Variable costs, including disposable supplies and diagnostic fees, represent 185% of gross revenue The model shows exceptional financial health, achieving breakeven in January 2026 (1 month) You must maintain sufficient working capital, as the analysis indicates a minimum cash requirement of $886,000 early on This guide details the seven essential recurring expenses you need to budget for sustainable operations
7 Operational Expenses to Run Preoperative Assessment Clinic
#
Operating Expense
Expense Category
Description
Min Monthly Amount
Max Monthly Amount
1
Support Staff Payroll
Fixed Overhead
Fixed payroll for 80 FTEs, including the Medical Director, totals $59,917 monthly in 2026.
$59,917
$59,917
2
Clinic Facility Lease
Fixed Overhead
The required fixed monthly lease expense locks in $12,500 of overhead.
$12,500
$12,500
3
Diagnostic Lab Processing
Variable Cost
Lab processing is the largest variable cost, set at 65% of revenue in 2026.
$0
$59,917
4
Disposable Clinical Supplies
Variable Cost
Supplies are a variable cost of goods sold starting at 45% of revenue in 2026.
$0
$59,917
5
Marketing and Commissions
Mixed Cost
This includes $4,000 fixed marketing plus a 50% commission on referral revenue.
$4,000
$59,917
6
IT and EHR Fees
Mixed Cost
Fixed IT maintenance is $2,200, plus a variable 25% transaction fee on EHR usage.
$2,200
$59,917
7
Insurance and Utilities
Fixed Overhead
Essential compliance costs combine $1,800 for insurance and $2,100 for utilities/janitorial.
$3,900
$3,900
Total
All Operating Expenses
$82,517
$315,985
What is the total monthly operating budget required to run the Preoperative Assessment Clinic sustainably?
The minimum sustainable monthly operating budget for the Preoperative Assessment Clinic starts at $83,750, combining fixed overhead and necessary support staffing before any patient volume is factored in. This baseline cost dictates your initial cash runway needs, so you need this capital ready to go.
Baseline Monthly Burn
Fixed overhead costs are set at $23,750 monthly.
Support staff payroll is estimated to run about $60,000 per month.
This $83,750 is your cost floor before clinical revenue hits.
You must cover this amount regardless of patient flow.
Funding the Floor
Aim to secure at least 6 months of this operating cost upfront.
If onboarding new surgical center partners takes longer than 14 days, your cash depletion rate accelerates.
This calculation doesn't include variable costs tied to patient volume yet.
Which cost categories will consume the largest percentage of revenue in the first year?
The largest cost drain for your Preoperative Assessment Clinic in year one will defintely be the variable expenses, which are projected at an unsustainable 185% of revenue, dwarfing the fixed payroll for non-clinical staff; understanding this dynamic is crucial before you even look at how How Much To Start Preoperative Assessment Clinic Business?
Variable Cost Shock
Variable costs are 185% of revenue booked.
This means $1.85 leaves for every $1 earned.
Supplies, lab fees, and commissions are the culprits.
You need immediate volume discounts on lab work.
Fixed Payroll Pressure
Fixed payroll for non-clinical staff is the second tier.
Keep administrative roles lean until utilization hits 75%.
Staffing must scale with practitioner capacity, not projections.
If onboarding takes 14+ days, churn risk rises fast.
How much working capital or cash buffer is necessary to cover operations during the first six months?
You need a minimum operating cash buffer of $886,000 set aside to cover the first six months of the Preoperative Assessment Clinic, separate from the $287,000 needed for initial capital purchases; understanding this full requirement is key before you look at How Much To Start Preoperative Assessment Clinic Business?
Six-Month Operating Cash
Target minimum cash buffer is $886,000.
This covers operational burn through January 2026.
You must plan for six months of negative cash flow.
This estimate is for operations, not equipment purchases.
CAPEX Financing Needs
Total capital expenditure requirement is $287,000.
This covers necessary clinic build-out and initial gear.
Financing this must be secured before operations start.
Don't use your operating buffer to pay for this stuff, defintely not.
If patient volume is 20% lower than projected, how will we adjust fixed costs to maintain profitability?
When patient volume for your Preoperative Assessment Clinic drops 20% below projection, you must immediately freeze new hiring and aggressively manage staffing levels, because core facility costs like the lease are locked in regardless. Before making cuts, you need a clear picture of your initial cost structure, which you can review when considering How Much To Start Preoperative Assessment Clinic Business?
Locked-In Facility Costs
Lease payments for the clinic space are contractually set.
Core IT infrastructure costs remain constant irrespective of patient flow.
General liability and malpractice insurance premiums are fixed obligations.
These costs dictate your minimum required monthly revenue floor.
Staffing Adjustment Levers
Staffing (FTEs) is your largest, most flexible cost driver.
Delay hiring for planned growth FTEs right away.
Use contingent staff or per-diem nurses instead of new hires.
If onboarding takes 14+ days, churn risk rises with sudden cuts, defintely.
Key Takeaways
The total average monthly running cost for the Preoperative Assessment Clinic is projected to stabilize around $152,000 in 2026, heavily influenced by payroll and facility overhead.
Support staff payroll represents the single largest fixed expense, totaling nearly $60,000 monthly, while variable costs like lab processing consume an extremely high 185% of gross revenue.
The financial model projects an exceptionally fast return on investment, achieving operational breakeven within the first month of service in January 2026.
A significant working capital buffer of $886,000 is required upfront to cover initial operating deficits and necessary capital expenditures before consistent profitability is secured.
Running Cost 1
: Support Staff Payroll
Payroll Dominance
Support staff payroll hits $59,917 monthly in 2026 for 80 full-time equivalents (FTEs), including the Medical Director. This cost dwarfs other fixed overheads. Managing this headcount efficiency is critical for hitting profitability targets early on.
Cost Inputs
This payroll figure covers all non-practitioner staff needed to run the clinic operations. The estimate uses 80 FTEs, which includes essential administrative, clinical support, and the Medical Director salary base. It's a fixed cost, meaning it doesn't change if you process 100 or 1,000 evaluations that month.
Covers 80 FTEs total staff.
Includes the Medical Director salary.
It's a fixed monthly commitment.
Managing Headcount
Because this is your largest fixed drain, efficiency hinges on maximizing the output per employee hour. Don't let administrative bloat creep in as volume ramps. If utilization dips below projections, this high fixed cost will crush your contribution margin fast, so be careful.
Tie hiring to confirmed utilization rates.
Monitor staff-to-patient ratios closely.
Avoid hiring ahead of demand spikes.
Break-Even Anchor
Covering $59,917 in payroll means your monthly gross profit must exceed this figure just to keep the lights on. Compare this against the $12,500 facility lease and $3,900 in insurance/utilities; payroll is defintely 75% of the total baseline fixed overhead you must generate.
Running Cost 2
: Clinic Facility Lease
Lease Overhead Floor
Your facility lease sets a high floor for monthly costs. At $12,500 fixed per month, this expense hits your profit and loss statement whether you see one patient or a hundred. This cost is non-negotiable until the lease term ends. You need volume just to cover this baseline overhead.
Lease Cost Inputs
This $12,500 covers the physical space for your clinic operations. It's a primary component of your fixed overhead, sitting alongside payroll and base IT fees. To budget this accurately, you need signed lease terms specifying square footage costs and duration. It's a significant hurdle before generating revenue.
Lease agreement terms.
Required square footage.
Build-out amortization schedule.
Managing Fixed Space Costs
Since this is fixed, you can't easily cut it month-to-month. Focus on maximizing utilization of the space you pay for. A common mistake is over-leasing space early on. Look for shorter initial terms or flexible expansion clauses, especially if patient volume ramp-up is uncertain. You defintely need to model utilization rates.
Negotiate shorter initial terms.
Ensure low tenant improvement allowance.
Prioritize high-density patient flow.
Lease Relative to Payroll
Compare this lease against your largest fixed cost: support staff payroll at nearly $60,000 monthly for 80 FTEs. The $12,500 lease is about 21% of that major fixed bucket alone. If your contribution margin is tight, you need significant patient volume just to service these structural, non-variable expenses.
Running Cost 3
: Diagnostic Lab Processing
Lab Cost Dominance
Diagnostic lab processing is your biggest variable drain, hitting 65% of revenue in 2026. This high percentage means every new evaluation costs you nearly two-thirds of the fee charged, severely restricting cash flow until scale hits.
Calculating Lab Spend
This expense covers external diagnostic services required for patient clearance. Estimate this by multiplying daily patient volume by the contracted unit price per required lab panel. This 65% share dwarfs other variable costs like supplies at 45%.
Volume x Negotiated Unit Cost
Impacts gross margin heavily
Requires firm vendor contracts
Cutting Lab Fees
You must aggressively negotiate tiered pricing with reference labs now. If you project 500 evaluations monthly, lock in pricing for 1,000 tests to secure better rates. Avoid scope creep where protocols mandate tests that don't directly mitigate immediate surgical risk.
Demand volume-based discounts
Standardize required testing panels
Review vendor contracts quarterly
Variable Cost Leverage
Because lab processing is 65%, your contribution margin before fixed costs is only 35% minus supplies (45%) and EHR fees (25%). This means revenue growth needs to be paired with immediate, significant decreases in the lab unit cost to ensure profitability.
Running Cost 4
: Disposable Clinical Supplies
Supply Cost Trajectory
Disposable clinical supplies are a major variable cost, hitting 45% of revenue in 2026. This expense should drop significantly as you scale operations, reaching 35% by 2030 due to volume efficiencies. Managing supply chain contracts now locks in future margin improvement.
Estimating Supply Spend
These supplies are your direct cost of goods sold (COGS) for performing the assessment, covering items like swabs, testing kits, and protective gear. Estimate this by tracking units used per patient evaluation multiplied by the supplier unit price. If revenue hits $1M in 2026, supplies cost you $450,000 right off the top. That's a big chunk of cash flow.
Track consumables per procedure code.
Use vendor quotes for unit pricing.
Factor in inventory holding costs.
Controlling Supply Costs
Reducing this 45% variable cost requires volume commitment. You can't compromise on compliance or quality here, but you can negotiate better tiers. If onboarding takes 14+ days, churn risk rises. Centralize purchasing across all clinics defintely.
Negotiate bulk tiers early.
Standardize supply kits per service.
Track usage per practitioner.
Leveraging Scale
The projected 10-point drop in supply cost between 2026 and 2030 is tied directly to volume commitments. Ensure your sales pipeline forecasts support the utilization needed to hit the lower 35% COGS threshold. This margin improvement is baked into your model, so don't let utilization slip.
Running Cost 5
: Marketing and Commissions
Commission Strategy
To build referral volume in 2026, plan for a fixed marketing spend of $4,000 monthly. This must be paired with a high variable cost: 50% commission taken directly from revenue. This structure heavily links acquisition cost to top-line success, so volume must be high.
Acquisition Cost Drivers
This cost category covers both direct referral incentives and general awareness campaigns. The 50% variable commission is the main driver, paid out only when revenue is generated. You need projected 2026 revenue to calculate the total dollar outflow for commissions, adding to the fixed $4,000 marketing budget.
Fixed marketing: $4,000/month.
Variable commission: 50% of revenue.
Goal: Drive referral volume.
Managing Payouts
A 50% commission rate is steep; defintely evaluate if this is standard for securing high-quality surgical center referrals. Negotiate performance tiers where the commission drops after volume milestones are hit. If you can shift volume to lower-cost channels, you save immediately.
Benchmark referral fees now.
Tie commission tiers to volume.
Watch for commission creep.
Margin Impact
Be aware that this 50% commission hits your gross margin hard before any fixed costs are covered. If your service fee is low, you won't cover the $59,917 monthly payroll for support staff. This expense demands high Average Revenue Per Evaluation (ARPV) clients.
Running Cost 6
: IT and EHR Fees
IT and EHR Costs
Your tech stack carries a fixed base cost of $2,200 monthly for maintenance and security, but the real pressure point is the 25% variable transaction fee tied to your EHR system in 2026. This structure means IT scales directly with patient volume, not just overhead.
Cost Structure Breakdown
The $2,200 covers essential IT maintenance and cybersecurity contracts, which are fixed overhead. The major cost driver, though, is the 25% EHR transaction fee applied to gross revenue starting in 2026. You need to model this variable cost against projected service revenue to understand its impact on gross margin.
Fixed IT cost: $2,200/month
Variable EHR fee: 25% of revenue
Risk: High volume increases this cost fast
Managing Transaction Fees
Since the 25% is a transaction fee, reducing it requires negotiating the EHR contract or improving efficiency per transaction. If you can bundle services or increase the Average Transaction Value (ATV) without triggering higher per-unit fees, you gain leverage. Don't let the fixed $2,200 balloon due to scope creep.
Negotiate the 25% rate now
Focus on higher ATV per patient
Avoid unnecessary IT scope creep
Pricing Reality Check
That 25% EHR fee acts like a high commission, directly eroding profitability on every single assessment performed. If your other fixed costs are tight, this variable expense can quickly push you into a loss territory if your service pricing isn't set high enough to cover it. It's a major lever.
Running Cost 7
: Insurance and Utilities
Fixed Compliance Burn
You must budget $3,900 monthly for core compliance overhead, covering insurance and site upkeep. This fixed expense includes $1,800 for General Liability Insurance and $2,100 for utilities and janitorial services. Make sure this amount is covered before revenue starts flowing in your clinic.
Inputs for Site Costs
This $3,900 covers mandatory site operations and risk transfer for your clinic. General Liability Insurance protects against third-party claims, while utilities cover essential facility function. Inputs needed are fixed quotes for insurance ($1,800) and estimated monthly site service fees ($2,100). These are non-negotiable fixed overheads you face day one.
Insurance: $1,800 fixed monthly premium.
Utilities: $2,100 for site services.
Total fixed compliance: $3,900.
Managing Site Overhead
Since the insurance premium is fixed, focus on the utility component for savings. Utility costs are location-dependent; shop around for competitive rates on electricity and waste removal contracts, definetly avoid long-term, high-cost janitorial contracts early on. Good negotiation here can shave a few hundred dollars off this baseline.
Shop utility providers aggressively.
Negotiate janitorial service scope.
Insurance rates depend on risk profile.
Contextualizing Fixed Costs
These $3,900 in compliance costs hit before your first patient evaluation. Compare this to your $12,500 clinic facility lease; this cost is about 31% of your monthly rent payment. If you can't cover this plus payroll, you'll burn cash fast. It's a crucial component of your minimum viable overhead.
