The Level Index
HealthcareHow does your practice compare?
Revenue cycle, overhead, and provider productivity benchmarks for U.S. medical, dental, physical therapy, chiropractic, and specialty practices. Sourced from MGMA, HFMA, ADA, AMGA, and the Level founding team's operator analysis.
Last refreshed April 2026. Government data (BLS), association surveys (MGMA, HFMA, ADA), and HFMA MAP Award statistical appendix. Anonymized, segmented by percentile, and rounded.
$5.3T
Market size
U.S. health spending (2024)
224K+
Establishments
Physician offices in the U.S.
135K+
Establishments
Dental practice establishments
9
Metrics tracked
Core operating metrics
Check your own numbers
Want to know where you actually rank? We'll show you and what to fix first.
Most owners read benchmark pages like trivia. The useful question is which number in your own P&L, payroll, billing, or operating data you trust least. Your numbers stay private, we never publish or share client data.
In the free audit, we check:
- •labor cost as a percentage of revenue
- •gross margin by job, account, or location
- •cash tied up in receivables and open work
We use this to prepare your audit before the call. Your numbers stay private.
About the Data
The Level Index is compiled from the founding team's analysis of 2,200+ contractors ($13.25B in revenue) across operating, private-equity, and CFO roles, plus named public filings, government statistics, and industry association surveys. This page focuses on medical, dental, pt & specialty practices, drawn from MGMA · HFMA · ADA · BLS, public company 10-Ks, and the founding team's operator analysis. Where private-company quartile data is not publicly published, we use the best available median, range, or surveyed cohort and label the source clearly.
Methodology
Quartile data for ambulatory medical groups is largely behind MGMA DataDive / AMGA paywalls. Where 'best published equivalent' is shown, the figure is a credible median/range or HFMA MAP Award winner cohort percentile (n=14), not a national private-practice median.
The Level CLEAR Framework
Five pillars of healthcare financial health
Every metric in the Level Index maps to one of five pillars. Together they give you a complete picture of where money is made, lost, stuck, or at risk.
Insurance reimbursement lag, patient out-of-pocket collections, claim processing speed. Every day past 30 in A/R costs you money; collections-industry data has long shown recovery probability falling sharply as receivables age past 90 days.
Provider productivity (revenue per FTE), support staff ratios, no-show rates. An underperforming provider leaves $100K-$300K on the table annually.
Net collection rate, procedure-level margins, overhead ratio by specialty. The gap between 55% and 52% overhead on $2M revenue is $60K in annual profit.
Patient volume trends, referral patterns, payer mix optimization, coding accuracy. Denial rates above 10% signal systematic revenue leakage.
Payer concentration, malpractice exposure, compliance gaps, coding audit risk. Single-payer dependency above 40% is a structural vulnerability.
Key Finding
Insurers denied 19% of in-network claims in the 2024 ACA Marketplace, and most practices don't see it.
If you only track 'denial rate of submitted professional claims,' your dashboard is missing the real magnitude. KFF analysis of CMS public-use files shows in-network denials at 19% across HealthCare.gov marketplace plans (37% out-of-network). Your practice's payer mix is not marketplace-only, so treat 19% as a ceiling reference rather than your expected rate, but even a move from a clean 5% to a double-digit denial rate is six figures in delayed and lost revenue for a $2M practice.
Top-quartile practices keep denials below 5% by fixing front-end eligibility, prior auth, and coding, not by hiring more billers.
Most practices wait 35-45 days to collect. The best collect in under 30.
Days in Net A/R
Source / sample: HFMA MAP Award + MGMA-style targets
HFMA MAP Award winners (n=14) cluster between 30-45 net A/R days. Practices over 50 days usually have front-end eligibility, charge lag, denials, or patient collection problems, not 'just billing.'
How we measured
HFMA MAP 2024 Statistical Appendix
Patient point-of-service collections separate the top from the bottom.
POS Cash Collection (% of patient liability)
Source / sample: HFMA MAP Award winners (n=14, 2024)
Patient balances are now a retail-collection problem. Practices that collect at time of service recover 50-70% of patient balances vs. 34-48% for those who bill after, a $100K+ annual swing for a busy practice.
How we measured
HFMA MAP 2024 Statistical Appendix
Better-performing practices generate $100K+ more revenue per physician.
Total Medical Revenue per Physician FTE
Source / sample: MGMA 2023 DataDive, Better Performers vs. all
The gap is rarely 'work harder.' Better performers staff differently: ~73% more support staff per physician at the top productivity quartile, with stronger APP leverage and tighter coding integrity.
How we measured
MGMA Better Performers Report 2023
Primary care overhead spans ~14 points across the distribution.
Primary Care Overhead Ratio
Source / sample: Industry literature; AMA PPI 2024 (PE = 51.1% of cost)
Specialty clinics run 40-50%, dental ~55%, primary care 55-65%. The biggest controllables: rent above 6-8% of revenue, underutilized practice management seats, and supply costs nobody renegotiated.
How we measured
AMA Physician Practice Index 2024 + industry benchmarks
Claim denials are a 4-to-19% problem, but you're probably measuring the wrong number.
Claim Denial Rate (% of claims)
Source / sample: Optum 2024 Denials Index + KFF 2024 ACA analysis
Each rework costs $25-$118. At 12,000 annual claims and a 12% denial rate, that's $36K-$170K in pure rework labor, before counting revenue lost on claims that never get resubmitted.
How we measured
Optum 2024 Denials Index, KFF 2024 ACA Marketplace Analysis
Bad debt and patient acquisition costs vary 6× by specialty.
Patient Acquisition Cost by Specialty
Source / sample: Marketing agency database (First Page Sage 2026)
PAC only matters relative to LTV and contribution margin per visit. High-PAC specialties (cosmetic, derm) have the visit economics to justify it, primary care typically does not.
How we measured
First Page Sage Patient Acquisition Cost Report 2026
Benchmarks by Practice Type
HealthcareMargins and revenue cycle metrics vary dramatically by specialty. Use these as rough anchors when reading your own numbers.
Primary Care
Revenue per physician
$668K (all) / $770K (top)
Surgical Specialty
Revenue per physician
$648K (all) / $777K (top)
Multispecialty Group
Revenue per physician
$748K (all) / $879K (top)
Dental, General
Avg gross billings/dentist
$942K
Dental, Specialty
Avg gross billings/dentist
$1,146K
Physical Therapy
Avg revenue per visit
$98-$101
Advanced Healthcare Metrics
Sub-segment breakdowns, advanced operational metrics, and percentile distributions for medical, dental, pt & specialty practices.
| Metric | Bottom Quartile | Median | Top Quartile | Note |
|---|---|---|---|---|
| Dental Net Margin | < 20% | 25-30% (before owner comp) | 30-40% | Definition matters: ADA Health Policy Institute Survey of Dental Practice 2024 shows median practice net income around 22% of gross billings BEFORE owner compensation, dropping to roughly 13% after a market-rate owner salary. The 25-30% band is a pre-owner-comp figure. |
| Primary Care Net Margin | < 8% | 12-15% | > 18% | Directional range; overhead discipline drives the gap. Note: many employed-physician models run a subsidy per provider (see below). |
| Specialty Clinic Operating Margin | < 15% | 18-24% | > 28% | This band tracks operating margin, not net. MGMA/analyst benchmarks put specialty operating margin at 18-30%; procedure-heavy specialty NET runs higher (25-40%). Procedure-mix dependent. |
| Net Collection Rate | < 95% | ~96% | 99%+ | MGMA/HFMA: payments / (charges minus contractual adjustments); below 95% signals a real problem |
| Clean Claim Rate (first-pass) | < 90% | ~95% | 98%+ | HFMA MAP Keys best practice 95%+ |
| Days in A/R | > 50 days | < 40 days | < 30 days | MGMA target; HFMA MAP winners 30-45 days |
| Cost to Collect | > 4% | 2-4% | < 2% | HFMA MAP Keys, % of net patient revenue |
| Subsidy per Employed Physician | > $300K | ~$307K | profitable | Kaufman Hall Physician Flash Report Q4 2024, investment/subsidy per physician FTE |
| Patient Collection Rate | < 34% | 40-48% | > 60% | At time of service vs. billing after |
| Bad Debt % of Charges | > 2.2% | 1.5% | < 0.6% | HFMA MAP Award winners 2024 |
| A/R Over 90 Days (% of total) | > 38% | 30% | < 22% | HFMA MAP Award winners 2024 |
| Cost per Claim Processed | > $12 | $8-$10 | < $6 | Directionally consistent with the CAQH Index (manual claim-submission cost per transaction $7.19 in 2023, rising to $8.03 in 2025; electronic $2.65-$3.45). Fully-loaded per-claim cost including rework runs higher. |
| No-Show Rate | > 10% | ~7% | < 5% | MGMA Stat 2023: 6.81% single-specialty avg |
| Staff Cost % of Revenue | > 35% | 28-32% | < 25% | Directional; non-provider staff (admin + billing), Level founding-team observation |
| Technology Spend % of Revenue | > 5% | 3-4% | < 2.5% | Directional; EMR, PM, billing, telehealth, Level founding-team observation |
Benchmarks for other service businesses
Simple pricing
Three tiers, one ladder.
$99-$500/mo
Bookkeeping
The clean data layer: monthly books, reconciliations, and organized financials AI can work with.
$1,500-$5,000/mo
Scale
The full AI operating layer: custom agents, weekly actions, and benchmarks to grow margin per hour.
Custom
Platform / Multi-Office
Multi-branch benchmarking and scorecards for PE-backed and multi-location groups.
How does your practice compare?
We'll benchmark your revenue cycle, overhead, and provider productivity against the industry. Free audit included.
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Frequently Asked Questions
What is a good net collection rate for a medical practice?
Top-performing practices achieve 97-99% net collection rates. Below 95% signals significant revenue cycle problems, typically claim denials, untimely filing, and poor patient collection. At $2M in charges, the difference between 95% and 98% collection is $60K annually.
How many days in A/R is acceptable?
Under 30 days is the HFMA benchmark. Over 50 days is a red flag. The key metric to watch is A/R over 90 days, it should be less than 10% of total receivables. Collections-industry data has long shown that recovery probability falls sharply as a receivable ages past 90 days.
What should my practice overhead ratio be?
Primary care typically runs 55-65% overhead, specialty clinics 40-50%, dental ~55%. If you're above these, the most common culprits are overstaffing, underutilized technology, and rent that exceeds 6-8% of revenue.
How much does a claim denial actually cost?
Each denied claim costs $25-$118 to rework (HFMA). With industry-average denial rates at 12-15%, a practice submitting 10,000 claims annually faces 1,200-1,500 denials costing $30K-$177K just in rework labor, not counting delayed or lost revenue.
What revenue should each provider generate?
MGMA: Primary care physicians typically $500K-$700K, procedural specialists $1M+. The key is revenue per provider FTE relative to total compensation and overhead allocation, under 2.5× their compensation, the practice is likely losing money on them.
Sources
- • MGMA DataDive (medical group medians)
- • HFMA MAP Award Statistical Appendix 2024
- • ADA Health Policy Institute Survey of Dental Practice 2024
- • AMA Physician Practice Index 2024
- • BLS Occupational Employment & Wages 2023-2024
- • KFF analysis of CMS QHP transparency files 2024
- • Level Index, the founding team's analysis of 2,200+ contractors ($13.25B revenue) across operating, private-equity, and CFO roles (contractor ground-truth cohort), extended with healthcare practice observations
The Level Index represents the personal analysis and professional opinions of the Level team, compiled from public industry surveys, government statistics, SEC filings, and the founding team's operator analysis. All data is anonymized and aggregated. Specific figures are rounded and should be treated as directional benchmarks, not precise measurements. The Level Index does not constitute financial advice. Individual results vary based on segment, geography, company size, and operational maturity. © 2026 Level. All rights reserved.
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