Medical Practice Revenue Recovery Calculator
Estimate what your practice is losing each year to undercoding, missing modifiers, and charges that never reach a claim. Move the sliders to match your practice. Nothing you enter leaves your browser, and there is no email gate on the result.
See Your Revenue Recovery Potential
Adjust the sliders to match your practice. We'll estimate the revenue you could recover every year.
Your practice
Revenue leakage
Estimates only, based on your inputs and industry benchmarks. Actual recovery depends on your documentation, payer mix, and coding.
How the estimate is built
The arithmetic is deliberately simple, so you can check it. There is no proprietary model behind the number.
- Gross annual charges. Providers, multiplied by encounters per provider per month, multiplied by twelve, multiplied by average charge per encounter, adjusted by a specialty multiplier.
- A leakage percentage per category. Undercoding, missing modifiers, and charge capture gaps are each applied as a percentage of gross charges. The net collection category uses the distance between your current and target rate.
- A realisation haircut. Identified leakage is not recovered leakage. The model discounts the total, because no practice captures everything an audit finds.
Two things follow from that. First, the output is only as good as the percentages you supply — the defaults are conservative assumptions, not benchmarks. Second, this is a sizing tool. It tells you whether the opportunity is worth an afternoon of investigation. It is not a measurement of your practice, because we have not seen your data.
Measure it properly instead
If the estimate is large enough to act on, stop estimating and measure one category. Each guide below explains how to check that category in your own data by hand, with no software involved.
- E/M Undercoding: How to Tell If Your Practice Is Billing Too Low
- Missed Charges: Finding the Services You Performed but Never Billed
- Modifier 25 and 59: The Modifier Mistakes That Cost Practices the Most
- Documentation Gaps: When Your Note Does Not Support the Code You Billed
Common questions
- Is the calculator free, and do I have to give you my email?
- It is free and it asks for nothing. There is no sign-up, no email gate, and no contact form between you and the result. Everything runs in your browser and none of the numbers you enter are sent to us or stored anywhere.
- What does the calculator actually estimate?
- It estimates annual recoverable revenue across four categories: E/M undercoding, missing modifiers, charge capture gaps, and the gap between your current and target net collection rate. It starts from your gross annual charges, applies a leakage percentage to each category, then applies a realisation haircut because no practice recovers one hundred percent of what an audit identifies.
- How accurate is the estimate?
- It is a sizing tool, not an audit. It tells you the order of magnitude of the opportunity so you can decide whether it is worth investigating, and it is only as good as the leakage percentages you give it. The defaults are deliberately conservative. Nothing here is a measurement of your actual practice, because we have not seen your data.
- Where do the default percentages come from?
- They are conservative starting assumptions chosen for a marketing tool, not published benchmarks, and you should replace them with your own figures if you have them. If you do not, the guides linked on this page explain how to measure each category in your own data by hand.
- Why does specialty change the result?
- Higher-acuity specialties bill more per encounter and carry more coding complexity, so the same leakage percentage represents more money. The calculator applies a multiplier by specialty to reflect that. The multipliers are kept conservative.
- What should I do with the number?
- Treat it as a threshold question. If the estimate is small relative to the effort of investigating, stop. If it is large, pick the single category the calculator weights heaviest for your practice and measure that one properly using the corresponding guide. Measuring one category well beats estimating four.