Margin-at-Risk Calculator
See how much buy-and-bill margin your infusion center is losing to documentation gaps — and what dropping denials to under 5% recovers.
Your infusion center
All inputs stay in your browser. Nothing is sent to a server.
12
Total active treatment chairs across your sites.
9
Industry typical: 8–12 infusions/chair/week for biologics; higher for oncology/IVIG.
Drug 1
% mix
Drug 2
% mix
Drug 3
% mix
Remaining mix (10%) is calculated as "other infusibles". Rates are based on CMS Medicare average reimbursement limits.
14%
Typical ranges: 10–20% for biologic & specialty claims before audit optimizations.
65%
CMS estimates: 60–70% of drug denials trace to eligibility, prior auth, or coding errors.
8%
Typically ranges between 5–10% net margins after overhead and acquisition costs.
Annual drug margin at risk
$1,842,750
14% denial rate × 65% documentation-related preventable share = $1,842,750 of drug revenue you've already paid acquisition cost on, lost annually.
Recoverable at <5% denial
$1.84M
Per chair per year
$154K
Per-drug exposure breakdown
| Drug | Ann. Reimbursement | Denial Loss | Recoverable |
|---|---|---|---|
| J1745Infliximab (Remicade)(40%) | $5.18M | $726K | $472K |
| J9312Rituximab (Rituxan)(30%) | $8.42M | $1.18M | $767K |
| J3380Vedolizumab (Entyvio)(20%) | $4.75M | $665K | $432K |
| OTHEROther infusibles (blended average)(10%) | $1.89M | $265K | $172K |
| Total Annual | $20.25M | $2.84M | $1.84M |
Denial Loss · Current vs <5% Target
Current denial rate (14%)$2,835,000
Target with DocuFindr <5%$1,012,500
Volume and revenue at a glance
5,400
Annual infusions
$20.25M
Ann. Drug Reimbursement
$1.62M
Ann. Gross Margin
Share this with your CFO. Or run the real numbers with us.
This estimate is intentionally conservative — built on public CMS ASP data and your inputs. A 30-minute review with your last 90 days of actual denial codes will give you a defensible, drug-by-drug recovery number.
Interested in a custom ROI analysis for your specific operation?Contact our strategy team