Tax Planning and Accounting for Plastic Surgeons

Most plastic surgery practices are paid differently from the rest of medicine. Cosmetic patients pay up front, often with deposits weeks before surgery, through third-party financing, or with package pricing that bundles surgery, anesthesia, facility fees, and follow-up care. Revenue can swing with the seasons and with marketing campaigns. Physician Planning Partners is an introduction service. We connect plastic surgeons with independent, qualified CPAs we select to partner with, professionals who understand cash-pay and mixed reconstructive practices.

Accounting issues specific to plastic surgery

• Deposits and prepayments. When you collect money before a procedure, how you record that revenue, and how you handle refunds and cancellations, matters for your books and your taxes.
• Patient financing fees. Financing companies typically take a discount from what you collect. That cost should be tracked as its own line item.
• Revisions and touch-ups. No-charge or reduced-fee revisions affect your true margin per procedure.
• Facility and anesthesia pass-throughs. If you own an accredited office-based OR, facility fees and anesthesia costs need clear allocation.
• Retail and med spa revenue. Skincare sales and injectables may involve sales tax and a separate entity.
• Reconstructive insurance revenue. Practices that mix reconstructive and cosmetic work need to track the two very different revenue cycles separately.

Topics surgeons often discuss with a CPA

1. Entity structure and reasonable owner compensation.
2. Estimated tax payments when monthly income is uneven.
3. Retirement plan options, including cash-balance plans for high earners.
4. Timing of equipment and build-out purchases.
5. Monthly reporting by procedure and by marketing channel, so you know your true cost per patient.

The CPA you meet is independent. They set their own fees and are solely responsible for their advice.

Seasonality and cash flow

Many practices see demand climb before summer and the holidays and dip at other times. A CPA can help you set aside money for taxes during busy months and plan payroll and marketing spending around slower stretches.

How the introduction works

1. Tell us about your practice, including your cosmetic and reconstructive mix, entities, and current accounting setup.
2. We suggest an independent CPA we partner with who fits.
3. You meet them directly and decide whether to engage.

Frequently asked questions

Do you provide tax or accounting services?

No. Physician Planning Partners is an introduction service. We connect you with independent, licensed CPAs.

How should I handle surgical deposits on my books?

It depends on your accounting method and refund policy. A CPA can set up a consistent approach.

Can a CPA help me understand profit per procedure?

Yes. Many surgeons ask for reporting that includes facility, anesthesia, implant, and marketing costs for each procedure.

What does an introduction cost?

Nothing. You pay the CPA directly if you engage them. We may receive compensation from partner businesses.

Physician Planning Partners is an introduction service, not a CPA firm, and this page is general information, not tax advice. See our disclaimer.