As the MSO performs, you share in the upside, a second income stream on top of your PC distributions.
Your capital investment. The MSO pays the seller directly. No loan, debt, or buy in for the PC.
How the Verdira Model Works
You own the PC
Verdira manages the business through an MSA. You pay one fixed fee from revenue, and everything left after that fee and your operating costs is yours.
Plus a profits interest in the MSO
A second economic layer on top of your practice income. Your upside is aligned with Verdira through the same operating agreement. PE gives you neither.
What the fee covers
Staff, payroll, marketing, billing, compliance, technology, facility, equipment, and insurance. Your only job is patient care.
Zero capital required
The MSO pays the seller directly. You own the PC at no cost. No loan, no debt, no obligation to Verdira.
The Breakdown
Component
What It Is
Range
Practice Revenue
Total collections
$1.2M to $6M
MSA Fee
All non-clinical operations
38% to 50%
PC Expenses
Malpractice, supplies, comp
20% to 35%
Your PC Take-Home
Revenue − MSA − PC
25% to 37%
+ MSO Profits Interest
MSO distributions
Grows with MSO
MSA fee varies by scope of services, market, and subspecialty. Higher percentages reflect comprehensive turnkey operations. For retina practices, anti-VEGF drug costs are pass-through expenses. MSO profits interest distributions are variable and depend on MSO performance.
Methodology
Where These Numbers Come From
PE Salary
Medscape Ophthalmology 2025; MGMA Ophthalmology 2025; Doximity 2025
Physicians Thrive Ophthalmology 2024; AMN Healthcare
Verdira internal modeling; J. Pinto; Jackson LLP; FTI Consulting
AAO/AAOE Academetrics; BSM Consulting; FTI April 2024
FTI Consulting; BSM Consulting; MGMA 2025
AAMC 2025 ($215K median); Grad PLUS 8.94%
This calculator is for informational purposes only and does not constitute financial, legal, tax, or investment advice. Actual income depends on practice performance, payer mix, geography, and MSA terms. All estimates are conservative to base case. MSA fee is a fixed amount at fair market value, CPOM/AKS compliant. MSO profits interest distributions are variable, depend on MSO performance, and are not guaranteed. The profits interest has zero value at grant and participates only in future MSO profits above the grant date baseline. The profits interest is subject to vesting, clawback, and the terms of the MSO Operating Agreement. Consult your own tax and legal advisors regarding all tax implications. Contact info@verdira.com for more information.
The Full Picture
Your Income Is Built in Layers.
A salary is a single flat number, but ownership stacks in layers, each one sitting on top of the last, and a job offers you only the first.
01
Your Practice Income
What you take home from the PC you own, after the fixed management fee. The number at the top of this page.
02
MSO Profits Interest
A share in the company running the business behind you. A second stream, on top of your practice income.
03
The Facility
Where a surgery center is part of the picture, a share of the facility fees your cases generate. The layer below shows how large that pool is.
A salary is a single flat number, but ownership stacks in layers, each one sitting on top of the last, and a job offers you only the first.
Where There’s a Surgery Center,
There’s More.
What you keep of it today, operating at a surgery center you don't own.
Where That Fee Can Go
Operate at a center you don't own
You keep the professional fee. The facility fee goes entirely to whoever owns the center.
Own a share of the surgery center
A portion of that facility fee becomes income you share in, alongside the platform.
Own the building it sits in
Rent on the facility becomes another stream on top, held with the platform.
The Fee You Never See
Medicare pays the facility, not just the surgeon. For a routine cataract in 2026, the surgery center is paid about $1,256 to host the case, while the surgeon is paid about $463 for performing it. The facility earns close to three times what the surgeon does on the same procedure, and across a full year of cases that adds up.
And the gap is widening. The 2026 facility rate rose about 3 percent, while the surgeon’s professional fee for cataract surgery was cut 11 percent, the largest single-year drop in three decades. The economics keep shifting from the work toward the facility, which is exactly the asset most surgeons don’t own.
At a center you don't own, that money is not yours. It flows to the owner of the facility, often a hospital outpatient department or a private equity fund. You did the work. Someone else holds the asset.
Ownership changes who captures it. Where a surgery center is part of a practice, our model is built so the physician and the platform hold that ownership together rather than handing it to a fund. The exact structure is built with healthcare counsel, deal by deal.
Methodology
Where These Numbers Come From
Facility Fee
CMS CY2026 ASC final rule, cataract (CPT 66984): $1,255.73 national rate
CMS CY2026 MPFS, CPT 66984: $462.94, down 11% from 2025 ($521.75)
CMS ASC Payment System; MedPAC 2025; ASCA
This module is for general education only. It is not a projection of your income, financial advice, or an offer. The figure shown is the total facility fee your case volume would generate at national Medicare rates, not income paid to you. It does not account for payer mix, commercial or cash pay rates, geography, or any specific arrangement. Facility ownership is governed by the federal Anti-Kickback Statute and its ASC safe harbor, varies by state, and any structure is determined with healthcare counsel on a deal by deal basis. Whether facility ownership is available in a given practice, and on what terms, is established in diligence, not here. Contact info@verdira.com for more information.
You’ve run the numbers. Now run them against your offer letter.
Disclosures
The content of this site is for general informational purposes only and is not intended to constitute an offer to sell or a solicitation to buy any security or other asset, or a promise to undertake or solicit business, and may not be relied upon in connection with any offer or sale of securities or other assets.
The content of this site is for general informational purposes only and is not intended to constitute an offer to sell or a solicitation to buy any security or other asset, or a promise to undertake or solicit business, and may not be relied upon in connection with any offer or sale of securities or other assets.
The content of this site is for general informational purposes only and is not intended to constitute an offer to sell or a solicitation to buy any security or other asset, or a promise to undertake or solicit business, and may not be relied upon in connection with any offer or sale of securities or other assets.
© 2026 Verdira Management NY, LLC