How much is PPO participation really costing you? Enter your procedures below to see total annual write-offs, effective collection rates, and what happens if you drop your worst plan.
| Code | UCR Fee | PPO Fee | Volume/yr | Write-Off | |
|---|---|---|---|---|---|
$ | $ | $16,000 | |||
$ | $ | $25,200 | |||
$ | $ | $52,500 | |||
$ | $ | $48,000 | |||
$ | $ | $22,000 | |||
$ | $ | $11,700 | |||
$ | $ | $22,000 | |||
$ | $ | $9,000 |
Total Annual PPO Write-Offs
$206,400
You are collecting 67.4% of your UCR fees
Revenue at UCR
$632,500
Full fee revenue
Revenue at PPO
$426,100
Contracted fee revenue
Total Write-Offs
$206,400
Annual lost revenue
Collection Rate
67.4%
PPO / UCR
If you dropped the PPO contract for your highest write-off procedure (D2740), assuming 70% patient retention at full UCR fees:
Current Write-Off
$52,500
Procedure D2740
Recovered Revenue
$36,750
70% retention at UCR
Net Annual Gain
-$1,500
45 procedures lost
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This tool compares your UCR (Usual, Customary, and Reasonable) fees against your PPO contracted fees for each procedure. The difference, multiplied by annual volume, gives you the total revenue you are writing off by participating in the PPO network.
For each procedure: write-off = (UCR fee − PPO fee) × annual volume. The effective collection rate is total PPO revenue ÷ total UCR revenue × 100%. This metric tells you what percentage of your full fees you are actually collecting.
The “drop worst PPO” scenario assumes you retain 70% of patients from the dropped plan (industry average for well-established practices), and those retained patients now pay full UCR fees.
| Metric | Average PPO Practice | High-Volume PPO | Fee-for-Service |
|---|---|---|---|
| Effective Collection Rate | 72-78% | 60-70% | 95-100% |
| Annual Write-Offs | $150,000-$300,000 | $300,000-$600,000+ | $0 |
| Write-Off as % of Production | 22-28% | 30-40% | 0-5% |
Before dropping a PPO, consider: patient retention rates in your market, your current capacity utilization, marketing costs to replace lost patients, and the competitive landscape. Practices in high-density areas with strong reputations typically retain 60-80% of patients after dropping a plan.