Selling Your Plastic Surgery Practice Without the $1.5M Tax Check

CA owner without §453 structuring loses ~$4M to taxes. With §453, recover $800K-$1M.

The math — $10M plastic surgery practice sale

Assumptions: $10M sale, 70% goodwill, 20% equipment ($2M — surgical suite, lasers), 10% supplies ($1M).

Plastic-surgery tax wrinkles

1. Cosmetic surgery revenue is fully retail (no insurance complications). Goodwill character cleaner than insurance-billed specialties.
2. Surgical center (ASC) carve-out. If practice owns the ambulatory surgery center, it's separately valued with CON-state implications. ASC has its own §1245 recapture profile.
3. Anesthesia contract. CRNA / MD anesthesiologist contracts may be separately valued.
4. Implant inventory (silicone, saline). Ordinary income.
5. Patient financing receivables (CareCredit, Alphaeon, Cherry). Separately valued AR.
6. State medical board ownership. Each state has rules; doesn't affect §453 mechanic.

When this fits

• $3M+ practice value
• Strong cosmetic / non-insurance revenue mix
• PE-backed buyer

When it doesn't

• Mostly reconstructive / insurance-billed
• Solo surgeon, no team

How I work

Hans Goldstein, IRC §453 specialist. Pacific Life, Independent Life, USAA Life and other A-rated Fortune 500 carriers — 50 states. Free fit-check.

Frequently asked

Q: I own the ASC. Two §453 structures? A: Often. Practice goodwill in one, ASC sale in another. Each tuned to its own schedule.

Q: My practice is reconstructive with insurance billing. Does that change anything? A: Lower multiple than cosmetic, but §453 mechanic works the same. The goodwill is the deferrable portion regardless.

Find out what your practice sale tax bill actually is — and what you can do about it

No retainer. The carrier compensates the broker — not you.

Find out what your tax bill actually looks like before you sell — including the parts your CPA may not raise until the return is already being prepared.

Most people find out what they owe after the sale closes, when nothing can be changed. A short conversation now tells you the number, which layers apply to your situation, and which options are still open while the sale is still in front of you.

• What you will actually owe — federal, the 3.8% surtax, recapture and your state
• Which of those layers you can still do something about
• Whether spreading the sale changes the number in your case

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What are you selling? (and roughly what you paid)

Approx. sale $$—Under $500K$500K – $1M$1M – $3M$3M – $10M$10M+

When are you selling?—Within 30 days60–90 days3–6 months6–12 monthsAlready soldJust exploring

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Walk me through my options

Hans Goldstein · 615-808-9731 · Goldstein & Co. LLC · This is an educational conversation, not tax advice. Bring your CPA in before you file.

Educational. Not tax or legal advice.