Let us put these principles to work and calculate a break-even volume for a hypothetical office-based bronchoscopy service. A physician group is able to acquire 1,000 square feet of office space adjacent to their office that can be incorporated into the existing space as a bronchoscopy unit. The group plans to perform bronchoscopy 5 days a week with a maximum of 10 procedures performed per day. Two personnel have been identified to work in the unit: a respiratory therapist and a nurse, both of whom shall work full time in the bronchoscopy unit. The group has elected to lease all equipment, including one video tower, two videoscopes, and cleaning supplies, instead of purchasing the equipment. Two types of bronchscopy services will be performed in the office: simple and complex. The group defines simple bronchoscopy as diagnostic bronchoscopy with BAL with brushing (CPT 31623 and 31624). Complex bronchoscopy is defined as diagnostic bronchoscopy with the following procedures alone or in combination: TBNA, transbronchial lung biopsy, and endobronchial biopsy (CPT 31629, 31628, and 31625). The group has elected to offer these services to patients covered by their two largest private third-party payers, preferred provider organization (PPO)-a and PPO-b. Favorable global fees have been negotiated with these carriers. PPO-a has agreed to a fee of $1,500 for simple bronchoscopy and $2,000 for complex bronchoscopy. PPO-b has agreed to a fee of $1,200 for simple bronchoscopy and $1,800 for complex bronchoscopy. The group has analyzed its past procedure volume by payer to determine that 40% of the bronchoscopies would be performed on PPO-a patients and 60% would be performed on PPO-b patients. Finally, the group estimates that half of its bronchoscopy services would be simple and half would be complex.