Tax Planning and Accounting for Orthopedic Surgeons

An orthopedic surgeon's income often comes from more places than a paycheck. You might draw from the practice, receive distributions from a surgeon-owned ambulatory surgery center (ASC), share in imaging, physical therapy, or DME income, and earn consulting fees or royalties from device companies. Each one is taxed and reported differently. Physician Planning Partners is an introduction service. We connect orthopedic surgeons with independent, qualified CPAs we select to partner with, professionals who understand multi-entity surgical practices.

Where orthopedic tax situations get complex

• ASC ownership. K-1 income, buy-in and buy-out payments, and distributions all need to be planned for.
• Ancillary services. MRI, physical therapy, and DME may be run through separate entities with their own returns and compliance considerations.
• Device consulting and royalties. 1099 income from industry relationships may trigger self-employment tax and quarterly estimated payments, and it may open up more retirement saving options.
• Multi-state work. Covering several facilities or living near a state line can create filing obligations in more than one state.
• Large equipment. C-arms, imaging, and surgical equipment purchases raise depreciation timing questions.

Topics surgeons often discuss with a CPA

1. Entity structure and owner compensation.
2. Estimated payments when ASC distributions vary from quarter to quarter.
3. Retirement plan design, including cash-balance plans for high-earning groups.
4. Tax impact of buying into or selling an ASC or practice share.
5. Coordinating returns for a household with multiple income sources.

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

Employed versus private practice

As more orthopedic surgeons take hospital jobs, many still keep ASC shares or consulting income on the side. A CPA can help you understand how a move between employment and private practice affects your taxes before you make the decision.

How the introduction works

1. Tell us about your practice, ASC, ancillaries, and outside income.
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 prepare tax returns?

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

How should I plan for ASC distributions?

Many surgeons work with a CPA on quarterly estimates and setting aside money for taxes. Your CPA can recommend an approach.

Is device consulting income taxed differently from my salary?

It's usually reported on a 1099, which may mean self-employment tax and estimated payments. A CPA can explain how this applies to you.

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.