Full-Service Ophthalmology Practice, Two-Office Southern California Group

$3.3M

Revenue

$850K

SDE

5.3x

Multiple

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Full Editorial Writeup

This is a full-service ophthalmology group operating from two offices in Southern California, delivering medical, surgical, and preventive eye care under one roof. The practice covers the full clinical spectrum including pediatric eye care, cataract treatment, glaucoma care, retina evaluation, oculoplastics, and routine exams. Revenue breaks down into roughly 50% exams and office visits, 25% surgical procedures, and 25% in-office procedures, which gives it a balanced mix between high-volume diagnostic throughput and higher-margin surgical work.

Founded in 2008, the group has built durable referral relationships with primary care physicians, medical groups, hospitals, and insurers, and it carries a 4.1 to 4.2 star rating across major review platforms. Payer mix is institutional and sticky: 50% medical insurance, 30% Medicare, and 20% HMO/PPO. The team is 15 people deep, including the selling MD owner plus multiple additional physicians, which means clinical capacity does not walk out the door entirely with the seller.

At $3.3M revenue and $850K EBITDA, this is a real specialty practice producing a genuine 26% margin, with surgical volume underpinning profitability. The business is concentrated in a single county today, which the seller frames as an expansion runway. The ask of $4.5M against $850K EBITDA is a 5.29x multiple, full for a practice sale and dependent heavily on how provider compensation and physician retention are structured post-close.

Why we like it

Earnings quality is strong for a practice this size: $850K EBITDA on $3.3M revenue is a 26% margin, supported by a balanced revenue mix of 50% office visits, 25% surgery, and 25% in-office procedures. The surgical and procedural lines carry the profitability while exams drive steady patient flow and referral generation.
The moat is referral-based and demographic. Long-standing relationships with local physicians, hospitals, and medical groups create a defensible patient funnel that competitors cannot replicate quickly, and eye disease prevalence rises with an aging population, giving structural demand tailwinds in cataract, glaucoma, and retina care.
This is as recession-resistant as healthcare gets. Cataract surgery, glaucoma management, and diabetic retina care are medically necessary and insurance-reimbursed, so volume holds through downturns, and the 80% insurance/Medicare payer mix means collections do not depend on discretionary consumer spending.
An operator advantage exists in the single-county concentration. The seller explicitly flags geographic expansion, and the comprehensive single-site care model (evaluate, treat, operate, manage) is proven and transferable to adjacent markets with added providers or a satellite office.

How to improve it

Audit and optimize the payer contracts in the first 90 days. With 50% commercial insurance and 30% Medicare, small improvements in negotiated rates and clean-claim submission can move several points of margin directly to EBITDA without touching patient volume.
Build an optical dispensary and premium lens upsell. The practice already sees patients for cataract surgery but a captive optical shop and premium intraocular lens program capture high-margin out-of-pocket revenue that the current insurance-heavy mix leaves on the table.
Formalize physician retention and compensation before close. The value hinges on the non-selling MDs and doctors staying, so lock them into employment agreements with productivity incentives so the referral base and surgical volume do not erode after the owner exits.
Expand surgical capacity and recapture ASC fees. If surgeries are performed at outside facilities, evaluating an in-office or owned ambulatory surgery center arrangement can capture facility fees currently flowing to third parties, materially lifting procedure economics.
Execute the stated geographic expansion deliberately. Open or acquire a satellite location in an adjacent county using the existing brand and referral playbook, treating it as a repeatable unit rather than a one-off to compound enterprise value.
Tighten scheduling and chair utilization analytics. With modern intake and online forms already in place, layering in provider-level productivity dashboards can lift visits per day and reduce no-shows, improving revenue per clinical hour.
Diversify the referral base to reduce concentration risk. Formalize outreach to additional primary care groups, optometrists, and endocrinologists (for diabetic retinopathy) so no single referral relationship controls a disproportionate share of new patients.

Diligence notes

Reconcile the EBITDA to physician compensation. The $850K EBITDA figure is meaningless until you know whether the selling MD and the other providers are paid at market rates inside that number. If EBITDA is inflated by under-compensating owner-physicians, true buyer cash flow could be far lower and the 5.29x multiple much worse.
Scrutinize provider dependency and credentialing. Identify which physician generates the surgical volume, confirm their intent to stay, and verify all MDs are properly credentialed with every payer, because a departing surgeon or lapsed credential can collapse the highest-margin revenue line overnight.
Verify payer mix, reimbursement rates, and contract assignability. Confirm the 50/30/20 split with actual remittance data, review each managed-care contract for renewal risk and whether it transfers on change of ownership, and assess Medicare reimbursement trend exposure on cataract and retina codes.
Confirm the ownership and operating structure for compliance. Ophthalmology in California sits under corporate practice of medicine restrictions, so verify how a non-physician buyer can legally acquire this (MSO/friendly-PC structure) and review any ASC, Stark, or anti-kickback exposure in referral arrangements.
Pressure-test the growth claim and the two-office economics. The listing says excellent growth but gives no trend data, so pull three years of monthly revenue by office and service line to confirm the trajectory and whether both locations are profitable or one is subsidizing the other.
Clarify the reason for sale and real estate situation. Reason given is other business interests, not retirement, so understand the seller's remaining involvement, and confirm whether the two offices are leased, what the lease terms are, and whether any real estate sits outside the deal.

Source

Originally listed on BizBuySell. View original listing →