Oncology & Radiation Centers

Oncology imaging sits at the intersection of diagnostic precision and treatment planning, and the equipment decisions made at the front end of a cancer center's infrastructure shape both patient outcomes and operational efficiency for the next decade. A cancer center that images poorly misses early-stage findings; one that images slowly creates scheduling bottlenecks that push patients toward competitors or, worse, toward delayed diagnosis. The equipment plan has to account for both failure modes simultaneously.

Radiation oncology centers add a third dimension: imaging systems used for treatment planning and on-treatment verification. Cone-beam CT for patient positioning, fluoroscopy for real-time organ motion monitoring, and diagnostic DR for treatment-response evaluation all play roles in a mature radiation oncology workflow. These are not the same imaging decisions as a general radiology department makes, and the financing needs to be underwritten by people who understand what the equipment is actually doing clinically.

We work with freestanding cancer centers, radiation oncology clinics, and oncology practices that are building or expanding imaging capability. Our minimum is $50,000, our sweet spot is $100,000-$500,000+, and we work with lenders who have placed equipment in medical specialty settings where standard lenders pull back.

Imaging equipment in oncology settings

Diagnostic imaging in an oncology practice covers a wide footprint. For initial staging and treatment response evaluation, a fixed digital radiography room handles chest and skeletal imaging efficiently. The DR room for oncology does not differ materially from a general DR room in terms of equipment, but the volume of chest studies in lung cancer follow-up and the frequency of skeletal surveys in myeloma follow-up practices can run higher than a comparable-size primary care clinic, making system reliability and throughput particularly important.

For tissue diagnosis, stereotactic biopsy systems are central to breast oncology programs. A stereotactic biopsy unit allows minimally invasive tissue sampling under fluoroscopic or digital guidance without an open surgical procedure, and the accuracy of the guidance system directly affects sampling yield. The Hologic Affirm prone biopsy system and the Siemens Mammomat variants are commonly used platforms, with new system pricing in the $150,000-$300,000 range.

Practices that do tumor-related interventional procedures, including port placements, biopsies under image guidance, and drain placements for malignant effusions, need a fluoroscopic system capable of real-time guidance. A radiographic and fluoroscopic system with a tilting table and overhead tube serves this role in most outpatient oncology settings. New R&F systems capable of oncologic procedural work typically run $150,000-$350,000.

Radiation oncology programs that do treatment simulation in-house need a simulation CT, which is outside our X-ray scope, but the diagnostic X-ray rooms and fluoroscopy used for treatment response and acute complication evaluation are very much in our wheelhouse. We finance those components of a radiation center's equipment plan even when the primary capital equipment (linear accelerator, CT simulator) is being funded elsewhere.

Refinancing and capital extraction for established centers

Established oncology centers and radiation clinics often have substantial imaging equipment that is fully paid off but still productive. A stereotactic biopsy unit purchased six years ago may be current-generation enough to run another four or five years, but the capital it represents is locked up in depreciating equipment rather than working as operating capital.

A sale-leaseback on fully owned imaging equipment releases that capital while the center continues using the equipment under a lease. For a center with $500,000 in paid-off imaging equipment, the sale-leaseback can generate $300,000-$450,000 in net proceeds depending on appraised value and lender LTV, with a monthly lease payment replacing the equipment's zero-cost status. That trade-off makes sense when the capital extracted funds a higher-return use: a new service line, additional staff, marketing for a new referral network, or paying down higher-cost debt.

Cash-out equipment refinancing is a related option for equipment that still carries a small remaining balance. Refinancing to a higher balance at current rates and pulling cash out preserves ownership of the equipment while extracting equity. We model both sale-leaseback and cash-out refinance scenarios side by side when clients ask us which makes more sense for their situation.

Timeline and documentation

Oncology equipment transactions tend to be larger and sometimes involve institutional borrowers, hospital-affiliated groups, or physician-owned specialty practices with complex ownership structures. We handle all of these, and the documentation requirements scale with the deal size and structure rather than following a single template.

For standalone freestanding cancer center transactions in the $200,000-$400,000 range, application-only underwriting is typically available. The application, three months of business bank statements, and the equipment quote are the starting documents. Closing runs one to two weeks from credit approval.

For larger transactions or center expansions involving multiple equipment packages, we work with lenders who want to see two years of tax returns, a current P&L, and a copy of any major facility or health system contracts in place. That documentation package usually takes a week to assemble and another one to two weeks to underwrite. Plan for three to four weeks from application submission to funding on large complex deals.

Practices that are working under a Section 179 deadline or a year-end tax strategy deadline should mention that upfront. We work with lenders who can prioritize and close ahead of the calendar year end when needed, but the window for that service narrows significantly after Thanksgiving each year.

Who we work with in this space

Medical oncology practices that have added in-house imaging capability as part of a broader comprehensive care strategy are a growing segment. A three-physician medical oncology group adding a stereotactic biopsy suite and a diagnostic DR room is a materially different project than a hospital department expansion, and practices like ambulatory surgery centers that handle overlapping procedural volumes face similar capital-planning questions, and it deserves financing that is sized and structured for an independent specialty practice rather than a hospital financing team.

Radiation oncology programs affiliated with larger health systems often need to finance equipment through their own separate legal entity rather than through the health system's capital budget. We work with physician-owned entities that sit adjacent to larger institutions but need to manage their own equipment finances independently.

Community cancer centers and rural oncology programs are also a meaningful part of our pipeline. Access to cancer care in smaller markets depends on community programs having the equipment to provide care locally, and we take seriously the role that equipment financing plays in keeping that care available outside of major urban cancer centers. If your program is in a market that the larger institutional lenders overlook, that's exactly the kind of situation we're set up to handle.

Start the financing conversation for your oncology program

Whether you are financing a stereotactic biopsy suite, an interventional room, or a diagnostic DR installation for treatment response monitoring, we can structure a deal that fits the practice's capital constraints and timeline. Call us or submit an application and we'll get back to you within a business day.

We're buying a stereotactic biopsy system and renovating the room at the same time. Can soft costs be financed?

Yes, room renovation and construction costs can typically be included in the equipment financing package up to 20-25% of the hard equipment cost. For a $200,000 biopsy system, that means up to $40,000-$50,000 in room build-out can be bundled into the same loan. For larger construction components, a separate small business loan or commercial construction line may be needed alongside the equipment facility.

Our center is affiliated with a hospital but we are a separate LLC. Can we finance equipment in the LLC's name?

Yes. The legal entity on the application is the borrower, and a physician-owned LLC is a standard borrower with our financing desk even if that LLC has an affiliated services agreement with a larger institution. The LLC's own financials, revenue, and credit are what we underwrite, not the affiliated hospital's credit. This is a common structure for hospital-affiliated but independently owned outpatient specialty practices.

Can we refinance a stereotactic biopsy system we bought three years ago to free up cash?

Yes. If the system is paid off or has equity above the remaining balance, a sale-leaseback or cash-out refinance can generate working capital while you continue using the equipment. The appraised value of the equipment drives the available proceeds. A three-year-old biopsy system from a major OEM in good service condition retains meaningful value and is a viable candidate for a leaseback.

Our center is new, open for 14 months. Do we qualify?

Yes, at 14 months you are past the 12-month threshold that most lenders require. Your bank statements from the past three months are the primary financial document, and if revenue is established and consistent the application is straightforward. The deal size will help determine which lenders are available to you, but 14 months with oncology-specific revenue is a workable starting point.

Are there tax advantages to leasing rather than owning our imaging equipment?

A fair market value lease allows you to deduct the full lease payment as a business expense, which can be advantageous if the practice does not have significant taxable income against which to apply a Section 179 deduction. Ownership via loan or $1 buyout lease allows Section 179 depreciation in year one, which is more valuable in profitable years. The better structure depends on your specific tax position for the year of purchase, and your CPA should weigh in before you commit to a structure.

We want to submit one application for a DR room and a fluoroscopy system as a package. Is that possible?

Yes, and it's cleaner than two separate applications. A DR room and a fluoroscopy system together typically run $250,000-$500,000, which is comfortably within our scope. One application, one credit decision, one closing, one payment. We pull the invoice from your vendor for both pieces of equipment and structure them under a single facility.

Related Financing Paths