Northern California
Medical Practice Valuation & Brokerage Services in San Francisco
The highest reimbursement and the highest costs in California share one zip code. Valuing Bay Area practices means netting the two honestly.
- CVA Certified NACVA Valuation Analyst
- USPAP Compliant Appraisal Reports
- 500+ Valuations 45+ specialties
The Bay Area Paradox
San Francisco practices operate at California's extremes simultaneously. Commercial reimbursement here runs among the highest in the nation — a legacy of concentrated provider systems (UCSF Health, Sutter/CPMC, Kaiser) negotiating with deep-pocketed employer purchasers. But operating costs run just as extreme: medical office rents, clinical wages, and the general Bay Area cost structure consume margins that the reimbursement seems to promise. Two practices with identical revenue — one in San Francisco, one in Sacramento — can have utterly different normalized earnings. Valuing Bay Area practices is an exercise in netting those forces with discipline, not in being impressed by either one.
Market Forces We Price in San Francisco
- System concentration. UCSF, Sutter, and Kaiser dominate; independent practices live in the spaces between — which makes the independents that thrive (strong niches, loyal panels, cash models) genuinely valuable and genuinely scarce.
- The concierge and cash-pay depth. San Francisco supports one of the country's strongest concierge, executive health, and cash-specialty markets. High-income panels with demonstrated willingness to pay are an asset class of their own here, and we value them as such.
- Tech-employer benefits economics. Generous employer plans sustain strong commercial rates — but employer concentration means payer mix can shift with the tech cycle. Durability analysis matters.
- Cost normalization is decisive. Owner-operators often under-pay themselves and over-absorb costs personally to survive SF economics; normalization regularly reveals earnings materially different from the books — in either direction.
- Demographic headwinds and tailwinds. The city's population churn cuts against pediatric and family panels and toward specialties serving professionals and aging affluent cohorts. The income approach should know which side your practice is on.
What we do in San Francisco
Medical Practice Valuation
Medical Practice Valuation in San Francisco
Certified opinions of value with high-cost-market normalization done right.
Learn moreASC Valuation
ASC Valuation in San Francisco
Center and interest valuations in a constrained, high-rate facility market.
Learn moreSelling a Medical Practice
Sell Your Medical Practice in San Francisco
Confidential sales into a market where scarce independents command attention.
Learn moreSelling Your ASC
Sell Your Surgery Center in San Francisco
Sell-side work where facility scarcity is the story.
Learn moreStatewide Standard, Bay Area Judgment
We serve San Francisco and the broader Bay Area from Newport Beach with the same model as everywhere: remote-efficient document work, targeted in-person interviews and walkthroughs at the milestones that matter, certified USPAP-compliant conclusions in 1–2 weeks, and brokerage run as a structured, competitive process.
A clear, three-step process
- 1
Discovery Call
A confidential conversation about your practice, your timeline, and the purpose of the valuation. We scope the right report tier before you commit to anything.
- 2
Financial Analysis & Interviews
We interview you and normalize your financials. Owner compensation, one-time expenses, and related-party leases all get restated. Typical turnaround: 1–2 weeks.
- 3
Certified Opinion of Value
You receive a defensible, USPAP-compliant conclusion of value, walked through line by line. The report is documented to withstand scrutiny from a buyer, a court, a partner, or a lender.
High revenue, high costs — what's the real number?
Normalization-first valuation answers the Bay Area question.
Trusted by physicians across California
Real Google reviews from physicians and practice owners we have served. Read them on Google
“As a physician with partnership transaction of medical practice, he was an exceptional to guide me and advise me. He showed not only professionalism but also his eagerness to help and guide me through. Highly recommend him for any business valuation and transaction.”
Dr. Kyong Kim
Partnership transaction
“Fantastic valuation/appraisal specialist. I reached out to Alexey to help me evaluate a medical practice buy-in on short notice. He was able to work me into his schedule and accommodate my timeline despite how busy he was and provided crucial insight into helping me decide my next steps.”
Dr. Xuan Cao
Medical practice buy-in
“They get 5 stars across the board. Alexey was extremely thorough and detailed oriented. He did a deep dive into my practice’s financials, coding and practice history. He was easily approachable and prompt in answering questions and in completing the Appraisal. I am confident in the results and I would highly recommend him to any physician/practice for an appraisal.”
Dr. Robert Sacks
Ophthalmology practice
“I called Nechay as I was navigating the potential of selling my practice, and I had a lot of questions about my various offers for sale. Nechay was so responsive, methodical, and educational. He really allowed me to understand the landscape of selling my practice. He is an effective communicator, very patient on the phone and obviously extremely knowledgeable. I will be hiring him to help complete my transactions!”
Dr. Garima Lal
Evaluating sale offers
“I hired Nechay Appraisals to value my ophthalmology practice last year and couldn’t have been more impressed. From start to finish, Alexey was fantastic to work with. The end result was a highly professional and polished valuation report that provided valuable insights on the current state of my business.”
Dr. David Salvay
Ophthalmology practice valuation
“Alexey has been an excellent asset in evaluating our practice. His experience and practice suggestions have helped us tremendously. His working knowledge of medical practice evaluation and application of these skills is second to none. He is always readily available at a moment’s notice.”
Dr. Elio Vento
Practice evaluation
“Very attentive. Quick to respond. Knowledgeable.”
Dr. Betty Daniels
“Very professional, responsive and creates an excellent report and is accessible. Thank you!”
Dr. Daniel Laroche
“Alexey is very professional and a pleasure to work with. I was under time constraints and he completed his review on time despite those additional pressures.”
Dr. Charles Jackson
“Nechay listened carefully and provided objective feedback tailored to my specific situation. His honest communication and expertise made a complex process much easier. I highly recommend him.”
Dr. Maria Soledad Romero
“Highly recommend! From start to finish, he demonstrated expertise, professionalism, and genuine care. Not only did he deliver a thorough, well-researched valuation report, but he also took the time to explain key findings, offer strategic advice, and answered all our questions — even talked to our accountant and bookkeeper to dig deep into our situation.”
Dr. Alicia Sanchez
Medical practice valuation
“We hired Nechay Appraisals to value our ophthalmology practice the year before last and couldn’t have been more impressed. From start to finish, Alexey was fantastic to work with. He was very organized and very patient with us as we gathered what he needed. Every week he would check in to make sure everything was on track. We are getting ready to utilize his services again and are looking forward to working with him.”
Jenna Keller
Ophthalmology practice valuation
“I greatly appreciate the help from Alexey. The process was easy and the information was invaluable. The data provided was comprehensive and gave me perspective of my company that I was not aware of. I highly recommend Alexey and his company.”
Dr. Linh Ngo
Medical practice valuation
San Francisco questions, answered
That's the Bay Area question, and it's answerable only through normalization: restating owner compensation, lease terms, and absorbed costs to economic reality. Some thin-netting SF practices hide strong earnings; others genuinely earn little and are worth their assets plus modest goodwill. The valuation tells you which — before a buyer tells you their version.
A selective but real one: systems filling specialty gaps, platforms entering the market, concierge operators buying panels, and physicians who want SF careers without startup risk. Scarcity of quality independents works in sellers' favor here.
The region — San Francisco, the Peninsula, Marin, East Bay, and South Bay engagements all run on the same model.
It defines the competitive frame: practices serving the non-Kaiser commercial population compete in a smaller pond with higher rates. Panel loyalty and niche strength matter more here than in any other California market — and both are measurable.
Bay Area Practices Deserve Bay Area Judgment
Certified valuations that net the extremes honestly.
All inquiries are kept strictly confidential.