Cosmetic vs. medical mix
Cash-pay cosmetic revenue carries premium margins but consumer-discretionary risk; medical dermatology carries payer risk but recession durability. Buyers pay for a documented, balanced mix.
Specialty focus · Dermatology
Dermatology Practice Valuation & Brokerage Services in California
Cosmetic revenue, medical dermatology, Mohs, pathology — four businesses in one practice, each priced differently by buyers.
- CVA Certified NACVA Valuation Analyst
- USPAP Compliant Appraisal Reports
- 500+ Valuations 45+ specialties
Four Revenue Engines, Four Risk Profiles
A dermatology practice is rarely one business. Medical dermatology delivers recurring, insurance-reimbursed volume. Cosmetic services like injectables and lasers bring high-margin cash revenue that depends on patient loyalty and marketing. Mohs surgery concentrates high reimbursement in one or two surgeons' hands. In-house dermatopathology adds a lab business with its own compliance and referral logic. Buyers look at all four. A strong mix supports value, and a missing revenue engine is often an opportunity a buyer will want to build out. A credible valuation gives each one its due consideration.
Dermatology Practice Valuation
Certified, USPAP-compliant appraisals for sales, buy-ins, divorce, disputes, SBA loans, and estate planning.
Valuation servicesSell Your Dermatology Practice
Confidential, valuation-led brokerage that puts your practice in front of the buyers active in dermatology across California.
Brokerage servicesWhat Moves Dermatology Value
Provider leverage
Dermatology's PA/NP model is the strongest in medicine. Earnings from physician extenders under proper supervision are transferable earnings, and they move multiples.
Mohs concentration
If one Mohs surgeon generates 40% of revenue, that's the valuation's central risk question and the deal's central structuring question.
Injector loyalty
Cosmetic patients often follow their injector, not the practice. Whether your aesthetic staff is well paid, loyal, and likely to stay through a transition directly affects transferable value.
Retail and skincare lines
Skincare product sales are real revenue, but buyers value them like retail, on their own margins and inventory.
The PE Factor
Dermatology was the first specialty PE consolidated at scale, and California remains a core market. Platforms know their math cold: post-reset EBITDA, extender leverage, same-location growth. Sellers who walk in without equivalent fluency negotiate at a disadvantage. That is why our dermatology brokerage engagements begin with a CVA-led valuation analysis and a model of each offer's true economics.
Common Engagements
PE offer second opinions; pre-sale valuations; associate dermatologist buy-ins; divorce valuations where cash-pay cosmetic revenue and goodwill make the number contentious; partner disputes over Mohs compensation allocation.
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.
How will buyers read your cosmetic revenue?
As a premium or as a risk. We help you make the case before they make it for you.
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
Dermatology questions we hear most
Not lower, just differently. Durable, multi-provider cosmetic revenue with strong rebooking rates can command premium interest. Cosmetic revenue that depends on the founder personally reads as riskier. The diligence question is always transferability, and we answer it before buyers ask it.
Positively, almost always. Extender-generated earnings survive your exit and scale without you. That is the core of what platform buyers underwrite. We take supervision structure and per-provider economics into account so the leverage is priced, not just claimed.
Both. It adds margin and control, but buyers scrutinize self-referral compliance, and some will only want the practice without it. We weigh what the lab contributes so you know what it adds to the price before you negotiate.
Related aesthetic entities like med spas and skincare LLCs get valued alongside the practice with related-party flows restated to market. Buyers will want the structure clean; the valuation is where cleanup starts.
Know What Your Dermatology Practice Commands
A valuation that weighs every revenue engine. A competitive sale process.
All inquiries are kept strictly confidential.