Stop hiring spreadsheet consultants for $2M facility decisions.
Building an ASC or OBL is a $2M–$8M decision with years of operational consequences. Most feasibility studies are produced by consultants who have never owned or operated a facility — they model spreadsheets, not workflows.
GigHz Advisory is physician-led. We've sat on the operator side of these decisions: case mix, equipment, payer timelines, the hospital relationship. Engagements scale from a $7,500 fixed-fee Feasibility Snapshot to full build-out advisory.
What spreadsheet consultants miss
Three places a non-operator feasibility goes wrong — and why it costs the physician group $500K+ in their first two years:
Payer contracting timeline
Pro forma assumes day-one in-network rates. Reality: 9–18 months to credential, contract, and onboard with the major payers in your market. Cash flow models that ignore this break in the first year.
Wrong case mix for margin
Outsider consultants build case mix from public CPT volume — not from what your specific specialty's procedure shop actually generates. The mix that maximizes RVUs often destroys margin.
Hospital relationship politics
Most physician ASC builds run alongside an existing hospital relationship that gets renegotiated when the new facility opens. Consultants don't model the political dynamics; physicians who've operated in those systems do.
What a GigHz engagement actually delivers
Three line items — pick the one that matches your decision stage.
Every engagement is run by a practicing interventional radiologist who has sat on the operator side of these decisions, not a consultancy analyst. The modeling is yours to keep: pro forma, equipment ROI, payer-mix sensitivity, staffing. Where aggregate commercial benchmarks inform it, they come from CenterIQ and are cited to their source. The methodology behind the benchmark work is published: commercial rate variation in IR procedures (medRxiv) →
Feasibility Snapshot
Two-week pro forma + payer mix sensitivity for a single facility location. Decision-grade for go/no-go. Credited toward the Full engagement if you proceed.
- Specialty-tailored case mix
- Equipment and build-out ROI for the specialty
- Payer mix sensitivity table
- Risks + open questions list
Full Feasibility & Payer Strategy
Multi-scenario modeling. Payer strategy and contracting timeline. Capital stack guidance. Most groups land here.
- 3+ scenario pro formas
- Payer strategy and contracting timeline
- Case mix optimization
- Capital stack & equity structure guidance
Build-Out Advisory
Ongoing physician-led advisory through buildout — payer negotiation, staffing, opening operations.
- Payer negotiation cycles
- Staffing model + comp benchmarks
- Case mix iteration in opening period
- Hospital-relationship navigation
Data note: commercial benchmarks are aggregate figures (P25 / median / P75 by state) derived from CMS-mandated hospital machine-readable files. Reporting is uneven — some hospitals and procedure categories are incompletely disclosed. We tell you what coverage looks like for your specific market before you engage, not after. Hospital machine-readable files obtained from the consolidated dataset published by Trilliant Health’s Oria data portal (snapshot of November 7, 2025). oria-data.trillianthealth.com
Why physician-led
Physician operator perspective
Led by Pouyan Golshani, MD. Engagements are run or directly supervised by a practicing physician who has been on the operator side of facility decisions.
Operator modeling, not consultant templates
Pro forma, equipment ROI, payer-mix sensitivity and staffing built the way an owner runs them — with the contracting timeline and the hospital relationship modeled, not assumed away.
Tier-priced, not bait-and-bill
Snapshot, Full, Build-Out — explicit line items with explicit deliverables. No discovery-call funnel before you can see what an engagement costs.
Common questions
What size group is this built for?
Single-physician practices through 30+ provider groups. Snapshot tier works for early-decision exploration. Full and Build-Out tiers fit groups with the capital and complexity to justify the engagement.
Can I just buy CenterIQ and DIY?
Yes. Many physicians do. CenterIQ is free. Advisory exists for groups that want a physician walking them through it — not because the platform is hidden behind it.
Do you handle the construction / regulatory side?
We focus on financial modeling, payer strategy, case mix, and operating economics. Construction, CON, and licensing typically come from local partners — we coordinate with them and can refer to vetted ones.
What about acquisition diligence (PE buying my practice)?
Yes — sell-side and buy-side diligence on physician practices is a separate engagement type, run with the same operator lens as the feasibility work. Talk to us about scope.
Where are you stuck?
Answer five questions and you get real commercial rate benchmarks for your state on the next screen — not a thank-you page. Roughly two minutes.
Build the model with someone who's owned the facility.
Feasibility Snapshot $7,500 fixed fee. Full Feasibility & Payer Strategy $35,000. Build-Out from $75,000. Explicit line items, explicit deliverables, no surprise billing.
Written and reviewed by Pouyan Golshani, MD, Interventional Radiologist — Last updated April 24, 2026
Part of the GigHz library: systems doctors were never taught.