Dental

Books and taxes for oral surgeons.

Surgical case payments, medical insurance claims, anesthesia fees, and biopsy lab bills that all move differently. Gus sorts every deposit, an accountant checks every transaction, and you get one number each month.

Book a call What we handle
  • From $197 a month
  • An accountant on every transaction
  • Cancel whenever
MarchExample month
$24,800
what you made

March made $24,800. The trauma case that billed through medical insurance came in as its own line, separate from the dental cases, same as always.

  • Wisdom teeth case paymentSurgical case payments
  • Medical insurance paymentMedical insurance payments
  • Pathology lab invoiceBiopsy and lab fees
  • Anesthesia supply orderSedation and anesthesia supplies
  • Sterilization serviceSterilization services
Money in$68,500
Money out$43,700
Set aside for taxes$5,700
An example month. Yours will have your numbers.

Why your books are different

An oral surgery practice's books go wrong in four familiar places.

Your practice runs on referrals, not ads, and on cases that sometimes bill medical insurance instead of dental. A generalist bookkeeper who does not separate the two turns a normal month into a confusing one.

  1. 1

    Medical insurance and dental insurance do not mix

    A wisdom tooth extraction bills to dental insurance, but an impacted tooth tied to an infection or a jaw fracture from an accident often bills through medical insurance instead, at a different rate and timeline.

    What we doKeeps medical insurance and dental insurance payments in their own categories, so a slower medical claim does not get confused with a dental one.
  2. 2

    Anesthesia is its own line, not part of the procedure

    IV sedation or general anesthesia for a surgical case carries its own fee and its own supply cost, separate from the surgery itself. Blended together, you cannot tell how much sedation is really costing against what it brings in.

    What we doKeeps sedation and anesthesia fees and supplies apart from the surgical fee, so both sides of the case are visible.
  3. 3

    A single case can be five figures

    A full-arch implant case with bone grafting can run past $20,000 in one visit. One case like that in a slow month makes the whole month look unusually strong, and the next quiet month look like a crisis.

    What we doFlags unusually large single cases so a strong month is understood for what it is, not mistaken for a new normal.
  4. 4

    Referral relationships do not show up as marketing

    Most new patients come from a general dentist's referral, not an ad. A generalist bookkeeper looking for marketing spend to explain new patients misses where the practice's business really comes from.

    What we doKeeps referral-related costs, like a coordinator's time or thank-you gifts, in their own place instead of guessing they belong to marketing.

Your categories

The categories Gus keeps for an oral surgery practice.

Set up once for how the practice gets paid and what it spends. You never pick a category. He does, and an accountant checks it.

Money in

  • Surgical case paymentsExtractions, wisdom teeth, and implant placements, paid by the patient.
  • Medical insurance paymentsTrauma, pathology, and some impacted tooth cases billed through medical coverage instead of dental.
  • Dental insurance paymentsStandard PPO coverage for extractions and other dental-coded procedures.
  • Patient financingCareCredit or Sunbit payouts for implant and grafting cases, net of the fee.

Money out

  • Surgical and sedation suppliesIV sedation medications, sutures, and surgical consumables.
  • Biopsy and pathology feesLab fees for tissue sent out after a biopsy.
  • Implant and grafting materialsImplant fixtures, bone graft material, and membranes.
  • Clinical staff paySurgical assistants and any associate surgeon, kept apart from front desk pay.
  • Sterilization and instrument servicesAutoclave supplies and outside sterilization or repair services.
  • Facility or OR feesTime booked at a hospital or surgery center for more complex cases.

What we watch for you

  • Case size average

    The average payment per case, since a handful of large cases can swing a month on their own.

  • Medical versus dental mix

    How much revenue comes through medical insurance against dental, since the two pay on different timelines.

  • Referral concentration

    How much of the practice's business comes from a small number of referring dentists.

  • The set-aside

    What you owe across medical and dental cases, tracked all year so April holds no surprise.

Ask Gus

Things oral surgeons ask Gus.

Text him like you would text anybody. He answers in plain English, and when a question is above his pay grade, an accountant looks and gets back to you.

A patient's jaw fracture case billed through their medical insurance instead of dental. Why the difference?

Trauma and some pathology cases are usually medical, not dental, coverage. I keep that payment in its own category since it moves on a different timeline than a typical dental claim.

This month had one huge implant case. Does that throw everything off?

I flagged it as an outsized single case, so it does not get read as a new normal for the practice. The rest of the month still shows through clearly.

I am thinking about buying a cone beam scanner for the office. Worth it before year-end?

I can show you what the practice made this year and what buying it now versus waiting would do to your number, but the right call for your case load is above my pay grade. I will get the accountant to look at the timing with you.

The tax side

The tax side of an oral surgery practice.

Most of what goes wrong here is timing and labels. A medical claim booked like a dental one, and equipment that gets filed like an ordinary supply.

What your return has to get right

Your accountant signs it, so it gets done right the first time.

  • Surgical equipment and imagingA cone beam scanner, surgical instruments, or an anesthesia delivery system can usually be written off the year you buy them. Bonus depreciation is 100 percent for property bought after January 19, 2025.
  • Medical versus dental coding timingCases billed through medical insurance often pay out slower than dental claims. That affects when cash arrives, not whether the income is taxable once it does.
  • Associate surgeon classificationAn associate oral surgeon paid a share of production is usually an employee, and state rules on who can own a dental or medical practice narrow the options further.
  • Contractor 1099sAn anesthesia provider, a relief surgeon, or a lab paid $2,000 or more in 2026 and not on payroll gets a 1099-NEC by January 31.

Deductions oral surgeons miss

Your bookkeeper knows what to look for in your statements. You never have to.

  • Surgical instruments
  • Sedation medications
  • Implant and graft materials
  • Malpractice insurance
  • Surgical scrubs and gowns
  • Continuing education
  • Oral surgery association dues
  • Sterilization supplies
  • Practice software subscriptions
  • Referral coordinator costs
  • Credit card processing fees

General information about 2026 federal rules, not advice for your business. Your accountant looks at your actual numbers before anything gets filed.

All year, not just April

An oral surgery year, kept every month.

Referrals come in on their own schedule. Your taxes come on the calendar's schedule. Your team keeps you ahead of both. Every month in between, your bookkeeper closes the books and speaks up the moment something looks off.

  1. January

    Plan the year

    Last year's return gets started, the contractor list for any relief surgeon or anesthesia provider is ready, and a monthly set-aside begins so April is not a scramble.

  2. April

    Filed and signed

    Your business return is filed. Between referral volume and medical claim timing, the set-aside running since January means no scramble now.

  3. July

    Midyear read

    A look at where the practice stands, what you will owe, and whether the mix of medical and dental cases changed the number.

  4. October

    Before the slow stretch

    Referrals often thin out around the holidays as general practices get busy with their own patients. Before that hits, Gus flags equipment worth buying and anything worth doing before December.

What you get

Starts at$197a month

What you pay depends on what your business needs, and it does not move after that, busy season or slow. No hourly bills, no surprise invoices, no setup fee.

Book a call
  • Monthly bookkeeping

    Every transaction sorted into categories set up for oral surgeons. You never categorize a thing.

  • An accountant checks every transaction

    Real review, every month, before your books close. Not a spot check.

  • Your business tax return, filed

    Prepared, reviewed, and signed by that same accountant every year.

  • The monthly number

    What you made, what you spent, what to set aside for taxes.

  • Your own bookkeeper

    A real person assigned to your business, in the app whenever you need them. No hold music.

  • On your books all year

    Every month, not just in April. Your team speaks up whenever something is worth your attention.

  • Cancel any time

    No contract. No cancellation call. Your books are yours.

Straight answers

Questions oral surgeons ask first.

How do you handle cases billed through medical insurance instead of dental?

They are kept in their own category since they move on a different timeline than dental claims. The payment is booked as it lands, whichever kind of insurance it came through.

One big implant case can double a slow month. Does that confuse the books?

No. Gus flags an unusually large single case so it reads as what it is, not a sign the practice suddenly changed pace.

Most of my new patients come from a handful of referring dentists, not marketing. Does that matter for the books?

It does not change how the books are kept, since revenue is revenue either way. Gus can help you see the pattern in what comes in, even though tracking the referral relationships themselves is something your team handles.

My surgical assistant is trained in anesthesia and paid more than a typical assistant. Does that change anything?

Not in how the books work. Gus keeps clinical staff pay in its own category regardless of specialty, so you can see labor cost against what the practice brought in.

My books have not been touched since we added a second surgeon. Can Gus catch up?

Yes. Send the bank statements you have. Gus sorts through the backlog and the accountant reviews it once everything is caught up.

Is a real accountant checking my books?

Yes. You get your own bookkeeper, Gus does the first pass on every transaction, and an accountant checks every one before your month closes. That same accountant prepares, signs, and files your business return. Goatkeeper is not a CPA firm, and we never pretend a person looked when they did not.

What does it cost, and can I cancel?

It starts at $197 a month, depending on what your business needs. No setup fee, no hourly bills, no contract. Cancel any time from the app, and your books go with you.

More in dental

We keep books for the business next door too.

What makes a bookkeeper worth paying for Every business we keep books for

Book a call

Pick a time. That's the whole signup.

Fifteen minutes with a real person on our team. They look at where your books are, tell you straight what it takes to get caught up, and get you set up on the spot if it fits.

  • $197 a month to start
  • An accountant on every transaction
  • Cancel whenever