Lease or Finance? We Help You Pick the Structure That Wins

Own It: Loan or $1 Buyout

An equipment finance agreement or dollar buyout lease means you own the gear and generally take Section 179. Best for long-life equipment.

Lowest Payment: Fair Market Value Lease

An FMV lease keeps monthly cost down and gives you a clean upgrade path, with payments deducted as an operating expense.

Structured Around Your CPA

We quote more than one option with real payments so you and your accountant can pick the structure that fits your tax picture.

Independent and On Your Side

500-plus lenders, from 5.49 percent APR for qualified practices, and challenged credit welcome. We match the structure to your equipment, not to one bank's paper.

Almost every medical equipment deal comes down to three structures, and the right one is a cash-flow and tax decision, not a coin flip. First, an equipment finance agreement, which is really a loan. You own the equipment from day one, you build equity, and you generally take Section 179. This is the default for long-life gear. Second, a dollar buyout lease. Payments look like a lease, but for a token one dollar at the end you own the equipment, so the IRS usually treats it like a purchase and you can still take Section 179. It is a loan wearing a lease's clothing, and it is popular because it can carry lower upfront cost. Third, a fair market value lease, sometimes called an operating lease. You get the lowest monthly payment, you deduct those payments as an operating expense, and at the end you return the equipment, renew, or buy it at its fair market value. There is also a 10 percent purchase option lease that splits the difference. Which one wins depends on how long you will use the equipment, how fast the technology changes, and what your CPA wants for your tax picture. We quote more than one structure so you can compare real payments side by side.

Real structures we closed recently, names withheld. Rates and structures are never guaranteed until underwriting.

• $240,000 echocardiography system (GE Vivid E95). Cardiology practice, 11 years, 736 credit. Chose an equipment finance agreement to own it. Result: 5.69% APR, 60 months, zero down.
• $150,000 body-contouring platform (CoolSculpting Elite). Med spa, 6 years, 704 credit. Chose a 36-month fair market value lease to keep the payment low and upgrade when the next generation ships. Effective rate near 6.49%.
• $28,000 procedure chairs and sterilizer (Midmark). Dermatology, 5 years, 698 credit. Chose a dollar buyout lease to own the long-life gear and take Section 179. Result: 6.49% APR, 48 months.
• $95,000 aesthetic laser (Cynosure Elite iQ). Med spa, 4 years, 688 credit. Chose a 24-month fair market value lease for a fast upgrade path. Effective rate near 6.79%.

See the logic. The cardiology group and the derm practice wanted to own equipment that will run for a decade, so a loan or dollar buyout made sense and Section 179 came with it. The med spas chose fair market value on lasers and body-contouring platforms where next year's model is a real consideration. We fund strong and challenged credit alike.

Taxes often decide the structure, so here is the plain version, and then take it to your CPA. If you own the equipment, through a loan or a dollar buyout lease, you generally get Section 179, which lets you expense the full purchase price in the year the equipment is placed in service, up to the annual cap, which recent law raised to $2,500,000 for 2025. 100 percent bonus depreciation was also restored for property placed in service after January 19, 2025. That is a large first-year deduction on gear you now own. A fair market value lease works differently: you usually do not own the asset, so you do not take Section 179 on the purchase price. Instead you deduct the lease payments as an operating expense as you make them. Neither is automatically better. A practice with strong taxable income that wants a big write-off now often prefers ownership and Section 179. A practice that wants the lowest payment, plans to upgrade in two or three years, or is watching cash flow may come out ahead expensing FMV payments and handing the equipment back. The equipment type matters too, because you do not want to own a laser platform that is obsolete in three years, but you happily own dental chairs for fifteen. We structure the financing. Your CPA confirms which deduction path fits your return.

A simple rule of thumb sorts most decisions. Own the gear that lasts. Dental chairs, sterilizers, exam and procedure tables, autoclaves, and imaging hardware with a long service life are natural candidates for a loan or a dollar buyout lease, because you will use them for a decade or more and ownership plus Section 179 rewards you. Lease the gear that moves. Aesthetic lasers, body-contouring platforms, and anything driven by fast-evolving software or consumables can be a better fair market value lease, because a lower payment and a clean upgrade path beat owning a device that the manufacturer replaces in three years. Cash flow tips the scale too. A newer practice guarding its reserves might choose FMV to keep payments low, while an established group with strong income might choose ownership to capture the deduction. Ticket size and how long you will realistically keep the equipment round out the call. We do not push one answer, because we are independent and we earn your repeat business by getting this right. We lay out the loan, the dollar buyout, and the fair market value option with real payments, tell you what we would do, and let you and your accountant make the final call. From 5.49 percent APR for qualified practices, whichever structure you choose.

What is the difference between a lease and a loan?

A loan, or equipment finance agreement, makes you the owner from day one and builds equity. A lease is use of the equipment for a term. A dollar buyout lease ends in ownership, while a fair market value lease lets you return, renew, or buy at market value.

Which is better for taxes?

It depends. Ownership through a loan or dollar buyout lease generally gets Section 179, a large first-year deduction. A fair market value lease lets you deduct the payments as an expense instead. Neither is automatically better, so run it by your CPA.

Can I own the equipment at the end of a lease?

With a dollar buyout lease, yes, for a token one dollar. With a fair market value lease, you can buy it at its fair market value, return it, or renew. There is also a 10 percent purchase option lease in between.

Which structure is better if I want to upgrade often?

A fair market value lease. It keeps your payment low and gives you a clean path to the next generation of equipment, which suits fast-moving technology like aesthetic lasers and body-contouring platforms.

What do most practices choose?

It splits by equipment. Long-life gear like dental chairs, sterilizers, and echo systems usually goes on a loan or dollar buyout lease for ownership and Section 179. Fast-evolving devices often go on a fair market value lease. We quote both so you can compare.