If you run a general-dentistry benchmark against an endodontic practice, you get the wrong answer every time. Endodontics is fewer, higher-value procedures, a referral-based pipeline, and a leaner clinical footprint, so the cost structure looks different.
The headline: a well-run endodontic practice targets total overhead of 58 to 65 percent of collections, with top performers between 55 and 60 percent. If you sit above 65, there is money to find. If you have never measured it, that is the first problem.
The lines, as a percent of collections. Staff and payroll, measured all-in with taxes and benefits, is the biggest lever at 25 to 30 percent. Clinical supplies run 5 to 8 percent. Rent and occupancy run 7 to 10 percent, higher in Northern Virginia and DC. Lab, marketing, and administrative costs fill in the rest.
The trap is reading any single line in isolation. Staff cost above range can be a growth season, not a structural problem, and you can only tell by reading labor cost and production per staff member together. That is why a benchmark, not a gut check, is the right tool.
Small overages compound. Eight points over on a $1.2M practice is about $96,000 a year, and it rarely shows up as one big line. It is staffing set for a slower season, supply prices never re-checked, and a lease that quietly renewed higher, all stacked together.