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No-Show Cost Calculator: What Missed Appointments Cost Your Practice
The cost of no-shows is missed appointments × the share you can't refill × revenue per appointment, minus any fees you collect. A practice with 400 appointments a month, 8% no-shows and 6% late cancels, a 25% refill rate and $250 per visit loses about $10,500 a month, or $126,000 a year. Enter your own rates to see yours.
Prepared by Prospyr · Reviewed October 3, 2026 · Free, no sign-up, runs in your browser
Your schedule today
Patient never arrives.
Cancelled too late to rebook normally.
From the waitlist or same-day bookings.
Enter 0 if you do not charge one.
What if your rates changed?
Enter the rates you want to test, such as after adding deposits or reminders. The tool does not assume any result.
Net revenue lost to missed appointments
$10,500per month
$126,000 a year. 56 missed appointments a month, 42 left empty, about 31.5 provider hours idle.
Revenue from empty slots
$10,500
Fees collected
$0
Net cost per miss
$187.50
Combined miss rate
14%
With your what-if rates
Net loss $5,670 a month (9% missed). Difference from today: $4,830 a month back, $57,960 over a year.
An estimate from your own inputs. It counts revenue only, not lost goodwill or fixed costs you pay either way. Fee policies and limits vary by state and payer; confirm yours with counsel.
No-show cost formula and worked example
- Missed appointments = booked × (no-show rate + late-cancel rate)
- Empty slots = missed × (1 − refill rate)
- Revenue lost = empty slots × average revenue per appointment
- Net loss = revenue lost − fees collected
Worked example. 400 appointments a month, 8% no-shows and 6% late cancels is 56 missed. With 25% refilled, 42 slots stay empty. At $250 each that is $10,500 a month and $126,000 a year, with 31.5 provider hours idle at 45 minutes a visit. If you collected a $50 fee on 60% of the 56 misses, you would offset $1,680, leaving $8,820.
Testing a no-show fee, deposit or reminder change
The second half of the calculator is a what-if. Enter the no-show and late-cancel rates you want to test, and the fee and collection rate for that case. The tool shows today's net loss, the what-if loss, and the difference per month and year. It does not assume what a policy will do, so enter a cautious number first and a hopeful one second.
Research on interventions is mixed by setting. A 2023 systematic review and meta-analysis of behavioral economics approaches to missed appointments is listed in the sources. If you want to compare deposits and reminders, Prospyr's deposits collect at booking and charge the card on file for a no-show, and the guide to how no-show rates affect revenue and the guide to automated reminders covers reminder mistakes.
Late cancellation fee policy: what to write down
A policy that patients can follow is easier to enforce. Keep it short and show it at booking.
- The cancellation window, in hours, and the fee inside it.
- What counts as a no-show, such as no arrival 15 minutes after start.
- Who may waive it, and for what reasons, so the team treats patients alike.
- Where the patient agreed to it, such as the booking page or intake form.
Fee rules differ by state and by payer. Ask counsel to review the wording before you charge anyone.
Frequently asked questions
How do you calculate the cost of no-shows?
Multiply booked appointments by your no-show and late-cancel rates to get missed appointments. Remove the slots you refill, then multiply the empty slots by revenue per appointment. For 400 booked, 14% missed and 25% refilled, that is 42 empty slots × $250 = $10,500 a month.
What is a no-show fee?
A no-show fee is a charge a practice makes when a patient misses an appointment without notice. Many practices set it as a flat amount or a share of the service price and list it in the booking policy. Check your state's rules and your own consent language, and confirm with counsel before you set one.
What is a late cancellation fee?
A late cancellation fee applies when a patient cancels inside a stated window, such as 24 or 48 hours before the visit. The window matters because inside it you usually cannot refill the slot. Put the window and the amount in the booking policy, and show it before the patient books.
Do deposits reduce no-shows?
They may, but the size of the effect varies by practice and patient mix, so this calculator does not assume one. Enter the no-show rate you expect in the what-if section, then compare. A systematic review of behavioral interventions for missed appointments is linked in the sources if you want the research.
What no-show rate should I use?
Use your own. Pull the last three months from your schedule: appointments marked no-show divided by appointments booked. Count late cancels separately, because they cost you a slot only when you cannot refill it.
Why does the calculator ask about refilled slots?
Because a cancelled slot you rebook costs you nothing in revenue. A waitlist, same-day openings and text blasts all raise the refill rate. The tool multiplies missed slots by one minus the refill rate to get empty slots.
Does this include the cost of staff time and rooms?
It counts lost revenue and idle provider hours, not payroll or rent, because you pay those either way. If you want a margin view, enter revenue per appointment after product cost. Figures are before taxes.
Sources and scope
- Behavioural economic interventions to reduce health care appointment non-attendance: a systematic review and meta-analysis. Werner K et al., BMC Health Services Research, 2023;23:1136
Peer-reviewed review of interventions aimed at missed appointments. Linked as research background; this calculator assumes no effect size.
- Prospyr deposits
Describes deposits collected at booking and no-show fees charged against the card on file.
An estimate from your own inputs, not legal advice. Fee policies and limits vary by state and payer; confirm yours with counsel.