Lease vs. Buy a CBCT: The Real Math
Walk into any CBCT vendor and the rep will hand you a financing comparison sheet. It almost always recommends FMV lease. Here's why FMV often loses on a real $80K Planmeca or Carestream install — and the specific case where it wins.
The setup
$80K CBCT, 60-month term. Practice in Texas, owner credit 720, established 4 years, in tier A pricing. We'll run three structures: 60-month equipment loan, 60-month EFA ($1-buyout), 60-month FMV lease.
Year 1 cash & tax
Equipment loan @ 8%: payment ~$1,620/mo. Year 1 cash out: $19,440. Section 179: claim full $80K deduction (tax savings ~$28K at a 35% effective rate).
EFA @ 8.5%: payment ~$1,640/mo. Year 1 cash out: $19,680. Section 179: same as loan. Slightly higher rate reflects lender's title-transfer-at-end structure.
FMV lease @ ~5% (lower payment factor): payment ~$1,400/mo. Year 1 cash out: $16,800. No Section 179 — the lessor owns the equipment and depreciates. Lease payments are operating expense (deductible at $16,800 — tax savings ~$5,880).
Net Year 1 cost
Equipment loan: $19,440 − $28,000 = practice nets +$8,560 (the Section 179 deduction more than covers the year's cash outflow).
EFA: $19,680 − $28,000 = +$8,320.
FMV lease: $16,800 − $5,880 = practice pays $10,920 out-of-pocket Year 1.
The Section 179 deduction is the biggest swing in the math. Lease loses Year 1 by ~$19K against finance. If your tax bill in the current year is high enough to absorb the $80K deduction, finance.
5-year total and end-of-term
Equipment loan / EFA total payments: ~$97K-$98K. End-of-term: you own the CBCT. Resale value of a 5-year-old digital imaging unit: $20K–$35K depending on model and condition.
FMV lease total payments: ~$84K. End-of-term: FMV buyout (10–25% of original equipment cost, so $8K–$20K) or return. If you keep the CBCT and buy out at 15%, your total cost is $96K — within $2K of the finance number. If you return the equipment, total cost is $84K but you no longer have a CBCT.
Where FMV wins
Two cases. First: practices that absolutely cannot use the Section 179 deduction in the current year (low or zero taxable income, NOL carryforward). For them, the deduction is delayed value anyway. Second: practices on a fast tech-refresh cadence — most relevant to chairside CAD/CAM, less so to CBCT. CBCT refresh cycles are 8–10 years; FMV's value at term-end is muted.