For a calendar-year medical practice, the Section 179 deduction for 2026 depends on one date: the day your equipment is placed in service. If an anesthesia machine is ordered in November but installed in January, the deduction moves to 2027. This article covers how to plan the timeline, financing, and purchase mix for equipment you want to deduct on your 2026 return. For the full rules, limits, and a savings estimate, see our Section 179 guide for medical equipment.
Not tax advice. Consult your tax advisor about your situation.
The 2026 numbers
The One Big Beautiful Bill Act (Public Law 119-21, signed July 4, 2025) set the Section 179 base limits at $2,500,000 and $4,000,000, indexed for inflation after 2025. For tax years beginning in 2026, IRS Revenue Procedure 2025-32 sets them at:
- Maximum deduction: $2,560,000
- Phase-out begins when Section 179 property placed in service during the year exceeds $4,090,000
- The limit reaches $0 at $6,650,000
The same law made 100% bonus depreciation permanent for qualified property acquired after January 19, 2025. Section 179 is a deduction, not a credit. It lowers taxable income, so the cash value depends on your tax rate. It is also an election: your tax preparer claims it on IRS Form 4562, Part I.
Work backward from December 31
Placed in service means installed and ready for its intended use. A paid invoice or a signed purchase order does not count. For capital equipment, the path from order to clinical use has several steps, and each one takes time:
- Quote, configuration, and approval inside your practice or ASC ownership group
- Financing approval, if you are not paying cash
- Order processing and shipping
- Delivery and receiving at your facility
- Installation, including mounting for ceiling lights and any electrical or medical gas work
- Biomedical checkout and staff in-service
Ceiling-mounted surgical lights and new operating rooms usually take the longest because they depend on contractors, inspections, and room readiness. A portable unit such as a patient monitor needs less. If a room build-out is behind schedule, ask your advisor whether equipment that can be used elsewhere in the facility in 2026 is a better fit for this year’s purchase.
Keep the delivery receipt, installation sign-off, and in-service record with the invoice. Those documents show when the equipment was placed in service.
Buy or finance: the deduction is the same
The deduction is based on the cost of the equipment, not on how much cash left your account in 2026. If a practice finances $60,000 of equipment (example figure, not an Infinium price) and places it in service in December, it can generally deduct the full $60,000 for 2026 while the payments run into later years.
The type of agreement matters:
- Cash purchase or equipment loan: qualifies
- $1 buyout lease (a conditional sale): generally treated as a purchase and qualifies
- Fair market value or operating lease: the leasing company owns the equipment, so the practice cannot take Section 179 on it
Infinium customers can apply for equipment financing or a $1 buyout lease through DoctorsLoans. Loan interest is deducted separately as an expense, not as part of the Section 179 amount.
Every purchase counts toward one pool
The $4,090,000 phase-out threshold applies to all Section 179 property your business places in service during the year, not to each order. If your practice also bought imaging equipment, IT hardware, or furniture in 2026, those costs add up with your surgical equipment. For a multi-location group, ask your advisor how the entities are structured, because related businesses can share the limit.
The deduction is also capped by your taxable business income for the year. Any amount over that income carries forward to future years instead of creating a loss.
The phase-out in plain terms
Below $4,090,000 of qualifying purchases, the full $2,560,000 limit is available. Above it, the limit drops one dollar for every dollar you spend over the threshold. A group that places $4,400,000 in service (example figure, not an Infinium price) loses $310,000 of the limit, leaving $2,250,000. At $6,650,000, the limit is $0.
For larger buyers, bonus depreciation is the backstop. It has no dollar cap, no phase-out, and no business-income limit, and it applies automatically unless you elect out. The usual order is the Section 179 election first, bonus depreciation on the remaining basis, and regular depreciation on anything left. Your advisor can choose how much to put under Section 179, since that election can be made for part of an item’s cost.
Refurbished and used equipment
Used equipment qualifies if it is new to your practice. A refurbished anesthesia machine such as a refurbished GE Avance S5 can be deducted the same way as a new unit.
The related-party rule is where used purchases go wrong. According to IRS Publication 946, property does not qualify if it is acquired from a related person (for this purpose, a spouse, ancestors, lineal descendants, or a business you own more than 50% of) or from another member of the same controlled group. Buying a retiring partner’s equipment from a practice they control, or moving equipment between two companies with the same owners, generally does not qualify.
Planning by practice type
Physician practice adding procedures
A dermatology, plastic surgery, or podiatry practice moving procedures in-house often needs a procedure table, a light, and a vital signs monitor. These are smaller purchases that can be installed quickly, so a November order can still be in use before year end. Confirm the practice will have enough 2026 taxable income to use the deduction this year.
Ambulatory surgery center
An ASC outfitting an operating room buys a surgical table, ceiling lights, an anesthesia machine, and patient monitoring together. The lights and room work set the schedule. If the room cannot be finished by December, the portable items placed in service now can be deducted in 2026, and the rest moves to 2027.
Multi-specialty clinic
Clinics often buy for several departments in the same year. Track every department’s equipment against the single $4,090,000 pool, and check how your state treats Section 179 and bonus depreciation. Many states set lower limits or do not follow federal bonus depreciation, so the state deduction can differ from the federal one.
Office-based or mobile anesthesia provider
Providers who bring anesthesia to dental, plastic surgery, or other offices use portable equipment such as the OBA-1 portable anesthesia machine with a patient monitor. Business use must be more than 50%, and the equipment is in service once it is ready for cases, which can happen soon after delivery.
A December checklist
- Ask your tax advisor to estimate 2026 taxable business income and total equipment purchases.
- Choose cash, a loan, or a $1 buyout lease. Avoid operating leases for equipment you plan to deduct.
- Confirm lead times and installation dates in writing.
- Collect the invoice, financing documents, delivery receipt, and in-service sign-off.
- Have your preparer make the election on Form 4562 with your 2026 return.
To see what your purchase could save, use the Section 179 savings calculator. To plan delivery for a room or a full package, request a package quote with your target in-service date.
This article is general information, not tax, legal, or accounting advice. Section 179 eligibility and savings depend on your circumstances. Consult your tax advisor before making purchasing decisions. Figures reflect IRS guidance for tax years beginning in 2026 (IRS Rev. Proc. 2025-32, IRS Publication 946) as of October 2026.