CAA
Clinical Asset Appraisal
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How CAI works

Methodology

A valuation of your equipment passes through three hands before it reaches your schedule, and most of the ones you have been offered stop after the first. This page walks all three in order: the data the number is built from, the appraisal discipline that turns recorded prices into a signed conclusion, and the underwriting that decides what the conclusion is worth once it reaches a policy.

They are separate skills. A price database has the first and neither of the others. An appraiser who works from a subscription price guide has the second and is renting the first. We do all three in-house, which is the entire reason this firm exists — and it is why every figure below can be traced back to the listing it came from.

Refreshed every 24 hours · We track 191 devices across 9 active sources.

MOVEMENT I

The data

What is collected, how it is classified, and how a peer-group median is computed. This movement is public and checkable — every device page links out to the listings underneath it. Nothing here is an appraisal; it is the evidence an appraisal is built from.

1. Asking prices AND realized sold prices — kept separate

We track two distinct things and never blend them into one number. The Library Median is the median of publicly listed asking prices (dealer marketplaces, surplus portals) — a useful ceiling and starting point, not an appraisal, and not a price any seller is bound to accept. Separately, we surface realized sold prices where we have them: auction closes(GovDeals / HiBid final winning bids), eBay Terapeak 90-day sold data, andcommunity-reported sales (Report-a-Sale). Each number is labeled with its basis and how many comps back it. Asking medians typically run well above realized prices — that gap is exactly why we show both: the asking ceiling, and what units actually clear at (auction closes are a liquidation floor, not a dealer price). A discount is always computed against one anchor and labeled as that anchor.

2. Peer-group classification

Every listing is classified into one of these mutually exclusive buckets before any pricing math happens:
  • Complete System — fully assembled, ready-to-deploy unit.
  • Major Module — significant operational sub-system (e.g. a probe, a detector, a vaporizer).
  • Part / Accessory — component, cable, battery, board, accessory.
  • For Parts / Repair — non-functional, salvage, "as-is" listings.
  • Consumable — single-use accessories.
  • Service Manual / Software — non-physical assets.
  • Under Review — listing whose classification confidence is too low to publish.

We never mix these buckets in a peer median. A complete-system median is computed only from complete-system listings. Mixing them is the single biggest reason third-party used-equipment price estimates fail.

3. Why median, not mean

Used clinical pricing is full of outliers. A single $82,400 DOTmed dealer asking price next to a $10 GovDeals lot for the same model destroys the mean. The mediansits at the middle of the price distribution and ignores both tails — that's exactly what you want for "what does this thing actually sell for". We show p25, median, p75, min, and max publicly. The mean is shown only as a small secondary number with a tooltip explaining the trade-off.

4. Confidence thresholds

  • A listing is published in peer-group comps only when classification_confidence ≥ 0.65.
  • A listing is counted toward a device only when both device_match_confidence ≥ 0.75 AND classification_confidence ≥ 0.65.
  • Active Listings on a device page require classification_confidence ≥ 0.75 — weaker matches go to admin review, not public display.
  • Per-bucket comp groups with fewer than 5 listings are labeled Thin and treated as directional only.

5. Source coverage grades

Each device gets a coverage grade based on its observed listings and source diversity:
  • STRONG — 50+ listings observed and 3+ sources contributing.
  • GOOD — 20+ listings, 2+ sources.
  • THIN — 5+ listings.
  • VERY THIN — fewer than 5 listings.
  • NO DATA — nothing observed yet (an expansion target).

The current source list (active vs planned) is visible on /stats.

6. Stable deals (how we know a deal has held)

We snapshot the firm below-typical deals once a day into a small history table. A device earns a ★ Stable deal badge when below-typical firm deals show up for it on a sufficient number of those daily snapshots within the last 7-day window.

  • The window adapts honestly: we only count snapshot days that actually exist. As history accrues, the window matures to the full ≥ 5 of the last 7 days criterion.
  • The badge reflects observed listing persistence — it does not mean any specific listing is still available. Sellers may relist, end early, or change price; every linked listing should be verified at the source.
  • If a device has no demonstrated persistence in the current window, it gets no badge. The signal's whole value is that it's true.
  • The history table is device-level, so the badge is per-device, not per-listing.

7. Known limitations

  • We don't see final sold prices — observed listing prices only.
  • Some sources require login or proprietary APIs — those are marked as "planned" on /stats.
  • Auction prices skew lower than dealer prices and are not directly comparable. We surface both, separately, in the per-source table on every device page.
  • Recall and adverse-event data are matched at the device family level unless we have an exact manufacturer + model match. Don't treat "X matched recalls" as a regulatory determination.
  • Verification (URL or screenshot) is decision support — it doesn't replace physically inspecting the unit, requesting service records, or confirming regulatory status.

8. Sources & regulatory data

Listings are aggregated every 24h from eBay · GovDeals · DOTmed · HiBid · LabX · PublicSurplus, classified, scored against peer-group medians, and source-linked. Coverage is FDA-aware: openFDA classification, clearance and recall coverage is read across the federal device record (matched at the device-family level — see limitations).

  • AccessGUDID — device identification
  • openFDA Recalls

9. Legal posture

The Equipment Library is recorded market data, not an appraisal, not medical or regulatory advice, and independent of — not endorsed, sponsored, or authorized by — any marketplace or manufacturer. We earn no commission, referral fee, or other consideration from any equipment transaction. We are paid to value equipment, never to trade it. Buyers are responsible for verifying condition, service history, regulatory status, and seller claims independently. We respect robots.txt and the terms of service of each source; we cache responses to avoid wasteful re-fetching. We do not collect, store, or process PHI/PII through any user-facing tool. See the Corrections page to report inaccurate data.
MOVEMENT II

The appraisal

A median is not a value. This movement is the discipline that turns recorded market prices into a conclusion someone will sign — and the rules that constrain what that signature can be used for.

10. The database is an input, not the answer

Everything in Movement I describes a population. Your equipment is a specific unit, and the distance between the two is the appraiser's work. A median assumes a working, complete, fairly-configured example. The unit in your room has an age, a condition, a service history, a software revision, an installed configuration, and a cost to remove that the market data cannot see.

So the median sets the frame and the appraiser sets the number. This is also the honest answer to the obvious question: if the price data is public, what are you paying for? You are paying for the judgement that the data does not contain, and for someone to stand behind the result in writing.

11. Scope of work: intended use and intended user

Before any value work begins, an appraisal has to state what it is for and who is entitled to rely on it. Both are named on the face of the report.

This is not paperwork. A schedule prepared for insurance placement and a schedule prepared for a partnership buyout are different numbers built on different premises, and moving a figure from one to the other is a misuse of the report — which is precisely why the report says on its own face which one it is. If you have been handed an equipment number with no stated intended use, there is no way to know which question it answered.

12. Effective date

Every conclusion is stated as of a specific date. Equipment values move — a model that clears well this year can fall hard when its successor ships, and a discontinued platform can firm up when the installed base still needs parts.

A number with no effective date is not a valuation, it is a memory. The effective date is also the reason renewals exist as a distinct engagement rather than a discount: what is being re-issued is the date, and the market underneath it has moved.

13. Competency, and saying no

An appraiser is required to have the knowledge and experience for the specific assignment, or to disclose the gap and take steps to close it before accepting.

In practice that means some assignments get declined, and it means the boundary of the library is stated out loud rather than papered over. The categories we hold depth in are published on the Equipment Library with their actual counts, including the thin ones. A category with no data does not render a number — absent means absent, and a fabricated figure is worse than a blank.

14. The workfile: why every number has a source

The evidence behind a conclusion is retained, not summarized and discarded. Each figure in a report resolves back to the recorded price points behind it, and those resolve back to the listings they were observed on.

That chain is the firm's whole proposition and the reason for the slogan. If a carrier, an accountant, an opposing appraiser or a county appraisal district asks where a number came from, the answer is a citation rather than an assurance. Most equipment schedules cannot survive that question. This one is built to be asked it.

What the certification is, and what a third party is actually looking for

Certified Machinery & Equipment Appraiser (CMEA), NEBB Institute. It is a designation. Machinery and equipment appraisal is not a state-regulated activity the way real property appraisal is, so anyone offering you a state credential in it is describing something that does not exist. What the certification represents is training in producing a report that conforms to USPAP, the Uniform Standards of Professional Appraisal Practice.

That matters because when a lender, a court, an insurer or a taxing authority asks for an equipment appraisal, what they are asking for is a report of a particular form. Not a valuation, not a dealer quote, not a broker’s opinion — a document with these five things in it:

  1. 01Scope of work, stated up frontWhat was and was not investigated, agreed before any value work begins.
  2. 02Intended use and intended userNamed on the face of the report. A third party can see immediately whether the report was written for the question they are asking.
  3. 03Effective dateThe value is as of a stated date, so nobody has to guess how old the number is.
  4. 04A signed certificationThe appraiser signs personally, states their qualifications, and states that no fee moved with the conclusion.

Why a real appraisal ends up in the room

A desktop appraisal values what you tell us you own. An on-site appraisal values what you own. Most of the time those are the same list, and when they are not, the difference is never small — because the errors do not cancel out, they compound in the same direction as whatever nobody has looked at in five years.

01Equipment that is not there

Assets get sold, traded in, moved to another site, or fail and get hauled off — and the schedule keeps carrying them long after. Nobody removes a line from a fixed-asset register; there is no process that does it. Every ghost asset is a value you are reporting and, on the insurance side, paying to carry.

02Equipment nobody wrote down

The other direction is more common and costs more. Equipment arrives as part of a package, gets financed separately, comes in with a new partner, or is bought out of a departmental budget that never reached the register. It is in the room and it is not on the schedule, which is precisely the equipment a policy will not pay for.

03Configuration, which is most of the value

Two units of the same model can differ in value by a wide margin on options, software licences, probe or detector sets, and service history. A model number tells you almost nothing about a specific machine. Reading the plate, the option list and the service tag is not something a spreadsheet can be asked to do.

04Installation, removal and what it costs to put it back

15. The fee cannot move with the number

The fee is set from your asset count — how many pieces of equipment there are to inspect and research — and it is fixed before any value is concluded. It does not move with the values reported, and it does not move with what your equipment later sells for.

A fee contingent on the outcome makes the appraiser a party to the result, which is exactly what an appraisal is supposed to protect against. Our pricing is published for the same reason: a number you can check before you call is a number nobody adjusted after seeing your equipment.

MOVEMENT III

The underwriting

The part nobody explains. A valuation does not stop being consequential when it is signed — it goes onto a policy, and what happens there is governed by mechanics most equipment owners have never been walked through.

16. One schedule, four legitimate answers

The same equipment has several different correct values at the same moment, and they are not close to each other:
  • Original cost — what the invoices totalled on the day each machine arrived.
  • Replacement cost — what it would cost to put the same capability back in the room today.
  • Depreciation schedule — the number on the books, written down on a tax convention.
  • Market value — what the equipment actually trades for, evidenced from the market.

Each is a defensible answer to a different question. The one that most often ends up on a policy is the depreciation schedule, because it is the number the practice already has in a spreadsheet — and it is the one answer on that list that was never computed with insurance in mind. It was computed for the IRS.

17. What a carrier actually does with the schedule

The schedule is not filed and forgotten. It sets the limit, and the limit is the ceiling on what a policy can pay regardless of what was lost. It also feeds the premium, which is why the incentive to keep it low is real and why nobody revisits it.

Two policies over identical equipment can behave completely differently depending on whether they are written on a replacement cost basis or an actual cash value basis — the second settles depreciated, the first does not. The valuation basis and the schedule have to agree with each other. When a schedule built on book value sits under a replacement-cost policy, the two are answering different questions, and the mismatch does not surface until it is expensive to discover.

18. Coinsurance, in plain terms

Most commercial property policies carry a coinsurance clause. It is a participation requirement: the insured agrees to carry a limit equal to a stated percentage — commonly 80, 90 or 100% — of the value of the covered property.

The mechanism that surprises people is that it applies to partial losses, not just total ones. Where the carried limit falls short of the required percentage, the settlement on a covered loss can be reduced in proportion to the shortfall — so a schedule that is short can reduce recovery on a loss far smaller than the gap itself. It is a term of the contract, not a penalty a carrier chooses to apply.

This is general information about how these clauses commonly operate, not a statement about your policy or your schedule. Your own terms govern, and only your policy and your broker can tell you what they are. What an appraisal contributes is the one input you can actually control: a defensible number, with the evidence attached.

A total that looks right, over lines that are all wrong

LineOn the scheduleWhat the evidence says
Imaging suite$240,000$385,000UNDER
Analyzers and lab$180,000$96,000over
Sterilization$95,000$41,000over
Exam and treatment rooms

THE SCHEDULE CHAIN

The weakest link here, named by us: Whether a coinsurance clause applies at all is a term of YOUR policy. An Agreed Value endorsement removes it entirely, and we cannot see which you have.

  1. 1

    One equipment schedule has four legitimate answers at the same moment: original cost, replacement cost, depreciation schedule, and market value.

    Offer Book, Finding One — illustration, representative practice

    Three of the four are the wrong answer to what a property policy is asking.

  2. 2

    The figure most often carried on a policy is the depreciation schedule, because it is the number the practice already has in a spreadsheet.

    Offer Book, Finding One — illustration, representative practice

    The number doing the work on the policy was computed for the IRS, on a tax convention, with no insurance question in mind.

  3. 3

    A coinsurance clause is a participation requirement: the insured agrees to carry a limit equal to a stated percentage — commonly 80, 90 or 100% — of the value of the covered property.

19. Why a property underwriter reads this differently

An accountant values equipment to compute income. A dealer values it to make a spread. An underwriter values it to size an exposure — and those three habits of mind produce three different numbers from the same room.

This firm's reports are prepared and signed by a practicing commercial property underwriter, so the schedule is built from the beginning to answer the question the policy is going to ask of it, rather than being translated into that question afterwards by someone who does not work on that side of the transaction. That is the third movement, and it is the one that is almost never in the room.

MOVEMENT IV

The limits

Move 03 applied to the whole method. What this index cannot reach, said before you find it — because a page that publishes its own boundary is the only kind whose interior you can trust.

20. Seven thousand classifications. Forty-seven medians.

7,085
device classifications in the federal record
openFDA /device/classification, retrieved 2026-08-07
47
device classes we publish a median for
Equipment Library · public_stats.json
191
devices tracked
Equipment Library · public_stats.json

That ratio is the honest description of what a price database can and cannot reach, and it is the number a competitor would never publish. We publish it because you are going to work it out eventually, and it is worth more coming from us.

It is also not the disaster it looks like. The 47 are not a random 47 — they are the classes where a secondary market actually exists and trades often enough to have a middle. A great deal of what is left has no public market at all, which is a fact about the equipment rather than a gap in the collection.

21. Seven sources, and the three that are not

The price points behind every figure on this site were sourced from seven marketplaces, each of which contributed at least four hundred listings. Three further sources appear in the record having contributed two listings, one, and one.

We do not count those three. A materiality floor that lands on a natural cliff in the data is defensible; a floor drawn to flatter a number is not, and the cliff here is between four hundred and two. Separately, five sources produced a row in the last seven days — that is a different question from where the accumulated data came from, and conflating the two is how a figure ends up describing nothing.

Equipment Library · source_listings, materiality floor ten listings

22. The distinct-listing count goes down as the data gets better

De-duplication runs daily. When it finds the same unit listed twice, the count of distinct listings falls.

So a shrinking number here is the collection improving, not decaying — which is an uncomfortable thing to publish and the reason most databases quietly report the larger figure instead. Price points continue to rise; the two nouns count different things and we never blend them.

The evidence ladder

Every conclusion in a report names the rung it stands on. That is not a disclaimer — it is the difference between a number you can weigh and a number you have to take on faith.

RungBasisWhat is disclosed
1Completed-sale evidence, exact model — settled auction results or documented transactions.Scarce. Named explicitly whenever present.
2Asking-market, exact model, n ≥ 5, adjusted for the ask-to-sold spread.The spread is stated as a range, never as a point estimate.
3Asking-market, model family or adjacent configuration, adjusted.The adjustment basis is named.
4Class-level. No model-specific evidence exists. Device-class median plus cost-new trended on the BLS Producer Price Index.Says out loud that nobody has better — including the dealer.

THE COVERAGE CHAIN

The weakest link here, named by us: Coverage is not the same as certainty on any one machine. Breadth of record tells you nothing about the unit in your room, which is what rung 4 of the evidence ladder exists to say out loud.

  1. 1

    There are 7,085 device classifications in the federal record.

    openFDA /device/classification, retrieved 2026-08-07

    That is the size of the field any equipment appraiser is working inside.

  2. 2

    This index publishes a median for 47 device classes and tracks 191.

    Equipment Library · public_stats.json

    We publish the number a competitor would never publish, because the ratio is the honest description of what a price database can and cannot reach.

  3. 3

    An appraiser working from personal familiarity is working from the machines they have personally handled in a career.

    Category statement about the profession

    That is a sample. It is not a record, and no amount of experience converts one into the other.

Clinical Asset Appraisal
Every number has a source.

Machinery and equipment appraisal for medical, dental, laboratory and veterinary practices in Texas.

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We are paid to value equipment, never to trade it — no fee we earn moves with the number we report or with what your equipment later sells for.

© 2026 Clinical Asset Appraisal. All rights reserved.

  • 05A retained workfileThe evidence behind every figure is kept, not summarized and discarded, and can be produced if the report is challenged.
  • A spreadsheet of purchase prices has none of those five. That is the whole difference, and it is why the same schedule that satisfies your accountant will not satisfy a lender’s credit file or survive a challenge in a dispute. The reports this firm issues are prepared to that standard and signed.

    What we will not tell you. We will not tell you that any particular bank, lender or institution has approved this firm, because none has been asked and none has agreed. Every institution sets its own requirements and decides for itself what it will rely on, and any appraiser who implies otherwise is telling you something they cannot know.

    If a specific lender, court or carrier is the reason you need this, tell us who and for what before we start — it is what sets the intended use and the intended user on the face of the report, and a report written for the wrong intended use is not repurposable. Ask them what they require. We will write to it or we will tell you we cannot.

    Replacement cost is not the price of the machine. It is the machine plus rigging, plus the door it will not fit through, plus the shielded room, plus the calibration, plus the days the room is not earning. A desktop engagement can estimate that. Standing in the room measures it.

    The inspection is also the part of the engagement that cannot be undone by an objection. A number derived from a document can be argued with by anyone holding a different document. A number derived from a machine that was photographed, tagged and recorded on a stated date is a different kind of thing.

    When the desktop is the right answer, and we will say so. A recently-purchased, well-documented schedule at a single site, with invoices and photographs available and no history of unrecorded additions, does not need a visit to be valued defensibly. We would rather quote the desktop and be right than sell the inspection and be resented for it.

    $210,000
    $148,000
    over
    Surgical and anesthesia$175,000$289,000UNDER
    IT, furniture, fixtures$100,000$41,000over
    Total$1,000,000$1,000,0000%

    Illustration · representative practice · every input illustrative

    Two lines are short and four are long. The total is close enough that nobody has ever questioned it, and that is precisely the problem: a blended total averages the errors into invisibility. Most practices are not over-insured or under-insured. They are both at once, on different lines, in the same building.

    The over-stated lines cost money every year whether or not anything happens. The under-stated lines cost money only once, and only when something does. Neither is visible from the total, and the total is the only number anyone looks at.

    Open your schedule and read the line items rather than the total. If every line traces to a purchase invoice and none traces to a market, you already know which kind of number you have.

    Standard commercial property policy form

    The reported figure is not a description of the equipment. It is a term of the contract.

  • 4

    Coinsurance applies to PARTIAL losses, not only total ones.

    Standard commercial property policy form

    A schedule that is short can reduce recovery on a loss far smaller than the shortfall itself.

  • 5

    Your declarations page states your limit and your coinsurance percentage on the business personal property line.

    Your own declarations page

    Divide the carried limit by the required percentage of value. That quotient is the fraction of a covered partial loss the policy is arranged to pay, and you can compute it tonight without us.

  • 5Disclosed extraordinary assumption. No market evidence at any level.The assumption is stated per USPAP, in the reader's plain language.

    Rung 4 is not a failure. Some equipment has no public secondary market at all — current-generation MRI, CT and PET, linear accelerators, OEM-resale-restricted surgical robots, closed-system analyzers with non-transferable software, anything under three years old. For those, no appraiser has model-specific evidence, because none exists to have. What rung 4 says is that the absence is the finding, and here is the method used in its place.

    The answer is never “no data.” It is a number with its rung named.

  • 4

    A record can be queried; a memory has to be trusted.

    openFDA /device/classification, retrieved 2026-08-07

    The analysis is machine-scale. The opinion is one person's, and his name is on the certification.