// What we flag
The fees most practices don't know they're paying for nothing.
Medical waste invoices are deliberately complex. National haulers layer ancillary fees on top of your base service charge — and most practice managers don't have time to question them. Here's what we flag every time.
Fuel surcharge
7–15% of bill
Tied to "fuel index" that goes up but rarely comes down. Stericycle's standard fuel surcharge has been 7.9–14.5% in recent years. Real fuel cost on an average pickup route: about 2%.
Service cost recovery
6.8% flat
Stericycle's standard line item. The official explanation: "to cover variable operational costs." The actual function: a permanent margin booster that auto-renews.
Environmental fee
$5–25/pickup
Charged across most national haulers. Sometimes called "environmental compliance fee" or "regulatory cost recovery." Vague enough to defy challenge — that's the design.
Energy surcharge
2–8% of bill
Distinct from the fuel surcharge but functions identically. Some haulers charge both. There's no real "energy" cost on a regulated medical waste pickup route.
Manifest fee
$5–15/pickup
A charge for generating the document the law requires the hauler to give you. Like a restaurant charging for the receipt.
Annual rate hike
8–20%/year
Buried in fine print, often without notice. Stericycle paid $26.75M in 2022 to settle a whistleblower lawsuit specifically about undisclosed rate hikes on government contracts.