Pickled Fresno chiles or cherry peppers, for topping, optional
Preheat a grill to medium high.
Form the sausage meat into 4 patties. Use your thumb to make an indentation in the center of each patty so they don't curl up while cooking. Grill until cooked through or the internal temperature reaches 160 degrees F, 3 to 5 minutes per side, depending on thickness. Add 2 slices of American cheese to each patty and close the grill until melted, about 1 minute.
Place some avocado slices on the bottom buns and season with pinch of salt. Add a patty, then top with an egg and a few pickled Fresno chiles. Add the top bun and serve.