US Ambulatory Surgical Centers Market 2026 – 2035

The US market size of the ambulatory surgical center is projected to be USD 43.75 billion in 2025 and is projected to increase by USD 46.51 billion in 2026 to approximately USD 80.60 billion in 2035 with the CAGR being 6.30%.

The market is expanding because of the increasing number of surgical operations in outpatient facilities that are not only cost effective but convenient, increased chronic illnesses that need surgical treatment, the positive CMS reimbursement policies and increase in payment rate, the increased interest of doctors and the increase in capital of private equity, the technology that has enabled surgery of higher acuity, the preference of patients for inexpensive and convenient surgical care, and the expansion of networks of Medicare-certified facilities.

Market Highlight

• The US has approximately 12,007 ambulatory surgical centers nationally and 6,398 of them are Medicare-approved which is the most developed ASC system in the world and provides over 60 million surgeries annually.

• By type of center, the single-specialty segment occupied about 61.4% of the market share in 2025 as it would have specialized expertise and efficiency of operation and the patients would prefer to obtain special treatment.

• Based on ownership, the most market share of 57.9% in 2025 was that of physician owned and the corporate owned centers are expected to increase by 10.12% at the projected 2026-35 period.

• The largest market share is that of the orthopedics segment at 30.22% in 2025 and the cardiology segment is showing the highest growth of 9.65% CAGR with the increasing approvals of CPT codes and creation of technologies.

• The highest, 29.16% in the year 2025, is the regional market share of Southeast, as the Midwest is increasing with the highest rate of partnering with HCA Healthcare and technological advancements.

• CMS has already finalized a 2.9-point payment rate increase for ASCs in calendar year 2025 that will assist the sector to continue making capital investments, modernizing equipment, and diversifying the range of services.

Significant Growth Factors

The US Ambulatory Surgical Centers Market Trends present significant growth opportunities due to several factors:

• Escalating Chronic Disease Burden Driving Surgical Volume Growth:

The fundamental cause of ASC market growth is the growing number of patients with one or more chronic diseases, including cardiovascular diseases, cancer, diabetes, obesity, arthritis, and gastrointestinal diseases, that drives the growth of the surgical volume in the market since it is estimated that by 2023, 194 million adults in the U.S. would be diagnosed with one or more chronic disease conditions, which generates a long-term demand of surgical intervention to The CDC data show that 8 out of 10 leading causes of death in the United States are chronic diseases and that 60% of Americans have one chronic condition and 40% have two or more chronic illnesses leading to the volumes of surgical operations across the orthopedics, ophthalmology, gastroenterology, pain management and cardiovascular specialties in which ASCS would be best placed to serve. In the year 2025, the American Cancer Society had predicted that more than 2 million new cases of cancer would arise and over 618,000 cancer incidences would be experienced in the United States, and the majority of the cancer-related operations like biopsies, port placement, tumor excision, and diagnostic endoscopies are slowly being incorporated in ASC services, owing to the convenience of the patient, reduced risks of infection and also owing to the cost-effectiveness of ASC services over the hospital-based ones.

Cardiovascular disease causes one third of the total number of deaths in the United States, and the economic cost of this disease has been estimated to cost the United States almost USD 1.4 trillion by 2050 with a direct medical cost of USD 1 trillion and an indirect productivity loss of USD 375 billion that leads to the necessity of shifting the demand to the specialized ASCs that provide catheterization services, electrophysiology services, peripheral vascular services, and pacemaker implants that hitherto were only offered by the hospitals. Diabetes was reported in 13.2% of adults in the US in 2017-2020, was reported in 10.3% in 2001-2004 and the long-term metabolic condition is a cause of many surgical complications requiring specialty ASC care, including wound care, vascular access intervention, and treatment of diabetes-related comorbid conditions in an array of surgical specialties. Arthritis is a widespread condition with a prevalence of 53.2 million adults in the United States of approximately 1 in 5 adults that is the primary source of disability and medical expenditure and loss of earnings incurred due to arthritis amounts to over USD 300 billion in 2013, which has given rise to an indirect demand for surgery in the orthopedic specialization to correct arthritis-related degeneration of joints, to perform arthritis-related surgeries to treat heart diseases, and gastroenterological surgeries to expertise and outcomes can compete with those of hospitals.

• Favorable CMS Reimbursement Policies and Site-Neutral Payment Momentum:

The development of ASC is supported by the combination of government reimbursement policies, which focus on increasing payment rates on a regular basis, including more procedures in a list of covered procedures, providing incentives for quality reporting, and site-neutral payment programs, which are also considered key factors of momentum, and CMS has been interested in the ambulatory surgery center reimbursement long-term, as it believes that it can save money and attain quality outcomes that are comparable to the outpatient department of a hospital. To accomplish the maximization of capital and equipment spending and expansion of greater service lines without unnecessary changes to quality and cost management of care services and allow ASCs to survive financially because of the augmentation in the expense of operations, CMS has decided to boost ambulatory surgical center payment rates by 2.9% on facilities fulfilling quality reporting requirements, grounded on a 3.4% rise in the market basket of hospitals decreased by 0.5% productivity influence.

The list of procedures reimbursable to ASCs is continuously increasing, the latest update of January 2021 includes four new HCPCS codes that describe technology associated to Peripheral Intravascular Lithotripsy, which proves that the regulatory community is ready to approve innovative cardiovascular procedures in the ambulatory setting and accelerate the transfer of more complicated cases that used to be done in the hospital setting to cost-effective ASC settings. The migration of the site-neutral payment policy which implies equalization of Medicare reimbursement rates of both the hospital outpatient departments and the ASCs in case of performing the same procedures offers potent economic migration forces of procedures to the lower-cost ASCs, federal savings as an estimate of billions of dollars annually and patient access and quality outcomes as facilitating factors to ensure that the ASC market continues to grow. Some quality reporting plans like the ASC Quality Reporting Program, introduce outcome-based measures like ASC-17 which introduces measures of all-cause unplanned hospital visits within seven days of orthopedic surgery and ASC-18 which introduces the same measures and attaches the reimbursement to the quality measures to the outcome to improve the post-procedural care pathway and to improve patient safety oversight and as an indicator that ASC takes transparency and continuous quality improvement seriously.

The medicare payment policy reforms removed total knee arthroplasty in 2018 and then total hip arthroplasty in 2020, and have continued to determine other complex orthopedic surgeries to be allowable in the outpatient setting, which is historic watershed moments that will allow ASCs to carve off high volume, high-revenue joint replacement procedures traditionally only available in the inpatient department. The Medicare policies are increasingly finding their reflection in the policies of the private payers, who are negotiating favorable ASC reimbursement rates that are conscious of the cost savings relative to that of hospital based care, steering programs that encourage patients to utilize ASC, with reduced copayments and initiating steering programs with the promise of offering partnership with centers of excellence where quality is assured and with the control of healthcare expenses benefiting the payers, employers and patients by reducing the overall cost.

• Cost Advantages and Patient Preference Driving Market Share Gains:

The high-cost difference between the ASC processes and hospital-based care, coupled with heightened patient awareness of the quality outcomes, convenience benefits, and diminished financial benefits, is a strong demand-side force that is driving patient migration out of the traditional hospital setting and into the ambulatory surgery-driven care system with similar or better clinical outcomes, with reduced total cost to the patient, payer, and the healthcare system at an unbelievable rate. The analysis of OR Manager as per CMS statistics reveals that 57 billion surgical procedures are performed annually in the United States of which less than 20% are performed in inpatient hospital facilities which is a manifestation of a radical shift in demand towards ambulatory surgery facilities where the healthcare expenditure is substantially lower than the hospital operation of 40-60% of the same operations reflecting the efficiency of the operation of the ASCs, which is reflected in reduced overhead costs and streamlined work processes as compared to the red tape of the hospital structure.

The convenience factors that are causing patients to become more open to ASCs in elective procedures include flexibility and shorter waiting time than in the operating rooms of the hospitals, a comfortable non-institutional environment that makes patients less anxious, same-day discharge that makes patients resume their usual activities very quickly, lower out of pocket costs due to lower facility charges and co-payments, and lower infection rates compared to the hospitals where exposure to the resistant bacteria and hospital-acquired infections are more risks than immunocompromised patients.

The ASC scores on patient satisfaction are higher than in the hospital outpatient department in many aspects including wait times, staff responsiveness, facility cleanliness, pain management, discharge instructions and overall experience, and ASC Press Ganey scores are frequently in the 90th percentile of national models of patient-centered care, individual attention by dedicated staff, and operational interest in elective procedures that can predict workflows and enhance patient experiences. The two transparency programs, including publicly available pricing, quality measures, and patient satisfaction areas enable consumers to make informed choices, and both employers and health plans are progressively making decision-support tools that compare costs and quality outcomes at each facility and refer their patients to high-value ASCs by paying them less cost-sharing on procedures performed at an efficient ambulatory facility rather than an expensive hospital.

What are the Major Advances Changing the US Ambulatory Surgical Centers Market Today?

• Private Equity Consolidation and Corporate Platform Growth:

The barest of structural shifts reconstructing the industry equation is the virulent growth of the private equity-affiliated ASC management platform and corporate ownership model whose platforms including Surgery Partners, AmSurg, and the USPI stable of hospitals under joint venture contracting pursue roll-up strategies to acquire physician-owned ASCs, accomplish economies of scale, negotiate preferred payer agreements, and professionalize operations without disturbance of physician partnerships in joint venture contracting. With private equity investment with buyout leverage of 7X EBITDA being to the benefit of the greatest plus scale benefits opening up payer-contract influence and supply-chain-saving procurement cost-savings plus share of market held by corporate ownership, the ambulatory surgery center owned by corporate companies is expected to experience the highest growth rate at 10.12% CAGR in the 2026-2035 with corporate-owned ambulatory surgery centers gaining the most advantage with the increasing weight of scale benefits as both financially and operationally advantageous to scale By 2021 the management of Tenet Healthcare's USPI portfolio had reached 438 centers and by 2025 projecting ASC contributions to approximately half the adjusted EBITDA, the management has plans to reach 575-600 facilities, as the company looks to concentrate on better margins in its outpatient business and sell nonperforming assets in the hospital in response to declining inpatient volumes and waning reimbursement pressures.

Mergers and acquisitions are active, and 27 ASC deals have been reported in 2023 in accordance with Levin Associates with most of the acquisitions being the initiatives of the private equity-backed platforms to accomplish geographic expansion, specialty diversification, and capture market share through consolidation strategies by acquiring independent physician-owned centers and smaller regional chains that are unable to compete with well-capitalized national platforms with the advantages associated with centralized services and leverage in negotiation.

• Technological Advancements Enabling High-Acuity Case Migration:

Technological change and advancements in areas such as least invasive surgery, robotic surgery, advanced anesthesia regimes, new imaging regimes, and patient monitoring technologies are allowing ASCs to safely take on more and more complex, higher-acuity cases formerly constrained to hospital inpatient environments, and thus increase their addressable markets to those procedures with higher reimbursement schedules. Robotic-assisted surgery systems such as da Vinci systems are being increasingly implemented in ASCs, and companies are providing financing schemes to equip a facility with such systems, as well as have design teams available that help to facilitate the implementation of these systems in outpatient facilities as more physicians build their own ASCs, making complex procedures such as urology, gynecology, general surgery, and orthopedic robotic procedures available in an outpatient environment with equal outcomes to that of operations done in a hospital without decreased recovery time, minimal postoperative pain, and the cosmetically desirable benefits State of art anesthesia procedures such as regional anesthesia, peripheral nerve blocks, multimodal analgesia protocols, and improved recovery after surgery (ERAS) protocols provide same-day discharge after major orthopedic surgeries such as total joint replacement, spine operations, and complex arthroscopic surgeries, and have been proven to have equivalent safety profiles and clinical outcomes to those of hospital-based care and save costs by a factor of thousands, overcoming the need to have an overnight hospital stay and staffing needs related to inpatient care.

Aspiring to a parallel workflow efficiency and cost model, ASCs can now carry out complex procedures that demand real-time visualization such as spine instrumentation, fracture reductions, joint reconstructions and interventional pain procedures with increased precision and safety equal to a hospital operating room and at a reduced cost due to intraoperative imaging developments such as portable C-arms, intraoperative CT, cone-beam CT and integration of fluoroscopy. ASCS improves patient selection by protocols, preoperative risk stratification tools, and standard care paths, allowing the identification of suitable candidates for ambulatory surgery, optimizing patients using prehabilitation programs, proactively managing comorbidities, and apply evidence-based protocols with minimal complications and unplanned hospital care, with the expansion of eligibility criteria to increasingly complicated patients through well-managed chronic conditions previously not considered ASC patients.

• Specialty Service Line Expansion and Multi-Specialty Center Growth:

The expansion of ASC specialty services beyond the traditional primary specialties, such as orthopedics, ophthalmology, and gastroenterology into new high-growth market segments such as cardiology, spine, bariatrics, ENT, and urology is indicative of substantial market development, and the multi-specialty centers are growing at the fastest rate to create complete surgical portfolios, operational efficiency due to shared resources, and diversification of revenue so as not to be dependent on the same type of fluctuation. Cardiology, with its 9.65% CAGR is the quickest expanding ASC specialty as of 2030 with the excellent reimbursement, cheaper cost of procedures than hospital catheterization labs, more single-specialty cardiology ASCs, and CMS adoption of more extended cardiovascular procedure codes such as peripheral procedures, electrophysiology studies, structural heart procedures, and device implantation placements, which in the past could only be performed by hospitals and with the cardiology migration is likely to accelerate as technologies improve and more evidence is

The segment growth is fastest in multi-specialty ambulatory surgical centers due to comprehensive patient-centered care of surgery, provision of a wide range of services in a single facility that simplifies patient experience in healthcare, operational synergies such as shared staff, equipment, and infrastructure that lower the costs of conducting surgical operations, and advantages in recruitment of physicians with 50-100 surgeons in multi-specialty centers offering a conducive working environment that talented physicians find appealing in the case of variety and professional stimulation which are constrained in single-specialty centers. The migration of spine surgery to ASCs increased with the advent of technological innovations in the fields of minimally invasive surgery, acquisition of specialty instrumentation to allow outpatient surgery, the experience of surgeons to prove the safety of ambulatory surgery, and the payers accepting the outpatient reimbursement of more and more spine operations such as decompressions, discectomies, and select fusions that are appropriate in the ambulatory surgery setting. There is an increasing trend toward OTL surgeries being done in ASCs, where about 9% of all ENT surgeries now are done in ambulances and that hearing loss disorders caused by noisy pollution, sinus disease caused by environmental factors, and sleep apnea are surgeries requiring ASCs. They are doing a good job by providing superior patient satisfaction and lower costs.

• Geographic Expansion and Market Penetration Strategies:

Geographic expansion through strategic development of facilities in geographic areas of high growth and low service concentration, suburban growth, and new deregulated states are critical growth vectors, where operators have sought to grow geographic footprint and market share in areas with population growth, migration of physicians, and improvement in healthcare utilization. The US ASC market is led by the Southeast region, which has a 29.16% revenue share in 2023 that is pushed by favorable demographics such as a quickly growing aged population, a large number of physician-owned ASCs reflecting the entrepreneurial physician culture, the rising popularity of outpatient surgery among cost-sensitive patients and payers, and relatively relaxed regulatory environments in states such as Florida, Texas, and Georgia that support the rapid development of facilities compared to highly regulated northeastern states that enforce strict CON requirements.

The Midwest region is on the fastest growth during the forecast period due to a number of reasons such as alliances between major national players, such as HCA Healthcare, and local physician groups developing capital-supported expansion, increased interest in patient-focused, high-quality care and specialist solutions especially in the orthopedics sector, technological innovations and new surgical procedures that reduce recovery times, and heavy investment by local healthcare systems in the ambulatory infrastructure in response to the reduction in hospital inpatient volumes. As of March 2025, California has 900 or so Medicare-certified ambulatory surgical facilities, the largest in the nation and more than large states such as Florida and Texas because of high population density, a rising population of the aging requiring surgical care, close working relationships with insurance providers, favourable healthcare regulations and policies helping to expand outpatient facilities, and healthcare institutions that are progressively resorting to the consideration of outpatient treatment in terms of expediency and economies over inpatient treatment. CN reform is a key regulatory trend where states like North Carolina and South Carolina have reformed or repealed CON requirements limiting past historical ASC development to enhance the competitive positioning of incumbent hospitals and other states with strict control limiting market entry where the likely outcome of regulatory liberalization is a blistering ASC development in formerly closed markets, with geographic expansion being an operator business strategy.

Category Wise Insights

By Center Type

Why Single-Specialty Centers Lead the Market?

The single-specialty centers with an approximate size of 61.4 will form the largest market share in the year 2025. Such prominence is the manifestation of patient preference in specialized cost-effective care by special teams of specialists, operational advantages in concentrating on specific procedures with specific equipment and well trained staff well trained in addressing the need of the specialties, and marketing advantages in brand recognition as destination centers in the specific surgical specialties. The single-specialty ASCs possess some competitive advantages including a high level of clinical expertise that is focused on one type of surgery, specific equipment and instrumentation that is specialized in one type of surgery to eliminate trade-offs needed in a multi-specialty setting, committed staff well trained in the particular specialty of care, routine clinical protocols that would yield predictable results and operational efficiency and strong connections with the referring physicians because of the specialty focus and reputation as a good provider of services in one type of surgery.

The ophthalmology single-specialty ASCs are large segments with high volumes of surgery operations like cataract surgeries, LASIK, vitreoretinal surgeries, and glaucoma surgeries, and cataract surgery is one of the high-volume medical procedures in healthcare with a simple clinical pathway that enables the ophthalmology surgery to be carried out in the high throughput, ophthalmology surgery has good reimbursement, and patient demographic has an aging population that creates a continuous demand to carry out ophthalmology surgery Orthopedic specialty facilities have the largest share in the development, with orthopedics having 30.22% of 2024 market share as the CMS elimination of total joint arthroplasty off inpatient-only list offered the potential of massive volumes, predictable prices of the implants, familiarity with bundled payment, automated robotic-assisted technology complex surgery in the outpatient environment, high patient volume as a result of sports injuries and degenerative diseases, and good economic incentives to physicians since orthopedic surgeons were among the top-paid

Multi-specialty centers are also increasing at an unparalleled rate owing to operational efficiencies like shared infrastructure, equipment and staffing expenses that reduce the cost of procedures as compared to that of three independent single-specialty facilities, the broad-line service capabilities that draw a variety of patients as well as referring physicians seeking a single surgical facility solution, the revenue diversification that shields the facility against fluctuations in volume of the single-specialty and reimbursement trends without facility-specific constraints, the recruitment advantages of 50-100 surgeons in multi-specialty centers settings creating collaborative professional environments, and the flexibility of adapting to market demands by adjusting the specialty mix based on local demographics, competitive dynamics, and reimbursement trends without facility-specific constraints.

By Ownership

Why Physician-Owned Centers Dominate the Market?

The highest market share of approximately 57.9 in 2025 is the segment of physician-owned centers. This dominance means that the physicians would like to obtain professional control over the standards of clinical settings and patient care, economical interests with ASC ownership providing high-income levels above professional fees by engaging in facility fees and flexibility of operations having the capacity to control the schedule and select cases but remaining clinical care providers. The physician ownership results in a number of advantages like the ability to exert maximum clinical control enabling the physicians to dictate a protocol, equipment and implant choice, staffing, and operational choices to suit individual preference, and entrepreneurial gratification of successfully constructing a business and providing high quality care to patients resulting in a professional reward more than clinical practice.

The physician model focuses on narrow scope practices in one location scenarios, bringing problems to physicians with the necessary training regarding the totality of the cases of the patient and offering personalized care and continuity of care that is nonexistent in large corporate institutions where physicians are rotated and physician to physician relationships that bring about trust and loyalty to remain with the institution. Legislations and regulations like Stark Law exceptions and Anti-Kickback Statute safe harbors permit physician ownership and investment in ASCs in some conditions including fair market value remunerations, proportional remuneration of earnings depending on the ownership percentage and not on referral quantities and clear governance provisions enabling physician involvement to remain free of fraud, misconduct, and misaligned financial incentives to manipulate clinical decisions.

The centers that are corporate owned have the strongest growth rate of 10.12% CAGR between 2026 and 2035 with the growth being a result of the availability of this capital to institutional capital markets that would enable small physician groups that lack access to these institutional capital markets to raise funds to develop their facilities, equip them and be able to expand geographically.

The highest division of the specialty is orthopedics, which makes up approximately 30.22% of the market share in 2024. Such dominance implies the watershed regulatory change where CMS removed total knee arthroplasty from the inpatient-only listing in 2018 and total hip arthroplasty from the inpatient-only listing in 2020, and high musculoskeletal condition, sports injury, and degenerative joint disease requiring surgical intervention among the diverse patient population. Arthroscopic surgeries like rotator cuff tears, meniscal tears, ACL reconstruction, and joint debridement are the best orthopedic surgeries that fit well in the ASC settings since they are high volume routine procedures with established protocols, total joint arthroplasty is a perfect surgery with better anesthesia procedures that enable the patient to be discharged immediately after the surgery and sports medicine procedures that serve active populations and need a quick recovery and early re-introduction to the activities.

Orthopedic ASC market is characterized by predictable pricing of implants with well-developed developed relationships with vendors, familiarity with bundled payments that permit financial modeling and risk management, robotic technology usage comprising MAKO and ROSA technology that improves accuracy and outcomes, and a high number of patients because of the aging population with degenerative joint disease and active baby boomers with sports injury repair needs and high economic incentives because orthopedic surgeons are rated as some of the highest paid physician earners because of their participation in the ownership of ASC. The result is no different than that in a hospital, and extremely lower costs benefit patients, payers, and healthcare systems, such technological innovations as robotic-assisted surgery, computer navigation, and custom implants based on preoperative imaging, as well as high-performance materials, enable more complex orthopedic surgery in ASC settings.

The cardiology division is recording the largest growth percentages of 9.65% CAGR through 2030 as CMS has approved more cardiovascular procedure codes to be reimbursed under the ASC Program, high payment rates are offered to ensure financial viability, the cost of the procedures is lower than that of hospital catheterization laboratories, the number of single-specialty cardiology ASCs is increasing, and technology advances have enabled complex procedures (e.g., peripheral vascular procedures, electrophysiology studies, structural heart interventions, and implantation of cardiac devices).

By Service Type

Why Surgical Services Dominate the Market?

The largest proportion is the surgical services, which will make up 77.23% of the 2024 revenue. This has been the core mission of the ASCs since the surgical facilities have been designed to render procedural care with orthopedic joint replacement, cataract surgery, colonoscopy, pain injections, and heart surgery as the volume drivers that drive a high facility fee, anesthesia fee, and supply revenues that help it survive financially, although the diagnostic and ancillary services are marginally secondary.

The facilities of the surgical procedures enjoy the resources of the various sources of payment, like facility fees that reimburse the overhead costs, facilities, nursing care, and supplies, anesthesia fees that reimburse anesthesiologist or CRNA-provided activities, implant and device revenues that are the product of orthopedic implants, intraocular lenses, cardiac devices and specialty surgical equipment and pharmacy revenues that are the result of medications used in a surgical procedure, with bundled payments increasingly contributing them to the one payment product even as the ASCs The percentage of diagnostic and ancillary services to the total revenue of 22.77% is growing at a yearly rate of 8.74 percentage points due to the on-site MRI/CT services offered by ASCs to gain control over the scheduling of procedures, downstream revenue retention, and convenience as a drawing power to patients and referring physicians, CMS telehealth parity and caregiver-training code effective 2025 supporting non-procedural revenue bases, and the diversification of strategies to have less reliance on surgical volumes which are vulnerable to economic fluctuations and seasonal changes.

Report Scope

Economic Impact Analysis

How Significant is the Industry's Economic Contribution?

The US ambulatory surgical centers market is a massive industry of healthcare services estimated to be USD 43.75 billion in 2025 and USD 80.60 billion in 2035 and has a robust growth to support healthcare cost control, patient access, surgical quality, and physician entrepreneurship and offer job opportunities at its clinical, administrative, and technical functions throughout the ASC network of the country. The ASC industry has approximately 12,007 facilities that are distributed throughout the country, with 6,398 Medicare-certified facilities that provide employment to thousands of healthcare professionals like surgeons, anesthesiologists, nurses, surgical technologists, administrative staff, and support personnel, with the usual ASC employing 15 to 30 full-time equivalent employees depending on facility size, specialty mix, and the number of procedures that result in a lot of direct employment and indirect economic activity given that less than 20% of all surgical procedures are performed in hospital inpatient facilities.

The cost savings that accrue to the utilization of ASC as opposed to the utilization of the hospital based care of the similar procedures are estimated to range between 40-60% according to various studies and these differentials are recovered by the Medicare and the private insurers through the preferential policy in the reimbursement of the health care services and are guided by the employers through employee benefit plans, with billions of dollars saved contributing to the health care affordability and economic productivity since they reduce the healthcare expenditure burdens on the individuals, families and businesses. ASC development, expansion and modernization cost USD billions annually, and the annual average cost of building a greenfield ASC development is USD 2-5 million with USD 500,000-USD 2 million for renovation of existing facilities and USD 1-2 million plus huge equipment purchases in support of the manufacturing of medical devices, building contractors, equipment suppliers, and professional service firms engaged in the ASC development and operation activities.

What is the Industry's Quality and Patient Safety Impact?

Quality measures depict ASC performance which is at least equal or superior to other hospital outpatient division on several fronts including; Surgical site infection rates remain at or less than ASC scope of service foundations since there is no influence by hospital-acquired pathogen exposure, patient satisfaction scores are generally in the 90 th%ile on a national basis due to patient-centered care models, and complication rates are also as high in ASCs as it is in a hospital setting where patients have been well selected to undergo surgical procedures that are within the ASC scope of service bases. Outcome based measures found in the ASC Quality Reporting Program include ASC-17 of all-cause unplanned hospital visit in 7 days after orthopedic surgery and ASC-18 of all-cause unplanned hospital visit in 7 days after urology surgery and the data present low rates of complications, emergency room visit and hospital admissions validate that it was found that the right patients were selected, clinical procedures were performed and quality managing systems ensured patient safety was maintained throughout the perioperative continuum.

One of the mechanisms that assures ASCs of high standards of provision of clinical care, infection control, medication management, emergency preparedness and quality improvement amongst other aspects is organizational accreditation, including The Joint Commission, Accreditation Association of Ambulatory Health Care and American Association of Accreditation of ambulatory surgery facilities among others, most of the ASCs certified by Medicare have voluntary accreditation which shows their commitment to quality beyond the minimum standards required by the authorities. The use of evidence-based practice, technology use and new surgical techniques has developed first in the ASC setting and is often diffused to hospital settings, where the ASCs are utilized as test laboratories to demonstrate that the practice is safe, feasible, and economical and then diffused more broadly to enhance the overall functionality of the healthcare system.

Top Players in the Market

• Tenet Healthcare (USPI)

• Surgery Partners Inc.

• AmSurg (Envision Healthcare)

• HCA Healthcare

• SCA Health

• Surgical Care Affiliates

• Physicians Endoscopy

• Covenant Surgical Partners

• ValueHealth

• Nueterra Capital

• Others

Key Developments

The market has undergone significant developments as industry participants seek to expand capabilities and enhance service offerings.

• In December 2025: CMS also announced a 5-year Prior Authorization Demonstration of 10 states including Georgia, Florida, and Tennessee which requires ASCs to obtain prior authorization before providing certain services listed under the following categories which CMS deems high-growth or medically variable, i.e., blepharoplasty, botox injections, panniculectomy, rhinoplasty, and vein ablation.

• In January 2025: AMSURG expanded its network of ambulatory surgery centers by gaining an ownership interest in Texarkana Surgery Center, a same-day surgery facility based in northeast Texas and operating in a range of specialties, that demonstrates ongoing consolidation and strategic growth by extensive ASC management platforms.

• In October 2023: SurgNet Health Partners, Inc. covered the acquisition of Lippy Surgery Center, an otolaryngology medical and surgical provider, and Executive Ambulatory Surgery Center, and it demonstrates that operators continue to be busy in the M&A arena, extending into new geographic locations and diversifying into new specialties. These strategic activities have allowed companies to strengthen market positions, expand geographic coverage, diversify specialty portfolios, and capitalize on growth opportunities within the rapidly expanding market.

The US Ambulatory Surgical Centers Market is segmented as follows:

By Center Type

• Single-Specialty

o   Ophthalmology Centers

o   Orthopedic Centers

o   Gastroenterology Centers

o   Pain Management Centers

• Multi-Specialty

By Ownership

• Physician-Owned

• Hospital-Owned

• Corporate-Owned

By Specialty

• Orthopedics

• Ophthalmology

• Gastroenterology

• Pain Management/Spinal Injections

• Cardiology

• Otolaryngology (ENT)

• Urology

• General Surgery

• Other Specialties

By Service Type

• Surgical Services

• Diagnostic/Ancillary Services