Introduction

Ambulatory Surgery Centers remain one of the strongest corners of healthcare services M&A. Investment has compounded over the last decade as payers, providers, and patients push procedures to lower-cost outpatient settings. With CMS continuing to expand ASC-eligible procedures and implementing steady reimbursement rate increases, we expect continued consolidation and platform expansion in the surgery center market. According to The Business Research Company, the global ASC market is projected to grow from $83.34 billion in 2024 to $108.76 billion by 2029, reflecting a compound annual growth rate (CAGR) of 5.2%. Recent deal flow has been driven by surgery center consolidators, hospital joint ventures, private equity backed MSO buyers, and several high-profile strategic partnerships.

Sustained Interest & Evolving Landscape

Despite broader healthcare M&A volatility, ASC consolidation has stayed resilient. From a consolidation standpoint, buyer interest depends on the buyer type. Some will target only the surgery center, while others will seek to acquire both the surgery center and the associated practices that operate in the center. 

For instance, Private equity MSO buyers pursuing a single- or multi-specialty platform typically prefer to acquire both the practice and affiliated surgery center, as they view the practice as the primary engine and the surgery center as a complementary ancillary that captures the facility fee revenue. Private equity MSO buyers will generally want to confirm that the practice’s shareholders or employed physicians hold majority ownership in the surgery center.

On the other hand, surgery center consolidators (Constitution Surgery Alliance, USPI, SCA Health, Surgery Partners, HCA, Regent, etc.) continue to emphasize their efforts on acquiring only the surgery center to capture the facility fee. They aim to leverage economies of scale and operational expertise to enhance reimbursement, build out infrastructure, improve operational performance, and ultimately achieve stronger results than would be attainable independently in the market.

Health systems are also increasingly active buyers and partners, pursuing ASCs as part of an outpatient strategy to retain procedural volume, enhance physician relationships, and compete with operators.

The range of available strategic alternatives has made it more compelling than ever for independent single- or multi-specialty surgery center operators to assess their options.

Current ASC Platform Landscape

Recent Notable Developments

• Welsh, Carson, Anderson & Stowe (WCAS) partnered with Constitution Surgery Alliance, creating a significant JV platform with a focus on expanding multispecialty ASC operations in key regional markets.
  
• Ascension and AmSurg entered into a new strategic partnership to jointly develop and operate ASCs, combining Ascension’s health system footprint with AmSurg’s management expertise and growth capital (The Business Research Company, 2025).
  
• Bain Capital submitted a take-private offer for Surgery Partners in early 2025. While the board rejected the offer, the move underscores sustained institutional interest in scaled ASC platforms and their long-term growth potential.

Anticipated Platform Mergers & Recapitalizations

Heading into 2026, we expect:

• Secondary sales/recaps of mid-scale regional ASC portfolios to larger strategics or sponsor-backed consolidators seeking scale in targeted geographies.
  
• Specialty Platforms to continue acquiring ASC assets across platforms to strengthen procedural density and referral capture.

Why This Matters for ASC Owners

For ASC owners, today’s mature market offers compelling opportunities alongside new complexities. With a wide range of strategic operators, health systems, and private equity-backed buyers active in the space, there is significant variability in deal structures, valuations, and partnership models.

Many centers that historically operated independently are now reevaluating partnership opportunities, as valuations remain attractive and the practice of medicine becomes increasingly complex. The benefits of a partner such as access to growth capital, enhanced operational resources, and strategic expertise are becoming increasingly clear.

However, capturing full value requires more than simply responding to inbound interest. Running a formal, competitive process ensures owners can:

• Maximize valuation and optimize transaction terms
• Select a partner that preserves autonomy and culture
• Align on post-close growth plans, service line expansion, and facility upgrades

Ensure the buyer has a successful track record

Select Number of Recent ASC-Related Transactions

Date	Target	PE Sponsor	Platform	State
Dec 2025	Advanced Center for Surgery	Ascension	AMSURG	PA
Oct 2025	Valley ASC	Ares Management	Duly Health and Care; Surgery Partners	IL
Oct 2025	Surgery Center of Conway	Ascension	AMSURG	SC
Oct 2025	Legent Health	Hospital for Special Surgery; General Atlantic	New	TX, FL
Aug 2025	Irvine Medical Management (Anaheim Surgery Center)	Sun Capital Partners		CA

Key Trends We’re Watching in 2026

• Shift to Outpatient Settings: Growing migration from hospitals to ASCs as cost-effective, high-quality alternatives for surgical care, driven by healthcare cost reduction pressures and payer preferences.

• Site-of-service shift accelerates: CMS proposals to add new ASC-eligible procedures, modest rate increases, and ongoing site-neutral payment discussions are supporting continued migration of more total joints, spine, cardio/vascular, and advanced GI to the outpatient setting (The Business Research Company, 2025).

• Physician alignment: Equity rollover, distributable cash flow, and block scheduling remain critical to surgeon recruitment/retention.

• Health system partnerships: Hospitals increasingly view ASC joint ventures as a strategic lever to retain procedural volume, capture market share, and expand outpatient offerings.

• Specialty service line expansion: Orthopedic, GI, Ophthalmology, and Cardiovascular platforms continue to integrate ASC capacity to support ancillary growth and expand procedural throughput.

The Bottom Line      

The ASC market remains one of the most active and competitive segments within healthcare services M&A. For owners evaluating their future, whether they are considering a sale or planning for a transaction several years from now, preparation and understanding the buyer landscape are essential.

Physician Growth Partners (PGP) has advised on numerous transactions involving surgery centers and specialty practices with ASC operations. Our tailored processes help owners navigate the competitive environment, select the right partner, and maximize both immediate and long-term value.

Interested in learning more? Fill out the form below to schedule a confidential discussion around current market dynamics, how your center would be positioned, and whether a strategic partnership is worth exploring.

The Business Research Company, “Ambulatory Surgery Center Market Report 2025, Size and Analysis.” The Business Research Company ASC Market Update, Jan. 2025,