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Ambulatory surgery centers (ASCs) generated $45 billion in revenue in 2024, a figure projected to climb to $57 billion by 2030.
ASC volumes are expected to expand by 9% between 2023 and 2028, according to Colliers’ Q3 2025 Healthcare Services report.
WHY THIS MATTERS
According to the report, hospitals increasingly see ASCs not only as a budget item but as a central element of strategy. Since 2011, the number of ASCs under national operator partnerships has grown from 1,339 to 2,140 in 2024, with the five largest operators controlling the majority.
Large operators include United Surgical Partners International, Surgical Care Affiliates, AmSurg and SurgCenter Development, which has been acquired by United Surgical Partners International, according to the report.
Another large operator is HCA, the Hospital Corporation of America.
The growth in ASCs reflects a broader shift toward outpatient care, driven by new technologies, favorable reimbursement policies and increasing demand for lower-cost, accessible treatment options.
Reimbursement trends play a critical role in financial outcomes for ASCs. Recent approvals by the Centers for Medicare and Medicaid Services of two dozen new ASC procedure codes will expand coverage, enabling more patients to receive care outside hospital campuses.
The report noted procedures performed in ASCs cost less than half of those conducted in hospital outpatient departments. Medicare alone saves an estimated $4.2 billion annually through ASC utilization, while patients see average savings of $684 per procedure.
These savings are amplified by advances in minimally invasive surgery, improved recovery drugs and policies promoting site-neutral payments.
The study points to technology-driven advances in orthopedics, cardiology and spine surgery as enablers for shifting complex procedures into outpatient settings.
“As these services expand, ASCs are delivering higher-margin opportunities in addition to traditional specialties such as gastroenterology and ophthalmology,” the report said.
THE LARGER TREND
The vast majority (92%) of ASCs are wholly or partially owned by physicians, making them both a care delivery model and a financial strategy for practitioners.
Private equity and corporate entities are also investing heavily in ASC infrastructure, seeking to capitalize on the growth trajectory, even as mergers and acquisitions reshape the ASC landscape.
In June, for example, Ascension Health announced plans to acquire AmSurg, an ASC management company, for nearly $3.9 billion. The acquisition would add 250 centers across 34 states to Ascension’s portfolio and is expected to close later this year.
Other systems are pursuing joint ventures and incremental investments. Tenet Healthcare, through its United Surgical Partners International division, entered a partnership with Choice Care Surgery Center in Texas during the first quarter of 2025, adding six centers. Tenet plans to allocate $250 million annually toward ASC M&A as it builds out its national network.
Private equity has re-emerged as a key financial player in the sector. Investment volumes, which dropped to $12 billion during the COVID-19 pandemic, rebounded to $19.7 billion in 2024 and reached $18.9 billion in the first half of 2025. Activity spans direct ownership of ASCs as well as joint ventures with physicians and health systems.
Medicaid eligibility is also rising as the U.S. population ages, with 20% of Americans expected to qualify by 2030. This shift ensures continued demand for ASC-based services, particularly for older adults with chronic conditions.
Despite financial momentum, workforce shortages present a challenge. The industry could lose 86,000 physicians by 2036, with anesthesiologists in particular affecting ASC operations.
The report noted operators are investing in recruitment strategies, flexible work arrangements and wellness initiatives to sustain staffing levels.