Chronicling ASC Market Share and Recent Acquisitions

Summary of this Article:  We will continually report the latest updates on ASC market shares, mergers, acquisitions, and possible consolidations of ASC centers throughout the United States. PCG hopes you find this article helpful and useful, not just once but for months and years to come, as we update this regularly.

2026 Summary

The ambulatory surgery center (ASC) industry continues to expand in 2026 as more complex procedures migrate from hospital inpatient and outpatient departments to cost‑effective, physician‑led facilities. A 2025 market survey by VMG Health found that United Surgical Partners International (USPI) remained the largest ASC operator with over 520 Medicare‑certified centers (~8 % market share), followed by SCA Health (Optum) with around 320 centers (about 4.9 % share), AmSurg with about 250 centers (3.9 %), HCA Healthcare with 150 centers (2.3 %) and Surgery Partners with 132 centers (2 %). Other multi‑site operators collectively operate roughly 894 ASCs, giving them a 13.8% market share. The largest chains continued to grow: USPI added 11 ASCs in 2025 and spent nearly $300 million on acquisitions, while SCA Health began 2025 with more than 320 surgery centers and acquired U.S. Digestive Health (24 ASCs). Ascension signed a $3.9 billion deal to acquire AmSurg, expanding its ASC footprint from 58 to more than 300 centers. Private‑equity interest remained strong, as seen in Great Hill Partners’ investment in Blue Cloud Pediatric Surgery Centers and Regent Surgical’s partnership with Patches Kids Care.

On the policy front, the CY 2026 Hospital Outpatient Prospective Payment System and ASC Final Rule, released in November 2025, significantly expanded the list of reimbursable ASC procedures. CMS added 289 procedures to the ASC Covered Procedures List (CPL) and transferred 271 procedures from the inpatient‑only list directly to the CPL, resulting in 560 newly approved ASC procedures. CMS also finalized an overall ASC payment update of 2.6 % for 2026, reflecting a modest net inflationary increase. These regulatory changes, coupled with continued consolidation, position the ASC sector for further growth and investment.

Market Share Snapshot (2026)

The table below summarizes the estimated U.S. ambulatory surgery center (ASC) market share in 2026, based on publicly reported Medicare-certified ASC counts and operator disclosures. It highlights the largest multi-site operators, their parent organizations, and relative market concentration. Figures reflect the most recent available data and announced acquisitions entering 2025–2026.

Transactions & Partnerships (chronological, most recent first)

RadNet enters Indiana – 6 imaging centers (Feb 2026)

Who:  RadNet — a Los Angeles‑based national provider of freestanding, fixed‑site diagnostic imaging that performs over 10 million outpatient imaging procedures annually and operates approximately 405 imaging centers across numerous states, employing more than 12,000 team members. Northwest Radiology Network, P.C. is a physician‑led imaging practice founded in 1967 that offers a comprehensive range of services—including MRI, CT, PET/CT, ultrasound, and mammography—and is one of Indiana’s largest radiology groups.

What:  RadNet acquired Northwest Radiology’s outpatient imaging assets, marking its entry into the Indiana market. The transaction included six multimodality outpatient imaging centers in the greater Indianapolis area. Northwest Radiology’s 18 radiologists will continue providing professional services, preserving existing physician relationships and continuity of care.

When: Feb. 3, 2026 (announcement date).

Financial Impact: RadNet projects the acquisition will add approximately $18 million in annual revenue to its operations.

Status:  Transaction closed (integration underway). RadNet plans to leverage its scale and AI‑enabled technologies to expand services and shift care toward proactive disease prevention.

Sources:  Beckers, RadNet Statement

Surgery Partners & Baylor Scott & White Health (Dec 2025)

Who:  Surgery Partners, Inc. — a Nashville‑based integrated healthcare services company that operates more than 250 locations across 30 states, encompassing surgical facilities, multi‑specialty physician practices, and anesthesia services. The company has over 15,000 employees, 4,600 affiliated physicians, and serves more than 600,000 patients annually. Baylor Scott & White Health is Texas’s largest not‑for‑profit health system, formed through a 2013 merger. It includes 48 hospitals, 900 patient care sites, more than 6,000 physician,s and 40,000 employees.

What:  The parties formed a joint venture to jointly own with physicians the 16‑bed Physicians Centre Hospital in Bryan, Texas. Surgery Partners will continue to manage daily operations while the hospital adopts the Baylor Scott & White brand. The facility provides a broad range of surgical services, including bariatric, ophthalmologic, oral/maxillofacial, orthopedic, gastrointestinal, podiatric, spinal, and urologic procedures.

When: Dec. 8, 2025 (announcement date).

Financial Impact: Terms were not disclosed. The joint venture expands Surgery Partners’ presence in central Texas and provides Baylor Scott & White with a local surgical facility to meet growing demand.

Status:  Partnership announced; operations continuing under the joint venture structure.

Sources:  Surgery Partners article

Regent Surgical & Patches Kids Care – Pediatric ASC (Sep 2025)

Who:  Regent Surgical — one of the largest privately held surgery center development and management companies. It has a 20+‑year history of partnering with health systems and physicians to develop, own, and manage ASCs, engages over 650 physician utilizers, and supports more than 100,000 surgical cases annually. Patches Kids Care is a pediatric ASC concept designed specifically for children, created by Blueprint Ambulatory Surgery Concepts. It provides a child‑friendly environment with pediatric‑trained staff, lower costs for families, and locations in Grapevine, Houston, Orlando, and Overland Park.

What:  Regent Surgical entered its first pediatric ambulatory surgery venture by forming a joint venture with Patches Kids Care. The partnership will jointly develop and operate outpatient pediatric surgery centers, starting with a location in Houston. Regent brings ASC development expertise, while Patches provides pediatric care experience. Regent’s CEO described the project as a strategic milestone that will offer high‑quality, specialized surgical care tailored to children.

When: Sept. 3, 2025 (announcement date).

Financial Impact: Financial terms were not disclosed. The venture targets a growing pediatric outpatient market—about 3.9 million surgeries are performed on U.S. children annually—and seeks to deliver safe, cost‑effective care with specialized facilities and staff.

Status:  Partnership announced; first pediatric ASC planned in Houston with additional centers to follow.

Sources:  Regent Surgical article

Great Hill Partners invests in Blue Cloud Pediatric Surgery Centers (Aug 2025)

Who:  Great Hill Partners — a Boston‑based private‑equity firm with over $12 billion in commitments that targets $100 million to $500 million investments in high‑growth, mid‑market companies across sectors such as healthcare. Blue Cloud Pediatric Surgery Centers, founded in 2011, is the largest operator of pediatric dental ambulatory surgery centers in the U.S., operating 32 accredited facilities across 12 states and treating more than 60,000 pediatric and special‑needs patients each year.

What:  Great Hill Partners acquired a majority interest in Blue Cloud, which is the nation’s largest operator of pediatric ASCs. Blue Cloud specializes in dental and oral surgery and operates 32 fully accredited facilities across 12 states. The firm purchased its stake from TPG’s The Rise Fund and added three Great Hill executives to Blue Cloud’s board. Blue Cloud serves more than 60,000 pediatric and special‑needs patients annually.

When: Aug. 13, 2025 (news release date).

Financial Impact: Financial terms were not publicly disclosed. The investment positions Blue Cloud for accelerated growth and underscores private‑equity interest in specialty‑focused ASC platforms.



Status:  Acquisition announced and majority stake transferred to Great Hill Partners; Blue Cloud remains an independent operator focusing on pediatric dental and oral surgery services.

Sources:  Beckers article

Optum’s SCA Health acquires U.S. Digestive Health (Aug 2025)

Who:  SCA Health — a national surgical and practice management company owned by Optum/UnitedHealth Group. SCA Health serves over two million patients annually at more than 370 clinical locations and 250 physician practice clinics, partnering with physicians, health systems, and health plans to deliver high‑quality outpatient surgery. U.S. Digestive Health Management (UDH), formed in 2019, is one of the largest gastroenterology practices in the U.S.. It encompasses over 40 practice sites, 24 ASCs, more than 250 gastroenterology provider,s and 1,300 employees across Pennsylvania and Delaware.

What:  SCA Health acquired U.S. Digestive Health, a gastroenterology platform formed in 2019 through the consolidation of three regional groups. UDH has more than 250 gastroenterology providers across 40 practice sites and 24 ASCs in Pennsylvania and Delaware. The deal expands SCA Health’s gastroenterology footprint and accelerates the migration of GI procedures to outpatient settings.

When: Early 2025 (deal announced; reported August 27, 2025, by Becker’s).

Financial Impact: Transaction value was not disclosed. The acquisition integrates a large GI practice into Optum’s network. Optum’s provider subsidiaries now include 423 ASCs, more than 880 home‑health providers, and 335 administrative entities.

Status:  Acquisition closed; SCA Health continues to integrate UDH’s sites and providers into its national network. Commentators note that the deal may improve care coordination but could reduce physician autonomy.

Sources:  Beckers article

Ascension agrees to acquire AmSurg (June 2025)

Who:  Ascension — one of the nation’s largest Catholic not‑for‑profit health systems. It employs about 97,000 associates, aligns with 23,100 providers, operates 91 hospitals and owns 29 additional hospitals through partnerships, along with 26 senior living facilities across 15 states and the District of Columbia. AmSurg Corporation is an independent leader in ambulatory surgery center services, partnering with physicians and health systems to operate more than 250 ASCs nationwide across specialties such as gastroenterology, ophthalmology and orthopedics.

What:  Ascension entered a definitive agreement to acquire AmSurg. AmSurg partners with about 2,000 physicians and operates 250 ASCs, making it the nation’s second‑largest ASC chain. Ascension President Eduardo Conrado noted that the acquisition will add 250 ASCs to Ascension’s existing 58 centers, expanding its presence to 34 states. Executives highlighted the transaction’s alignment with Ascension’s mission to provide compassionate, affordable, and locally accessible care.

When:  June 17, 2025 (agreement announced). The transaction is expected to close in late 2025 or early 2026, pending regulatory approvals.

Financial Impact: The deal is valued at approximately $3.9 billion, making it one of the largest ASC acquisitions in recent history. The combination will more than quadruple Ascension’s ASC portfolio, positioning it as a leading national operator.



Status:  Agreement signed; transaction awaiting regulatory approval. Integration planning is underway.

Sources:  Beckers article

Surgery Partners acquires two San Jose surgery centers (May 2025)

Who:  Surgery Partners, Inc. — a national operator of surgical facilities with over 250 locations across 30 states. The company has more than 15,000 employees and 4,600 affiliated physicians, delivering care to over 600,000 patients annually. The sellers were the physician owners of Montpelier Surgery Center and Advanced Surgery Center, two large independent ASCs in San Jose, whose sale expanded Surgery Partners’ catchment area and solidified its position as the region’s largest ASC operator.

What:  Healthcare investment bank Bailey & Company facilitated the sale of two independent ASCs—Montpelier Surgery Center and Advanced Surgery Center—to Surgery Partners. The strategic acquisitions expand Surgery Partners’ catchment area in the South Bay and solidify its position as the region’s largest ASC operator. Local surgeon Dr. Huy Trinh said the deal will help continue serving the community while leveraging Surgery Partners’ network.

When:  May 29, 2025 (press release date).

Financial Impact: Terms were not disclosed. The acquisitions strengthen Surgery Partners’ regional presence and support its broader growth strategy.

Status:  Transactions completed; centers integrated into Surgery Partners’ network.

Sources:  Bailey & Co. article

Stay tuned for more updates!

The 2026 ASC landscape is shaped by rapid consolidation, private‑equity investment and health‑system expansion. Major operators like USPI and SCA Health are growing through acquisitions and joint ventures, while new entrants such as RadNet and specialized platforms like Blue Cloud highlight the diversity of investments. Regulatory changes—including CMS’s decision to add 560 procedures to the ASC Covered Procedures List and provide a 2.6 % payment update—signal continued federal support for outpatient surgery. Together, these developments suggest that ASCs will play an even larger role in delivering cost‑effective, patient‑centered surgical care in the years ahead.