Ambulatory Surgery Centers NAICS 621493
Unlock access to the full platform with more than 900 industry reports and local economic insights.
Get access to this Industry Profile including 18+ chapters and more than 50 pages of industry research.
Industry Summary
The 5,900 ambulatory surgery centers (ASC) in the US provide facilities and services to physicians to perform medical procedures that do not require an extended patient recovery period. Common services include eye procedures, endoscopies, biopsies, pain management treatments, and orthopedic procedures. Physicians have some type of ownership interest in about 93% of ASCs. Through joint ventures, hospitals have ownership interest in at least 28%.
Dependence upon Insurers
ASCs derive the majority of their revenue from third-party payers, including private insurers, managed care systems, and government sources, such as Medicare and Medicaid.
Legislation Targets Physician-Owned Centers
Amendments to Stark laws, which prohibit self-referrals for Medicare and Medicaid beneficiaries, limit growth opportunities and could significantly change ownership structures for ASCs.
Recent Developments
May 1, 2025 - Hospital Association Opposes Site-neutral payment Policies
- A structural reimbursement crisis affecting hospitals would only get worse if more site-neutral payment policies are enacted to allow ambulatory surgery centers (ASCs) to be paid as much as hospital outpatient departments (HOPDs) receive for performing identical procedures, according to the American Hospital Association (AHA). Hospitals have a higher cost structure than independent physician offices (IPOs) and ASCs due in part to the costs of standby capability and capacity, according to the AHA. This standby role is built into the cost structure of hospitals and supported by revenue from direct patient care — a situation that does not exist for any other type of provider. HOPDs aren’t simply same-day surgical centers for health systems, according to the AHA. They also provide complex cancer, infectious disease, mental health and other services — and therefore should not be paid the same Medicare rate as standalone physician offices.
- Certificate-of-Need (CON) laws, which restrict construction and/or expansion of healthcare facilities, may have reduced access to medical care, according to the CATO Institute. CON laws, which are in place in 35 states, require hospitals, nursing homes, ambulatory surgical centers (ASCs), and other healthcare providers to obtain regulatory approval before opening a new practice, expanding, or making certain capital investments. Medical care in those states is higher-cost and lower-quality than in states without CON laws, according to CATO research, but the majority of this research shows correlations but does not show that CON laws cause reduced access, higher expenditures, and lower quality.
- The Centers for Medicare and Medicaid Services (CMS) issued a final rule through which ambulatory surgical centers (ASCs) will get a 2.9% Medicare reimbursement increase in 2025, up from the 2.6% increase floated in the draft rule. The increase will affect approximately 6,100 ASCs, according to CMS.
- Ambulatory surgery center industry employment decreased slightly and average wages for nonsupervisory employees increased moderately during the first month of 2025, according to the US Bureau of Labor Statistics (BLS). Ambulatory surgery centers sales are forecast to grow at a 5.75% compounded annual rate from 2025 to 2029, faster than the growth of the overall economy, according to Inforum and the Interindustry Economic Research Fund.
Industry Revenue
Ambulatory Surgery Centers
Industry Structure
Industry size & Structure
A typical ASC operates out of a single location, employs about 30 workers, and generates $7.3 million in annual revenue.
- The ASC industry consists of about 5,900 companies which employ 176,300 workers and generate $43.1 billion annually.
- There are about 7,600 freestanding ASCs in the US. Of these, around 72% are Medicare-certified facilities.
- Physicians have some type of ownership interest in about 93% of ASCs. Through joint ventures, hospitals have ownership interest in 28%. Only 3% of ASCs are owned entirely by hospitals.
- About 25-30% of ASCs are owned by multiple facility chains.
- Large companies include Amsurg, United Surgical Partners, Surgical Care Affiliates, HCA, NueHealth, and Surgery Partners.
Industry Forecast
Industry Forecast
Ambulatory Surgery Centers Industry Growth
Vertical IQ Industry Report
For anyone actively digging deeper into a specific industry.
50+ pages of timely industry insights
18+ chapters
PDF delivered to your inbox
