Ambulatory Surgery Centers NAICS 621493
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Industry Summary
The 6,179 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
Jul 1, 2026 - US Adults' Ability to Afford Healthcare at a Five-Year Low
- Fewer than half of Americans (49%) can consistently afford the care and medications they need, according to the latest West Health-Gallup Healthcare Affordability Index. Ambulatory surgery centers may be negatively impacted by decreasing health care affordability. The share of adults who are “cost secure” has decreased from a 2022 peak of 61%, and an estimated 2.8 million more people fell out of that category between 2024 and 2025 alone. Cost insecurity now reaches groups long considered insulated: just 61% of adults 65 and older are cost secure, down from 73% in 2021.
- National health care partnerships increasingly see ambulatory surgery centers (ASCs) not only as a budget item but as a central element of strategy, according to professional services firm Colliers. The number of ASCs under national operator partnerships has grown from 1,339 in 2011 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 the Hospital Corporation of America.
- The Trump administration’s proposed new rules for Affordable Care Act (ACA) plans would shift more health care costs to Americans in 2027, according to The New York Times. The plans would have much higher deductibles that could lead to larger medical bills. People who rely on the Affordable Care Act for their health insurance coverage could choose plans with much lower monthly premiums under the proposal but that could leave them exposed to medical expenses totaling thousands of dollars more than current ACA plans do before their insurance would kick in, according to The New York Times. The proposal would allow one kind of health plan to raise the annual deductible to more than $15,000 for an individual and $31,000 for a family. The individual deductible would be eight times the average for someone with employer-provided insurance.
- Ambulatory surgery center industry employment and average wages for nonsupervisory employees decreased slightly during the first five months of 2026, according to the US Bureau of Labor Statistics (BLS). Ambulatory surgery centers sales are forecast to grow at a 5.72% compounded annual rate from 2026 to 2030, 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 one to two locations, employs about 30 workers, and generates $7 million in annual revenue.
- The ASC industry consists of about 6,179 companies which employ 178,400 workers and generate $43.1 billion annually.
- There are about 10,200 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
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