As more procedures migrate to ASCs, hospitals are still paying salaries to keep surgeons on staff, according to Kaufman Hall’s Q2 2026 Physician Flash Report, which analyzed data from more than 200,000 employed physicians and advanced practice providers across 100-plus specialties.
The median investment/subsidy per physician FTE in the surgical specialty cohort was $454,000 in the second quarter of 2026 — the highest of any specialty group in the report, and up from $438,000 two years earlier. That subsidy has largely leveled off over the past year, hovering between $451,000 and $457,000 since the second quarter of 2025, but it remains well above what health systems are paying to subsidize other physicians.
By comparison, the median subsidy per physician FTE was $445,000 for medical specialty physicians, $279,000 for hospital-based specialties and just $194,000 for primary care in the same quarter. Surgical specialists, in other words, cost health systems more than double what primary care physicians cost — even before accounting for the facility fees and downstream referrals surgeons typically generate.
The pay picture tells a similar story. Providers in surgical specialties were paid a median $72 per work relative value unit in the second quarter of 2026 — tied with hospital-based specialties for the highest rate in the report, and up from $70 two years earlier. Medical specialty providers earned $67 per wRVU in the same period, while primary care providers earned just $48.
For ASC operators and physician investors competing for the same surgical talent pool, that combination — high subsidies plus high per-unit pay — raises a real recruitment question. If health systems are willing to keep subsidizing surgeons at these levels even as case volume shifts to outpatient settings, ASCs may need to match or exceed those comp structures to pull surgeons away from hospital employment, or to keep the ones who already split time between both settings.
At the Becker’s 32nd Annual Meeting: The Business and Operations of ASCs, taking place October 29-31 in Chicago, ASC leaders, surgeons and healthcare executives will explore strategies to drive growth, enhance operational performance, navigate reimbursement challenges and prepare for the future of ambulatory surgery. Apply for complimentary registration now.
