United Surgical Partners International has spent the past decade transforming from a mid-tier player into the largest ASC chain in the country, riding its parent company Tenet Healthcare’s broader shift away from hospitals and toward outpatient care. With orthopedics as its stated top growth priority and a Medicare policy shift on the horizon, USPI shows no signs of slowing its expansion.
Here are five things to know about the company.
- USPI is the largest ASC chain in the country, and its lead keeps growing.
Tenet Healthcare’s ambulatory arm holds ownership interests in more than 530 ASCs and 25 surgical hospitals across 37 states, giving it roughly an 8.1% share of the national ASC market.
- It got there by riding Tenet’s hospital-to-outpatient pivot.
USPI’s growth over the past decade has been a deliberate transformation, with Tenet selling off its hospital portfolio and reinvesting the proceeds into USPI as the company’s core growth engine — a strategy that started with Tenet buying 50.1% of USPI for $425 million in 2015.
- Orthopedics is USPI’s stated top growth priority.
CEO Saum Sutaria, MD, has called orthopedics the “number one growth vector” in the ASC space for the next five to 10 years, citing both the migration of hospital-based cases to freestanding centers and overall expansion of the patient base choosing outpatient orthopedic care.
- The company is spending aggressively to keep expanding.
USPI invested nearly $350 million and added 35 facilities in 2025 alone, with same-facility revenue growing 7.5% and double-digit same-store volume growth in total joint replacements performed in ASCs.
- USPI expects Medicare’s inpatient-only list phaseout to accelerate its momentum further.
Executives have pointed to CMS’ 2026 phaseout of the inpatient-only list as a policy tailwind that will gradually push more higher-acuity procedures into lower-cost outpatient settings, a shift the company says it’s already positioned to capitalize on.
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.
