The U.S. ASC market will grow from $49.19 billion in 2026 to $84.17 billion by 2035, according to an Oct. 8 analysis from Ottawa-based Precedence Research.
The market is projected to expand at a 6.15% compound annual growth rate through 2035. The firm cited three drivers: procedures moving out of hospitals, payer incentives that favor lower-cost settings, and physician ownership and joint ventures.
The U.S. has about 6,000 to 6,600 Medicare-certified ASCs. According to the analysis, only about one-third of freestanding centers belong to large multisite operators. The five largest operators control 22% of centers, and no single operator holds more than 8%.
Orthopedic, cardiovascular and spine procedures are expanding the addressable market as new techniques and protocols make more complex cases eligible for outpatient care. Ophthalmology, gastroenterology, pain management, ENT and urology remain core specialties.
Consolidation is accelerating, according to the report. St. Louis-based Ascension completed its acquisition of Nashville, Tenn.-based AmSurg in 2026, adding more than 250 ASCs across 34 states. AmSurg then added five North Carolina centers in July.
The report also found that Brentwood, Tenn.-based Surgery Partners ended 2025 with 157 ASCs and 19 surgical hospitals across 30 states. 2025 revenue rose 6.2% to $3.31 billion, and the company recruited nearly 700 physicians. Nashville, Tenn.-based HCA Healthcare operated 121 freestanding ASCs and 31 freestanding endoscopy centers at the end of 2025.
CMS finalized a 2.6% payment update for 2026 for ASCs that meet quality reporting requirements.
The analysis added that procedure mix, physician alignment and local market economics, not center count alone, will decide which ASC operators gain ground.
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.
