Anesthesia stipends, once limited to a small share of surgery centers and hard-to-staff hospitals, have become a routine line item across much of the surgical market.
The pressure is coming from several directions at once: a thin workforce pipeline, rising pay for anesthesiologists and certified registered nurse anesthetists, lower case density in many ORs and Medicare rates that keep slipping. With CMS expected to finalize its 2027 physician fee schedule in early November, the gap facilities are covering is unlikely to narrow soon.
Here are 10 numbers that show where the stipend situation stands:
1.About 80%. About 80% of ASCs in NorthStar Anesthesia’s network now pay anesthesia stipends, up from 10% to 15% that needed a subsidy before the COVID-19 pandemic, CEO Adam Spiegel told Becker’s. Irving, Texas-based NorthStar is one of the largest anesthesia practice management companies in the country, with more than 3,000 providers at more than 195 facilities in 21 states, so its book of business offers a broad view of the market. As a contractor, it is also on the receiving end of the stipends it describes.
2. 57.4%. The share of California hospitals paying any anesthesiology stipend rose from 35.5% in 2002 to 57.4% in 2021, according to a 2025 Health Affairs study.
3. $2.9 million. Among California hospitals that paid a stipend, the average annual payment climbed from $647,985 in 2002 to $2.9 million in 2021, the same study found.
4. $40.11. In 2021, stipends worked out to an average of $40.11 per 15 minutes of anesthesia services, compared with $21.56 paid by Medicare, according to the Health Affairs analysis.
5. 85% to 70%. Hospital block utilization has dropped from 85% to 70%, and facilities that once ran six cases per OR per day are now running five, Mr. Spiegel said. Fewer cases per room means less billable revenue to offset the fixed cost of staffing it.
6. 15%. NorthStar has seen about a 15% increase in coverage requests from ASC and hospital partners, even as overall volume fell about 5%, according to Mr. Spiegel.
7. $20.2143. CMS has proposed a 2027 Medicare anesthesia conversion factor of $20.2143, a 1.38% decrease from $20.4976 in 2026, according to the American Society of Anesthesiologists. The final rule is expected around Nov. 1.
8. $300,000. Median advertised CRNA pay reached $300,000 in September, up about 7% from $280,000 in November 2025, according to a job-posting index from Anesthesia Operations Consultants. Median advertised anesthesiologist pay held flat at $550,000 over the same period.
9. 71% and 85%. Among job postings that state a pay model, 71% of anesthesiologist postings and 85% of CRNA postings pay by the shift through daily locums or hourly rates, according to the same index.
10. 10,660. The Health Resources and Services Administration projects a shortage of 10,660 anesthesiologists by 2038. About 1,700 anesthesiology residency positions are offered each year, according to a February report from Stout.
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.
