With median transaction multiples hitting an eight-year high in 2025 and private equity pouring nearly $19 billion into the sector in just the first half of the year, demand is strong in the ASC market.
Here are seven things to know:
1. According to VMG Health’s 2026 Healthcare M&A Report, the median total invested capital-to-EBITDA multiple for ASC transactions ticked up to 7.9x in 2025, the highest level in at least eight years.
2. Single-specialty ASCs typically trade at 5x-8x EBITDA, while larger multispecialty centers can command 6x-10x EBITDA, according to Scope Research, a company that specializes in appraising healthcare businesses and services arrangements. Regional and national operators with multiple centers and demonstrated growth capability can reach 11x-17x EBITDA.
3. Surgery Partners, one of the largest publicly traded ASC operators, trades at an EV/EBITDA multiple of 12.7x-14x based on December 2025 and 2026 estimates respectively, according to VMG Health’s ASC report. HCA Healthcare trades at 9.8x-10x and Tenet Healthcare, parent company of United Surgical Partners International, at 6.8x-7x, though both are diversified platforms where hospital operations influence overall valuation. At the lower end of the public market, DR trades at just 3.4x-3.5x, illustrating the wide range that operational profile and platform scale can produce.
4. ASCs generated $45 billion in revenue in 2024, a figure projected to climb to $57 billion by 2030, with ASC procedure volumes expected to expand by 9% between 2023 and 2028, according to Sullivan Colliers’ third quarter 2025 Healthcare Services report.
5. According to the same report, private equity investment in ASCs, which dropped to $12 billion during the COVID-19 pandemic, rebounded to $19.7 billion in 2024 and reached $18.9 billion in just the first half of 2025.
6. According to a Medscape report, ASC deal volume dropped roughly 50% in early 2025 compared to the prior two years due to high interest rates, but market analysts note that smaller-scale consolidation, including deals with independent practices and joint ventures, never really stopped, as these transactions simply aren’t publicly reported.
7. Ascension’s definitive agreement to acquire AmSurg for approximately $3.9 billion, one of the largest ASC deals on record, signals just how much strategic value health systems are placing on scaled ambulatory platforms. Tenet Healthcare’s USPI deployed nearly $300 million in acquisition activity through just the first three quarters of 2025.
At the Becker's 23rd Annual Spine, Orthopedic and Pain Management-Driven ASC + The Future of Spine Conference, taking place June 11-13 in Chicago, spine surgeons, orthopedic leaders and ASC executives will come together to explore minimally invasive techniques, ASC growth strategies and innovations shaping the future of outpatient spine care. Apply for complimentary registration now.
