Same-facility total joint replacements in Dallas-based Tenet Healthcare’s ASCs rose 12.8% year over year in the third quarter. It was the company’s strongest quarter for the procedure in 2026.
Tenet’s ASC arm, United Surgical Partners International, reported $537 million in adjusted EBITDA for the quarter. That’s up 9.1% from the same period in 2025, with a 39.2% margin. Same-facility revenue grew 4.5%. Net revenue per case rose 6.1% while case volume fell 1.5%. Tenet attributes that split to its focus on higher-acuity procedures.
On the company’s Oct. 29 earnings call, Chairman and CEO Saumya Sutaria, MD, said the joint growth reflects cases moving out of hospitals and into freestanding centers.
“I think it is coming from migration of cases from probably an HOPD to a freestanding outpatient setting,” Dr. Sutaria said.
He said USPI helps surgeons build that volume in two ways. The first is clinical protocols that show which cases are likely to be safe and successful in an ASC, and which patients should stay in the hospital. The second is letting surgeons try USPI centers without becoming joint venture partners or equity owners. Dr. Sutaria said those surgeons could become partners in future de novo centers.
Beyond orthopedics, USPI is building out urology, general surgery, advanced robotics, spine and new cardiac centers. Dr. Sutaria called the cardiac work a slower process.
He also said the joint growth came in a soft market for surgery overall.
“I would not say this is a gangbusters surgical environment right now,” he said.
Tenet expects USPI to grow same-store revenue in 2027 with consistent margins. Dr. Sutaria said the segment should not be materially affected by changes to the ACA exchanges or Medicaid work requirements.
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.
