The new ASC hot spots 

Florida, California and Texas have long been hot spots for ASC openings, but other states experiencing high population and economic growth also could be ripe for new ASCs.

Here are three potential ASC hotspots:

South Carolina

The population of several cities in South Carolina, including Myrtle Beach, Spartanburg and Charleston, is skyrocketing — making the state ripe for new surgery centers.  

Population growth is key for eyeing new hot spots, Chris Skagen, executive director of the Oregon Ambulatory Surgery Center Association, told Becker's

"Looking at general trends, surgery center density has a direct correlation to population density," he said. 

Additionally, the South Carolina Department of Health and Environmental Control proposed to increase the threshold for capital expenditures that require a certificate of need to more than $5 million and the threshold for equipment acquisitions that require a CON to more than $2 million. These thresholds will be indexed to account for inflation. 

These amendments now await the South Carolina General Assembly to take action, but would make it drastically easier to open ASCs in the state, according to a Jan. 11 article in JDSupra from the law firm Nexsen Pruet. 


Wyoming is also ripe for new surgery centers — it received the highest score in Becker's ASC Review's ranking of top states for ASCs, which compiled data from the 2020 census, Bureau of Labor Statistics, state regulations on new ASCs and new business applications per capita.

Wyoming is the state with the most new business applications per 1,000 residents. And while it is the least populated state in the nation, it still has 20 ASCs — more than several other states.


Washington added more than 93 ASCs between 2021 and 2022 — the most of any state — according to data from the ASC Association. The state, which is the top state for nurses to practice, is also the best state to find a job

Washington was also named the second best state for business by CNBC in August. The ranking took into account workforce, infrastructure, cost of doing business, economy, life and health, technology and innovation, business friendliness, education, access to capital, and cost of living.

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