The number of Medicare-certified ASCs in the U.S. grew from roughly 6,100 to 6,468 between December 2022 and March 2025, according to data from the Ambulatory Surgery Center Association. But amid that national growth there is a quieter trend of a shrinking ASC footprint in a handful of states.
Five states and jurisdictions posted a net decline in Medicare-certified surgery centers over that period.
Washington led all states in losses, dropping from 183 ASCs to 171 — a net loss of 12 centers in roughly two years. New Jersey fell from 259 to 250, a loss of nine. Connecticut, West Virginia and the District of Columbia each shed one center.
The declines are modest in absolute terms but notable given the sector’s broader growth trajectory. Nationally, states including Georgia (+37), Florida (+49), Texas (+39) and Arizona (+27) added surgery centers at a pace that more than offset the losses elsewhere.
Closures can reflect consolidation by private equity-backed management companies, Medicare certification lapses, facility mergers or operators choosing not to renew certification. Washington’s double-digit decline stands out: the state lost more ASCs than any other, even as neighboring Oregon held flat at 91.
ASCA reported state-level counts as of March 2025 using CMS certification data. The 2022 baseline reflects CMS data from December of that year.
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.
