ASC growth: The rapid rise and what’s fueling it

Ambulatory surgery centers are expanding clinical capabilities and redefining standards for outpatient care

There’s a transformation happening in procedural care that’s changing how specialists and clinics approach where care is delivered. Not long ago, if a patient needed a joint replacement or spine procedure, they were sent to a hospital and braced for the surgery, the bill, and the overnight stay. These days, specialists often schedule procedures at an ambulatory surgery center (ASC), where patients receive care and return home, often having experienced more attention, a smaller price tag, faster discharge, and convenient scheduling.

ASCs aren’t new, but the pace and scale of their growth are worth paying attention to. They’re changing how surgical care is delivered and redefining what’s possible outside of hospital walls. What began as a space for low-risk procedures is now a hub for high-acuity, high-efficiency care.

From pain management to orthopedics, ASCs are expanding rapidly, and the volumes, clinical outcomes, and operational realities all reflect an upward trend. Other specialties, like gastroenterology and cardiovascular care, are experiencing similar growth, paving the way for new business models and care delivery pathways outside traditional hospital settings. In fact, home-based care and outpatient services, including ASCs, are projected to be the fastest-growing care sites over the next decade, with volumes increasing by 22% and 14%, respectively.¹

For practice owners and managers, the pressing question isn’t whether these facilities are gaining traction — it’s what this momentum means for their own growth and strategic next move. Whether you’re exploring a joint venture, thinking about launching your own center, or evaluating a partnership, understanding the drivers behind ambulatory surgery center growth is key to making informed decisions.

More high-acuity procedures are moving outpatient

Ambulatory surgery centers used to handle mostly routine procedures like cataracts, colonoscopies, joint injections, and basic orthopedic procedures, but those days are long gone.

With over 6,300 Medicare-certified ASCs and more than 18,000 operating rooms (ORs) available across the country, the demand for outpatient services is soaring.² Did you know the number of knee replacements occurring in an outpatient setting increased by 293% from 2019 to 2023?³ This is largely thanks to advancements in anesthesia, minimally invasive techniques, and post-operative care.

Procedures that once required overnight stays are now being performed safely and effectively in outpatient settings. These include total joint replacements, cardiology procedures, and spine surgeries — complex interventions that were once deemed too risky for outpatient care.

This shift highlights a significant transformation in how specialty care is accessed and delivered. It’s not about pushing boundaries; it’s about matching the right patient to the right setting. ASCs are proving they can deliver quicker, safer, and efficient care with strong patient outcomes.

Payers are aligned, and the cost savings are real

Payers are actively incentivizing migration to these outpatient settings, and for good reason. It’s no secret that ambulatory surgery center care costs less. A lot less.

Bain & Company estimates that procedures performed in an ASC can cost up to 50% less than in a hospital outpatient department.⁴ For payers, that adds up. For clinicians, it creates an opportunity to capture volume while maintaining quality and positive outcomes. Patients benefit, too. With cost transparency and more personalized care, they can choose their clinicians and care settings, confident that these options deliver comparable or even better outcomes and safety, but at typically lower cost.

This movement to ASCs movement to ASCs isn’t just a cost-saving strategy, it’s value-based care (VBC) in action. VBC contracts are accelerating this trend, as ASCs are ideally structured to meet value-based reimbursement demands with their streamlined environments, efficient staffing, and focus on episode-of-care outcomes.

Despite this strong outlook, ASCs still face pressure from regulations and reimbursements, including varying rates and unpredictable private payer dynamics. However, when everyone’s interests align (payer, clinician, patient) you gain momentum — fast.

Policy changes are (quietly) opening doors

Regulations around ASCs are shifting in impactful ways. Some of the biggest changes in surgery center success include:

• CMS has expanded the ASC-covered procedures list, adding nearly two dozen new procedures for 2025.⁵
• Several states have either removed or loosened certificate-of-need (CON) restrictions.⁶
• Telehealth and remote post-op monitoring are being folded into ongoing reimbursement policies.

These changes don’t always make headlines. But they do reshape what’s possible — legally and financially. Despite state-level rules and regulations that can add a layer of complexity, the growth of ambulatory surgery centers is outpacing other care settings. For health system planners and ambulatory leaders, these changes are fuel. Less friction means faster scaling, offering even more reason to pay attention.

Consolidation is picking up — but so is co-ownership

National ASC platforms are actively seeking partnerships with aligned physician groups. Many major players like Surgery Partners are pursuing acquisitions and joint ventures with health systems or management services organizations (MSOs) that provide physicians with opportunities to invest, guide operations, and share in the rewards. There’s a reason private equity is investing in these facilities; the model works.

For independent groups, the window to secure favorable terms may be narrowing as market consolidation accelerates, making it critical to plan their next move. Physician ownership and co-investment models that offer clinical input and governance are emerging as the gold standard for aligning high-quality care with strong financial performance. Specialties like orthopedics, pain management, urology, cardiology, and gastroenterology are well-positioned for this shift, as their most common procedures continue to migrate to outpatient settings.

Here’s the challenge: once you scale, complexity increases. You’re now managing:

• Multi-site scheduling
• Payer-specific authorization workflows
• Credentialing and compliance
• Revenue tracking across entities

That’s where data, technology, and operational discipline come into play. Surgical care doesn’t exist in isolation; it connects diagnostics, pre-op consults, labs, imaging, primary care, and follow-ups. To make it all work smoothly, systems need to talk to each other so data can move easily across all those touchpoints. For clinicians considering the ASC model, thinking through the technological implications is just as important as the clinical and financial ones.

The ASC model is showing its financial strength

Compared to hospital ORs juggling trauma, emergencies, and staffing shortages, ASCs can operate like a finely tuned machine. Their overhead can be lean, and while staffing is tight, it is also specialized. Turnover times? Usually much lower than those in inpatient ORs, allowing for greater schedule density and benefiting both patients awaiting care and the doctors providing it.

Many physicians are getting on board with ASCs because ownership or partnership opportunities provide access to new revenue streams, like a share of facility fees, and reduce their reliance on hospital-based contracts. For practices feeling the pressure from fee-for-service rates, ASCs present a valuable source of additional revenue while aligning with broader value-based care initiatives.

The numbers behind ASC performance are compelling. Surgery Partners reported revenue growth of over 14% year over year, even in a tight labor market. And profitability across leading ASC operators remains strong, with consistent EBITDA margins and robust procedure pipelines. Surgical case volume is also on the rise.⁷

This sustainable growth is enticing for physician practices looking to expand into outpatient surgery. Financial stability lays the groundwork, while EHRs and practice management systems make it easy to manage processes like consent documentation and patient safety checks, helping practices meet compliance requirements without slowing down. With this, expansion feels less of a leap and more of a logical next step.

The growth of ambulatory surgery centers is transforming surgical care delivery. The next move? Yours.

Specialty spotlight: Where the ASC model thrives

A few specialties lead ambulatory service center volumes today, but the list keeps growing:

• Orthopedics: The rising need for joint replacements (especially hip and knee) and minimally invasive techniques, particularly among aging patients continues to fuel continues to fuel growth. Procedures like rotator cuff repairs, arthroscopic knee surgeries, and bunion removals remain in high demand.
• Pain management: Common interventions like injections, blocks, and stimulators are well-suited to the ASC setting and see steady, high-volumes.
• Cardiology: With CMS approving several outpatient electrophysiology and interventional procedures, along with support from commercial payers, cardiology is becoming a fast-growing ASC specialty.
• Urology: Many urologic cases, from stone procedures to prostate biopsies, can now be performed more efficiently in outpatient settings. For example, Chesapeake Urology Associates, reports that over 90% of their urologic procedures are suitable for outpatient care.⁸
• Gastroenterology: GI has long been a leader in surgery center efficiency, and that continues with rising demand for screenings and outpatient diagnostics. Alongside colonoscopies and endoscopies, surgeries like gallbladder removals and appendectomies are contributing to this demand.

The common thread? High volume, repeatable workflows, and procedures that benefit from faster throughput and tighter cost control of an ASC. And the horizon is expanding. AI-assisted features, virtual pre-ops, and remote post-op monitoring are opening even more doors and driving the rapid rise of ASCs.

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ASC growth isn’t slowing down, are you ready?

The rise of ambulatory surgery centers marks more than a change in location. It’s a transformation in care delivery. For forward-thinking practices with the right mix, ASCs offer an opportunity to expand access, elevate patient experience, and build a scalable model that’s clinically sound and often financially smart.

As a technology partner to ambulatory practices, we understand the workflows, challenges, and decisions that come with expanding into surgical care. After 25 years of focusing on technology for ambulatory care, we’re bringing our innovative solution to the ASC space, offering a unified experience that enhances clinical and operational efficiency.

If you’re evaluating what an ASC might mean for your future or looking to connect your clinical practice with your ASC, we’re here to help you navigate the next step with confidence. Reach out today and set up a time to connect.