Image by Nattanan Kanchanaprat from PixabayThe ambulatory surgery center (ASC) industry continued to expand in late 2025, pushing the U.S. market to an estimated value of $45.6 billion.
That’s according to new data from industry research and intelligence firm ASC Data. But that $45.6 billion figure doesn’t tell the whole story. ASC Data’s latest quarterly market report suggests the ASC industry’s next phase of growth will be more targeted, likely shaped less by raw center counts and more by specialization, geography and acuity.
However the data is sliced and diced, the tailwinds are undeniable.
“The Q4 data confirms that ASCs continue to be a vital part of the health care landscape, delivering high-quality outcomes at lower costs,” the report states. “With more than 80% of surgeries now performed in outpatient settings, the market is well-positioned for continued expansion.”
Specifically, ASC Data’s Q4 2025 Insights Report tracked 10,494 ASCs across the nation, including 6,566 Medicare-certified facilities. The Medicare-certified universe grew modestly during the quarter, with 49 ASCs added and 28 removed, resulting in a net increase of about 1.5% since the first quarter of 2025.
Digging deeper into the numbers
The composition of the ASC market remains strikingly balanced, according to ASC Data.
Single-specialty facilities accounted for 51.4% of Medicare-certified ASCs at the end of 2025, while multi-specialty centers made up the remaining 48.6%. That near-even split underscores a defining tension in the sector: the operational efficiency of focused service lines versus the revenue stability and case mix flexibility of broader platforms.
It’s a balance that will likely evolve moving forward as well, with higher-acuity procedures shifting into the ASC space often requiring specialization and purpose-built facilities.
Facility-size trends point to a similar dynamic. More than half of ASCs operate just one or two operating rooms, while only 5% qualify as “mega” centers with seven or more ORs.
Those larger facilities tend to cluster in high-growth metropolitan areas, often backed by health systems or private equity sponsors with the scale to absorb upfront costs.
Location, location, location
Geography continues to shape the ASC industry’s profile.
California remains the nation’s largest ASC market with 917 Medicare-certified centers, followed by Florida and Texas. Those three states also lead in total operating rooms, reflecting favorable demographics, strong physician supply and, in some cases, regulatory frameworks more accommodating to outpatient expansion.
Urban concentration remains pronounced, according to ASC Data.
Roughly 91% of Medicare-certified ASCs are located in urban areas, reinforcing concerns about uneven access in rural markets. While telehealth and mobile surgical models have chipped away at those gaps, most capital continues to flow toward dense population centers where case volumes and payer mix are more predictable.
In terms of cities, Las Vegas, Atlanta and Houston have the largest number of ASCs, each with at least 51.
