The median ambulatory surgery center sold for 7.9 times EBITDA in 2025, the highest multiple in at least eight years, according to VMG Health's 2026 Healthcare M&A Report as cited by Becker's ASC. Multispecialty centers traded even higher, at 6 to 10 times EBITDA, while total deal volume for physician practice management fell to roughly half of 2025's pace in the first half of 2026, according to PitchBook data reported by STAT News.

For a practice executive weighing a sale, an affiliation, or a capital raise, the two trends run in opposite directions at once. Prices per deal are up. The number of deals is down. Below is what the current data says about what a practice or ASC is actually worth in 2026, who is buying, and which practices are closing instead of selling.

What ASCs Are Selling For

Single-specialty ASCs are trading at 5 to 8 times EBITDA, and multispecialty centers at 6 to 10 times, according to VMG Health's 2026 Healthcare M&A Report. Regional and national operators that run multiple centers with a demonstrated growth track record are commanding 11 to 17 times EBITDA. VMG Health notes that the best-in-class assets, meaning centers with strong physician alignment, a favorable specialty mix, and clean financials, have reached double-digit multiples even in the smaller single-center category.

Public comparables give a second reference point. Surgery Partners, one of the largest publicly traded ASC operators, trades at an EV/EBITDA multiple of 12.7 to 14 times based on December 2025 and 2026 estimates. HCA Healthcare trades at 9.8 to 10 times, and Tenet Healthcare, the parent company of United Surgical Partners International, trades at 6.8 to 7 times.

Seller typeEBITDA multiple
Single-specialty ASC5x - 8x
Multispecialty ASC6x - 10x
Regional/national multi-center operator11x - 17x
Median ASC transaction (2025, all types)7.9x
Tenet Healthcare / USPI (public)6.8x - 7x
HCA Healthcare (public)9.8x - 10x
Surgery Partners (public)12.7x - 14x

Source: VMG Health, 2026 Healthcare M&A Report, as reported by Becker's ASC.

Fewer Deals, Higher Prices

Private equity-backed physician practice management deals peaked at 851 in 2021, according to PitchBook data cited by STAT News. In the first half of 2026, that count was 105, putting the full year on track for roughly half of 2025's total deal volume. STAT News attributes part of the slowdown to more than a dozen states that have passed laws adding oversight of private equity transactions in healthcare over the past few years.

Fewer transactions have not pulled multiples down. A smaller pool of buyers is competing for a smaller pool of well-run, well-documented assets, and that competition is what keeps the 7.9x median intact even as overall deal counts drop. A center with disorganized collections, high accounts receivable, or unclear payer contracts is a harder sell in this market than it was during the higher-volume years around 2021.

Who Is Buying, and How Much They Own

Private equity firms owned or held an investment stake in practices employing about 6.5% of physicians nationally in 2024, up from 4.5% in 2022, according to a 2025 Government Accountability Office report on health care consolidation. Over the 2019 to 2023 period, private equity accounted for 65% of all physician practice acquisitions tracked in the studies GAO reviewed. The GAO also found that ownership share varies widely by specialty and by geographic market, though it stopped short of drawing conclusions on care quality or access, citing a lack of rigorous research on those outcomes.

Those figures describe stakes in physician practices broadly, not ASC transactions specifically, but the two markets overlap. Many of the operators bidding 11 to 17 times EBITDA for regional ASC platforms are the same private equity-backed groups counted in the GAO's acquisition data.

Not Every Practice Is Cashing Out

At least 30 ASCs and physician practices closed or announced closure in the first half of 2026, spread across more than 20 states, according to Becker's ASC and Becker's Physician Leadership reporting. The reasons cited most often were reimbursement rates that no longer cover the cost of care, staffing shortages that leave a practice down to a single physician, and rural markets that cannot attract a replacement provider when one leaves. A share of the 30 also reflects consolidation, where a practice closes its own doors after being absorbed into a health system rather than shutting down for financial reasons.

The closures and the record multiples are describing two different populations. The 7.9x median applies to centers with a buyer already at the table. The 30 closures are, in large part, practices that reimbursement and staffing pressure caught before a buyer showed up.

What the Numbers Mean for Practice Leaders

The gap between a 5x single-center sale and a 17x regional-platform sale comes down to documentation as much as size. VMG Health points to physician alignment, specialty mix, and clean financials as the three factors separating top-decile multiples from the rest. For a practice or ASC weighing its options in 2026, the deal data says the buyers are still out there and still paying up, but only for assets with contracts, collections, and financials in order well before a term sheet is on the table.

Sources

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