4.10.2.1Vertical

Gastroenterology ASCs

Ambulatory surgery centers focused on GI endoscopy procedures.

Market snapshot

These figures describe Ambulatory Surgery Centers (ASC) (4.10.2), the segment that Gastroenterology ASCs sits within. They are not figures for Gastroenterology ASCs on its own.

Market size
~$44B
Growth
~7.4%CAGR (2017–22, nominal)
Companies
~6,179 firms
Firms by employee count

68.2% of firms have fewer than 20 employees: 4,217 micro-businesses, below most mandates.

The investable universe1,962 firms with 20+ employees
20–99
1,37770%
100–499
22411%
500+
36118%

With ~6,200 firms, ambulatory surgery centers are the site-of-care-shift winner, moving procedures out of hospitals into lower-cost outpatient settings at ~7.4%/yr. Physician-owned and increasingly PE- and health-system-backed (USPI, SCA), with a deep buyer pool (361 firms over 500 employees). Orthopedics, GI, and ophthalmology migration drives the volume.

NAICS 621493. U.S. Census Bureau, 2022 Statistics of U.S. Businesses; U.S. Census Bureau, 2022 Economic Census.

Business model & economics

Revenue model

Facility fees on outpatient surgical procedures

Key economics

Revenue per firm
$7,133,918
Revenue per employee
$216,958
Employees per firm
31.5
Recurring revenue
Moderate

procedure-volume-driven

EBITDA margin
Strong

efficient outpatient surgical economics

Capex intensity
High

Characteristics

  • Balanced cost base: payroll is 27% of revenue, leaving room to scale margin without cutting staff
  • Deep strategic-buyer pool: 361 firms exceed 500 employees, so a scaled asset has trade buyers
  • Migration of surgery from hospitals to ASCs.
  • Physician-ownership and ancillary economics attractive.
  • Scaled operators and MSOs consolidating via JVs.

NAICS 621493. U.S. Census Bureau, 2022 Statistics of U.S. Businesses; U.S. Census Bureau, 2022 Economic Census.

M&A deal context

Deal activityHigh

Who’s acquiring

  • Scaled ASC operators
  • Specialty MSO platforms
  • Health-system & physician JV partners

What’s driving deals

  • Surgery migration to outpatient settings.
  • Physician-JV and ancillary economics.
  • Consolidation by scaled ASC platforms.

Find Gastroenterology ASCs acquisition targets

Search Acquisera’s index for companies classified under Gastroenterology ASCs (4.10.2.1) and build a targeted deal pipeline.

Search companies