Top 10 ASC Management Companies in 2026

For surgeons. Updated October 2, 2026 · Prepared by Prospyr. Prospyr makes practice software for aesthetic and plastic surgery practices, not surgery center management, and none of the companies below is a Prospyr product. Each summary reflects what the company publishes on its own website, checked October 2026. Ownership terms, management fees and contract length are rarely published, so get every term in writing and have a healthcare attorney review it before you sign.

What does an ASC management company do?

An ambulatory surgery center (ASC) management company runs the business side of an outpatient surgery center so surgeons can focus on cases. Depending on the firm, that means feasibility studies, design and construction, state licensure, Medicare certification and accreditation, then day-to-day operations: staffing, supply chain, payer contracts, billing and quality reporting. The key split is ownership. Some companies take an equity stake and share in profits; others work for a fee and leave ownership with the surgeons. For a plastic surgeon, the first question is often smaller: an accredited office-based suite or a licensed ASC.

The 10 ASC management companies at a glance

How we chose this list

We looked for companies that develop or manage surgery centers and publish enough about their model for a surgeon to judge fit before a first call. We checked four things:

• Ownership model. Does the site say whether the company takes equity, works for a fee, or both?
• Office-based surgery. Many plastic surgeons start with an accredited in-office suite. Firms that state they build or certify those got credit.
• Published track record. Number of centers developed or managed, years in business, and named centers or locations.
• Scope. Development only, management only, or both, plus whether billing and payer contracting are in-house.

Most of these firms serve every specialty. Few name plastic surgery directly, and we say so where they do. The order is our editorial view, not a measure of results.

1. Custom Surgical Partners

Custom Surgical Partners develops and manages ambulatory surgery centers and office-based surgery (OBS) suites, with offices in Maryland and Longboat Key, Florida. Its services run from concept and feasibility through design and build, licensure, certification and accreditation, staffing and first cases, then ongoing management, compliance and coaching. It also describes a hybrid OBS and ASC model.

What stands out:

• Plastic surgery experience, stated plainly. Its office-based suite page says it has built in-office suites for 20 years across all specialties, "with a heavy concentration in ophthalmology and plastic surgery."
• Published numbers. It reports 800+ customers served, 165+ ASCs developed, 30+ OBS suites developed and 20+ centers managed.
• Free first conversation. The site offers a free consultation.

Right for: a plastic surgeon weighing an in-office operating suite against a full ASC, or one who wants to start office-based and grow. Ask: whether it takes any equity, how its management fee is set, and which plastic surgery suites it can give as references.

2. Surgery Center Services of America

Surgery Center Services of America (SCSA) describes itself as a non-equity ASC developer. It reports 450+ ASCs developed over 35+ years across 49 U.S. states and Canada. Its turnkey service covers feasibility and financial modeling, architectural planning and construction coordination, state licensure, Medicare certification, accreditation, and operational readiness with post-opening support.

What stands out:

• No equity. SCSA states, "We never take equity. Your ASC remains fully owned and controlled by the surgeons who lead it."
• Scale of development history. 450+ centers is one of the largest development counts published by any firm on this list.
• Feasibility first. It offers a feasibility assessment to test whether an ASC makes sense for your practice before you commit to a build.

Right for: a surgeon or surgeon group that wants to own 100% of the center and needs an experienced team to get it built and certified. Ask: how it is paid (flat fee, phased fees or percentage of project cost), what post-opening support includes and for how long, and who will manage the center once it opens.

3. The ADA Group

The ADA Group is a compliance consulting firm for ambulatory surgery development and office-based surgery development, founded by Anne Dean, BSN, HCRM. The firm states it has been involved in ambulatory surgery projects since 1979. It helps with office registration, state licensure, Medicare certification and accreditation for ASC and OBS facilities, and builds policy and procedure programs as the base of compliance.

What stands out: the list of centers on its homepage includes the Wise Center for Plastic Surgery in Wayne, New Jersey, alongside ophthalmology and endoscopy centers, and it says it also works with mobile surgery settings.

Right for: a practice that already has, or is building, an in-office operating room and needs licensure and accreditation handled correctly. Ask: which accrediting bodies it works with most, what its guarantee covers, and what ongoing compliance support costs after the survey.

4. Ambulatory Strategies, Inc.

Ambulatory Strategies, Inc. (ASI), based in the Tampa Bay area of Florida, provides consulting and management for ASCs, hospital outpatient departments and office-based surgery programs. Its services include ASC development and management, OBS state licensure and accreditation, financial feasibility studies, life safety compliance, emergency preparedness, Medicare certification, risk management and financial turnarounds. ASI positions itself against national firms with "personalized, hands-on support."

Right for: an independent surgeon or small group, especially in Florida, that wants consulting or management without a national operator. Ask: how many centers it manages today, who your day-to-day contact is, and whether it works on a fee or equity basis.

5. ASCOA

ASCOA (Ambulatory Surgical Centers of America), based in Hanover, Massachusetts, develops, acquires, turns around and manages surgery centers, and works on hospital joint ventures. It reports refining its management model in more than 70 surgery centers since its founding in 1997. ASCOA describes itself as one of the only ASC companies owned and still managed by physicians, with no outside private equity or venture funding.

Right for: surgeons who want a corporate equity partner that brings capital and a defined management model, and who prefer a physician-owned company. Ask: what equity share ASCOA expects, how profits and decisions are split, and how it handles a center where plastic surgery is a minority of cases.

6. Merritt Healthcare

Merritt Healthcare, based in Ridgefield, Connecticut and founded in 2001, focuses only on ASC development and management, plus consulting and M&A advisory. It reports partnerships with over 500 physicians and health systems including Mount Sinai Health System, and 24 facilities developed. It states it has no private equity or silent investor ownership and aims to maximize hospital and physician ownership.

Right for: surgeons in the Northeast or anyone planning a physician and hospital joint venture. Ask: whether its leaders invest in your project, what the management agreement term is, and how the M&A advisory side avoids conflicts if you later sell.

7. Pinnacle III

Pinnacle III reports 20 years in the ASC industry. It offers de novo development, operational management of clinical and business operations, revenue cycle management, patient billing, payer contracting, facility audits, data analytics, marketing and new service line development for new and existing centers. Its leadership page notes its CEO helped found the Colorado Ambulatory Surgery Center Association.

Right for: an existing center that wants management and billing under one firm, or a new center that wants both from day one. Ask: how billing fees are structured, how it reports collections, and how it handles self-pay aesthetic cases that never touch insurance.

8. Solara Surgical Partners

Solara Surgical Partners, founded in 2003 with offices in Oklahoma City and Southlake, Texas, provides ASC development, ASC management and joint ventures with hospitals and health systems. It states physicians keep their ownership stake and control over clinical decisions while Solara handles business and administrative work, and that it is privately owned with "no corporate affiliations or conflicts of interest."

Right for: surgeons in Oklahoma, Texas and nearby states who want a privately held partner. Ask: whether it has managed a center with a meaningful aesthetic case mix, and what its exit and sale support looks like.

9. Surgery Partners

Surgery Partners, headquartered in Brentwood, Tennessee, reports more than 300 locations in 30 states, including surgical facilities, multi-specialty physician practices and anesthesia services. Plastic surgery appears in its location search as a specialty. It says it can structure the relationship with a physician as a partner, an affiliate or an employed physician.

Right for: surgeons who want to join an existing center in their market or sell into a national operator. Ask: which of its centers near you have plastic surgery block time, how profit distributions work, and what non-compete terms apply.

10. United Surgical Partners International (USPI)

USPI describes itself as the leading ambulatory network in the United States. It reports 535+ ambulatory surgery centers and surgical hospitals, 2 million+ procedures a year, 50+ health system partners, 11,000+ physicians (including 6,000 physician partners) and operations in 37 states.

Right for: surgeons who want to partner with a health system and a national operator in a joint venture. Ask: which centers near you take aesthetic cases, how much say physician partners have in governance, and how buy-in is priced.

Questions to ask any ASC management company

1. Do you take equity, and how much? Get the ownership split, capital calls and profit distribution in writing. Compare it with a fee-only developer.
2. How is your management fee calculated? Ask whether it is a percentage of collections, a flat monthly fee or both, and what is included.
3. Office-based suite or ASC? Ask the firm to explain which setting fits your case mix, anesthesia needs and state rules, and to show its numbers for both.
4. How do you handle self-pay aesthetic cases? Many ASC models are built around insurance and Medicare. Ask how pricing, deposits and collections work for cosmetic cases.
5. What does the contract say about leaving? Ask about term length, termination rights, non-compete clauses and buyout terms.
6. Who do you report to? Ask what governance the surgeons keep, how often you get financial statements and who signs off on major spending.
7. Can we call three surgeons you work with? Ask for references from centers with plastic surgery volume.

Where Prospyr fits

An ASC manager runs the facility. Your practice still handles consultations, quotes, deposits, pre-op paperwork and follow-up before and after the operating room. Ask how surgery dates booked by your team reach the center's schedule so nobody keeps two calendars. Prospyr covers the practice side for plastic surgery practices, including online scheduling; you can book a practice demo.

If you are also staffing your operating room, see our lists of surgical first assistant services and sterilization and instrument services. For consent processes, see informed consent in aesthetic surgery.

Frequently asked questions

Do I need an ASC to perform aesthetic surgery outside a hospital?

No. Many plastic surgeons operate in an accredited office-based surgery suite instead of a licensed ASC. Rules on which procedures and anesthesia levels require which setting vary by state, so confirm your state's requirements with a healthcare attorney or a compliance firm such as those above.

Do ASC management companies take ownership of the surgery center?

Some do and some don't. Equity partners such as ASCOA invest in the center and share profits; fee-only developers such as Surgery Center Services of America state they never take equity. Ask for the model in writing before you share financials.

How much does an ASC management company charge?

None of the companies on this list publishes its fees. Management is often priced as a percentage of collections, a monthly fee or a mix, and development is often a project fee. Get at least two written proposals to compare.

How long does it take to open an ASC?

None of these companies publishes a standard timeline. Feasibility, construction, licensure, Medicare certification and accreditation each add time, and state approval steps differ. Ask each firm for timelines on its last three projects.

Want your company considered?

We review this list quarterly. Companies that develop or manage surgery centers for surgeons can send their website and what they offer practices to info@prospyrmed.com. Inclusion is editorial and not paid.

Editorial scope

This list is based on each company's public website, checked October 2026 with AI-assisted research. Companies did not review this article before publication. It is not a guarantee of results or a substitute for checking references, licensure, accreditation and contracts. Read our methodology or report a correction.