Surgery Partners delivered Q4 revenue of $885 million, a 2.4% increase, driven by a 3.5% rise in same-facility revenue from 1.3% case growth and 2.1% rate gains. Adjusted EBITDA reached $156.9 million, representing a 17.7% margin, with misses isolated to three surgical hospital markets facing payer-mix and anesthesia cost pressures.

For 2025, net revenue rose 6.2% to $3.3 billion, while adjusted EBITDA climbed 3.5% to $526 million, though margins compressed by 40 basis points. The company performed nearly 670,000 surgical cases, saw total joint replacements grow 19% year-to-date, added six surgical robots for a total of 74, completed $182 million in acquisitions and opened eight de novo facilities.

Management projects 2026 net revenue between $3.35 billion and $3.45 billion and adjusted EBITDA of at least $530 million, assuming modest margin compression. The board authorized up to $200 million in share repurchases, and the company enters the year with $933 million of liquidity against $2.6 billion of corporate debt (net leverage ~4.3x–4.9x).

Margin pressure in three surgical hospital markets stemmed from slower case growth, sharper-than-anticipated payer-mix shifts and unanticipated anesthesia payments. New leadership has been installed in those markets, with the COO dedicating additional support to address these identifiable, measurable and addressable issues.