Revenue Growth
Full year net revenue of $3.3 billion, up 6.2% year-over-year; full-year same-facility revenue growth of 4.9%.
Adjusted EBITDA and Margin
Full year adjusted EBITDA of $526 million, up 3.5% year-over-year; adjusted EBITDA margin of 15.9% (40 basis points of margin compression year-over-year).
Case Volume and Specialty Mix
Performed nearly 670,000 surgical cases in 2025 versus 656,000 in 2024 (~2.1% increase); fourth quarter same-facility case growth of 1.3%; strong traction in orthopedics with over 42,000 orthopedic cases in Q4 — total joint cases grew 15% in Q4 and 19% year-to-date.
Physician Recruitment and Technology Investment
Recruited almost 700 physicians in 2025 and expanded surgical capabilities with 74 surgical robots in service (six added in 2025), supporting a strategic shift to higher-acuity procedures.
Capital Deployment and M&A Discipline
Deployed $182 million of acquisition capital in 2025 (modestly below target), with management noting acquisitions were made at attractive valuations and M&A pipeline remains strong; opened eight de novo facilities in 2025 (four in Q4).
Portfolio Optimization Progress
Active portfolio optimization efforts, including a Baylor Scott & White joint venture (Bryan, TX) that will deconsolidate the facility but is expected to improve run-rate earnings efficiency and support strategic alignment; management expects resolution on key actions in H1 2026.
2026 Initial Guidance
Initial 2026 guidance: net revenue $3.3 billion to $3.45 billion (single-digit growth) and adjusted EBITDA of at least $530 million (at least 0.7% growth), reflecting conservative planning that incorporates identified headwinds.