Surgery Partners 2025 Results: Headwinds Trim Growth, EBITDA Floor Sets Stage for 2026

Executive snapshot

Surgery Partners, Inc. (NASDAQ: SGRY) closed 2025 with a mixed-biscaled profile: top-line growth in the face of margin pressures and a strategic tilt toward higher-acuity procedures. The company produced full-year revenue of about $3.3 billion, up 6.2% from 2024, while Adjusted EBITDA rose 3.5% to $526.2 million. Despite the revenue ascent, the firm reported a full-year net loss of $77.9 million, and a fourth-quarter net loss of $15.0 million, underscoring the ongoing tension between operating leverage and depreciation, interest, and other non-cash or non-operational factors.

Early in the document, the emphasis is on EBITDA rather than EPS in the period’s narrative. There is no GAAP EPS figure disclosed in the release, and the notes here implicitly invite readers to think in terms of EBITDA and revenue metrics as the primary lens. For market observers who track EPS consensus or look for an earnings surprise against expectations, this filing provides a reminder: the earnings story for this company is increasingly told through cash-flow-like metrics and volume-driven revenue rather than a single per-share result.

Key 2025 financials at a glance

• Fourth quarter 2025 revenue: $885.0 million, up 2.4% year over year (vs. $864.4 million in Q4 2024).
• Full-year 2025 revenue: approximately $3.3 billion, up 6.2% from 2024.
• Same-facility performance (full year): revenues up 4.9%; revenue per case up 1.4%; same-facility cases up 3.4%.
• Fourth quarter 2025 Adjusted EBITDA: $156.9 million, down 4.2% from $163.8 million in Q4 2024.
• Full-year 2025 Adjusted EBITDA: $526.2 million, up 3.5% from $508.2 million in 2024.
• Net loss: $15.0 million in Q4 2025; $77.9 million for the full year 2025.

2026 guidance and revenue forecast

The company issued an initial 2026 outlook, framing it as a bridge to growth through organic expansion, strategic M&A, and portfolio optimization. Specifically, Management guided for Adjusted EBITDA of at least $530 million and revenue in a range of $3.35 billion to $3.45 billion, excluding any M&A impact. In other words, a modest EBITDA floor with room for upside if volumes and mix cooperate.

The language suggests caution about near-term margin dynamics while preserving optionality from potential acquisitions or asset redeployments. The CFO’s commentary underscores a margin-pressure narrative in the near term, paired with confidence in demand strength and structural tailwinds in the ambulatory surgical center (ASC) market.

Voices from the podium

Eric Evans, Chief Executive Officer, remarked that 2025 tested the organization with unanticipated headwinds even as demand for services remained robust. He framed the company’s strategy as tightening execution and accelerating its shift toward higher-acuity procedures, supported by organic growth, disciplined M&A, and portfolio optimization.

Dave Doherty, Chief Financial Officer, highlighted margin pressure as a driver of the year’s performance while reaffirming a path toward long-term shareholder value. His note pointed toward a measured stance on guidance, focusing on free cash flow improvement, debt reduction, and ongoing portfolio optimization to support sustainable growth.

What this might portend for SGRY and peers

The 2025 narrative reinforces a familiar theme across ASC operators: volume growth is achievable, but sustaining margin expansion requires discipline on cost structure and capital allocation. The shift to higher-acuity procedures can yield better pricing power but demands clinical and operational investments, potentially pressuring near-term EBITDA if payer dynamics or labor costs tighten.

For SGRY, the 2026 revenue forecast in the $3.35–$3.45 billion band implies limited room for revenue acceleration without additional M&A or portfolio changes. The at-least $530 million Adjusted EBITDA target signals a desire to maintain a baseline of profitability even as the company navigates conversion costs, integration, and potential capacity realignment. The presence of a share repurchase program suggests capital return is a priority alongside growth investments, a balance sheet note that can be interpreted as confidence in the medium-term cash-generating ability.

Sector peers watching these dynamics may interpret this message as a cautious but constructive stance: governance around leverage, capex, and portfolio mix matters as much as top-line growth. If M&A remains a meaningful growth vector, the question becomes not just “how much revenue can we add?” but “how cleanly can we integrate acquisitions to protect margins and support ongoing returns to shareholders.”

Risks and considerations

The reported net losses remind readers that EBITDA-centric narratives can mask profitability gaps under GAAP accounting—depreciation, interest, and other non-cash items still matter for per-share outcomes. The company’s forward-looking guidance excludes M&A, so any deal-driven upside or downside will be a meaningful swing factor for the EPS-like metrics investors often monitor in this space.

In the broader context, headwinds could stem from labor costs, payer mix shifts, and changes in post-acute demand, as well as competition within the ASC space. Success will hinge on execution, patient volumes across core markets, and the balance between volume growth and operating efficiency.

Bottom line

2025 delivered a revenue uplift and a modest improvement in Adjusted EBITDA, tempered by a year-end push from headwinds that the company says did not meet its expectations. The 2026 forecast offers a clear EBITDA floor and a revenue corridor, with M&A as a potential upside lever. For investors tracking SGRY and its sector peers, the key narrative remains: can the company sustain volume-driven gains while translating them into margin resilience in an evolving ASC landscape? The answers may hinge on execution, deal flow, and the ever-watchful eye on EPS-like outcomes versus the EBITDA-centric reporting that has become the industry standard.