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Surgery Partners, Inc.: Q4 FY2025 earnings call

What management said about Q4 FY2025, from the documents filed with the SEC on 2 March 2026: press release. Guidance figures: 3 new. The quarter’s numbers.

Key takeaways

  • Fourth-quarter revenue rose 2.4%: Revenue rose 2.4% in the fourth quarter to $885.0 million, against $864.4 million a year earlier. The full year rose 6.2%. Source
  • Fourth-quarter Adjusted EBITDA fell: Adjusted EBITDA decreased 4.2% to $156.9 million in the fourth quarter, against $163.8 million a year earlier. Source
  • Full-year results against Q3 ranges: Full-year revenue of $3,308.7 million and Adjusted EBITDA of $526.2 million, compared with the revenue and Adjusted EBITDA ranges given in the third-quarter release.
  • Fourth-quarter surgical cases declined: Cases fell to 170,468 in the fourth quarter from 174,185 a year earlier. Full-year cases rose 2.0% to 669,732. Source
  • Same-facility revenue rose 3.5%: Same-facility revenue growth came from a 2.1% increase in revenue per case and a 1.3% increase in same-facility cases. Source
  • Adjusted EBITDA margin declined: Adjusted EBITDA margin was 17.7% in the fourth quarter, against 18.9% a year earlier. The full-year margin was 15.9%, against 16.3%. Source
  • Shift to higher-acuity procedures: Management said it is tightening execution and doubling down on its shift into higher-acuity procedures as it progresses through 2026. Source
  • Net leverage about 4.3 times: Net debt to EBITDA under the credit agreement was about 4.3 times at year end. On consolidated debt before reducing for NCI, leverage was 4.9 times. Source

“Our fourth quarter results reflect a degree of margin pressure, which impacted our full-year performance.”

Dave Doherty, Chief Financial Officer

Guidance

AreaPeriodFigureAgainst last quarter
Revenue Source2026$3.35 billion to $3.45 billionNew
Adjusted EBITDA Source2026at least $530 millionNew
Share repurchases SourceProgram authorized February 26, 2026; period not statedup to $200 million of common stockNew

What changed from last quarter

  • New guidance: Initial 2026 revenue and Adjusted EBITDA guidance issued, excluding M&A. Source
  • New: New share repurchase program of up to $200 million authorized by the Board on February 26, 2026. Source

Fourth quarter and full-year results

  • Fourth-quarter revenue rose 2.4%: Revenue rose 2.4% in the fourth quarter to $885.0 million, against $864.4 million a year earlier. The full year rose 6.2%. Source
  • Fourth-quarter Adjusted EBITDA fell: Adjusted EBITDA decreased 4.2% to $156.9 million in the fourth quarter, against $163.8 million a year earlier. Source
  • Full-year Adjusted EBITDA rose 3.5%: Full-year Adjusted EBITDA increased 3.5% to $526.2 million, from $508.2 million in 2024. Source
  • Net loss attributable to company: Net loss attributable to Surgery Partners was $15.0 million for the fourth quarter (prior year $108.5 million) and $77.9 million for the full year (prior year $168.1 million). Source
  • Full-year results against Q3 ranges: Full-year revenue of $3,308.7 million and Adjusted EBITDA of $526.2 million, compared with the revenue and Adjusted EBITDA ranges given in the third-quarter release.
  • Income tax expense lower year over year: Fourth-quarter income tax expense was $13.6 million, against $120.8 million a year earlier. The prior-year period included a $99.5 million valuation allowance change. Source

Cases and same-facility growth

  • Fourth-quarter surgical cases declined: Cases fell to 170,468 in the fourth quarter from 174,185 a year earlier. Full-year cases rose 2.0% to 669,732. Source
  • Same-facility revenue rose 3.5%: Same-facility revenue growth came from a 2.1% increase in revenue per case and a 1.3% increase in same-facility cases. Source
  • Full-year same-facility growth: Full-year same-facility revenue rose 4.9%, with revenue per case up 1.4% and same-facility cases up 3.4%. Source
  • Third-quarter same-facility growth higher: In the prior release, same-facility revenue for the third quarter rose 6.3%.

“Despite these challenging headwinds, demand for our services remains strong, and we remain optimistic on the structural tailwinds underpinning long-term ASC market growth.”

Eric Evans, Chief Executive Officer

Costs and margins

  • Adjusted EBITDA margin declined: Adjusted EBITDA margin was 17.7% in the fourth quarter, against 18.9% a year earlier. The full-year margin was 15.9%, against 16.3%. Source
  • Operating cost lines increased: Salaries and benefits were $254.4 million in the fourth quarter, against $240.7 million. Supplies were $239.2 million, against $223.0 million. Professional and medical fees were $103.1 million, against $91.1 million. Source
  • Depreciation rose, G&A fell: General and administrative expenses were $23.7 million in the fourth quarter, against $36.0 million. Depreciation and amortization was $59.9 million, against $33.9 million. Source

Strategy and 2026 approach

  • Shift to higher-acuity procedures: Management said it is tightening execution and doubling down on its shift into higher-acuity procedures as it progresses through 2026. Source
  • Measured approach to 2026 guidance: The CFO said the company took a measured approach to 2026 guidance while it navigates the near-term operating environment and runs its core growth pillars. Source
  • Transaction costs declined: Transaction and integration costs were $18.5 million in the fourth quarter, against $34.0 million. For the full year they were $73.9 million, against $100.1 million. Source
  • Organic growth, M&A and portfolio levers: The CEO named continued organic growth, strategic M&A and effective portfolio optimization as initiatives positioning the company in the market. Source

“We are confident in our path towards returning to the consistent growth that we know our platform is capable of, supported by strong fundamentals”

Dave Doherty, Chief Financial Officer

Cash flow, leverage and distributions

  • Fourth-quarter operating cash flow lower: Operating cash flow was $103.4 million in the fourth quarter, against $111.4 million for the same period in 2024. Source
  • Full-year operating cash flow lower: Full-year operating cash flow was $274.3 million, against $300.1 million in the prior year period. Source
  • Net leverage about 4.3 times: Net debt to EBITDA under the credit agreement was about 4.3 times at year end. On consolidated debt before reducing for NCI, leverage was 4.9 times. Source
  • Distributions to NCI holders rose: Distributions to non-controlling interest holders were $57.2 million in the fourth quarter, against $48.1 million. The full year was $226.0 million, against $170.5 million. Source

Investment and balance sheet

  • Acquisition payments lower for year: Payments for acquisitions, net of cash acquired, were $109.5 million in the fourth quarter, against $87.6 million. The full year was $162.1 million, against $378.8 million. Source
  • Capital spending lower: Purchases of property and equipment were $12.8 million in the fourth quarter, against $22.3 million. The full year was $78.7 million, against $90.4 million. Source
  • Liquidity at year end: Cash and cash equivalents were $239.9 million, and borrowing capacity under the revolving credit facility was $692.8 million, at December 31, 2025. Source

Facilities and affiliate revenue

  • Surgical facility count rose: Surgical facilities were 176 at period end, against 161. Consolidated surgical facilities were 121, against 118. Source
  • Revenue per case increased: Revenue per case was $5,192 in the fourth quarter, against $4,963. The full year was $4,940, against $4,742. Source
  • Management fee revenue from affiliates: Management fee revenues from non-consolidated facilities and managed facilities were $9.0 million in the fourth quarter, against $7.0 million. The full year was $33.6 million, against $27.0 million. Source
  • Affiliate Adjusted EBITDA rose for year: Adjusted EBITDA related to unconsolidated affiliates was $16.1 million in the fourth quarter, against $16.4 million. The full year was $59.0 million, against $51.6 million. Source

Per-share and non-GAAP measures

  • Adjusted diluted EPS lower: Adjusted diluted EPS was $0.12 in the fourth quarter, against $0.44. For the full year it was $0.47, against $0.93. Source
  • GAAP net loss per share: Basic and diluted net loss per share was $(0.12) in the fourth quarter, against $(0.86). The full year was $(0.61), against $(1.33). Source
  • Equity-based compensation reconciling item: In the adjusted net income reconciliation, equity-based compensation was (2.2) in the fourth quarter, against 6.2 a year earlier. The full year was 14.8, against 33.3. Source

Figures management reported

FigureReported
Same-facility revenue growth Source3.5% in Q4 2025; 4.9% for full year 2025
Surgical cases Source170,468 in Q4 2025 (down 2.1%); 669,732 for full year 2025 (up 2.0%)
Same-facility case growth Source1.3% in Q4 2025; 3.4% for full year 2025

Risks management discussed

  • Operational: Management said it is driving operational improvements and tightening execution while navigating the near-term operating environment. Source
  • External: Management described significant and unanticipated headwinds that affected the year's performance and the fourth-quarter results. Source
  • Financial: Interest expense, net was $67.6 million in the fourth quarter, against $52.9 million. The full year was $272.6 million, against $201.7 million. Source

Earlier plans management reported on

  • Not stated: Management listed improving free cash flow and reducing leverage among the supports for its path back to consistent growth. Source
  • Not stated: Management said it is doubling down on its shift into higher-acuity procedures as part of strengthening performance. Source

Other quarters

Summarised with AI from the documents the company filed with the SEC. Every point is checked against the filing before it is shown: management’s own words word for word, figures against the line or table row they come from. A point that fails the check is left out. Source opens the filing at that line.