Payer mix
Commercial-heavy centers earn durable margins; heavy government mix compresses them. We analyze reimbursement by payer and by procedure line.
Surgery center specialists
ASC Valuation Services in California
Surgery center appraisals that look past headline multiples — to payer mix, physician concentration, and what your interest is actually worth.
- CVA Certified NACVA Valuation Analyst
- USPAP Compliant Appraisal Reports
- 500+ Valuations 45+ specialties
Headline Multiples Are Misleading
You’ve heard that surgery centers sell for 7–8x EBITDA. Sometimes they do — for a controlling interest, in a multi-specialty center, with diversified physicians, sold to a strategic buyer. Your 20% minority interest in a single-specialty center with one surgeon producing half the cases is a different asset entirely, and pricing it off a headline multiple is how physicians get hurt in buy-ins and buyouts. ASC valuation is its own discipline, and it’s one we practice constantly. With 500+ valuations behind us, Nechay Advisors brings full USPAP-compliant rigor to ambulatory surgery centers across California — focused on the factors that drive ASC value.
What Actually Drives ASC Value
Physician concentration risk
If two surgeons generate 70% of cases, the center’s earnings are two retirements away from collapse. Buyers discount for this — your valuation must quantify it.
Out-of-network exposure
OON revenue can inflate historic earnings that won’t survive a transition to in-network rates. We normalize for sustainable reimbursement, because every sophisticated buyer will.
Controlling vs. minority interest
A 51% block that controls distributions and strategy is worth more per unit than a 10% passive interest. Control premiums and minority/marketability discounts are quantified, not hand-waved.
Growth capacity
Unused OR time, room to recruit, expandable specialties, and certificate/licensure posture all carry value a buyer will pay for.
Deal structure
Stock versus asset purchase changes which assets and liabilities transfer — and the effective price. We model this so you compare offers on a true like-for-like basis.
Three Approaches, Reconciled
As with practices, we develop the Asset Approach (your floor — equipment-heavy ASCs often have meaningful tangible value), the Market Approach (real ASC transaction comps, adjusted for interest level), and the Income Approach (DCF of normalized distributable cash flow at a risk-adjusted rate). The reconciliation is documented so a buyer, partner, lender, or court can follow every step.
ASC Valuations by Purpose
Selling
ASC Valuation for Selling
Know what your surgery center is truly worth before a buyer tells you what they want to pay.
Learn morePartner Buy-In & Buy-Out
ASC Partner Buy-In & Buy-Out Valuation
A fair, independent number both partners can trust, whether buying in or cashing out.
Learn moreDivorce
ASC Valuation for Divorce
Court-ready, USPAP-compliant valuations for marital dissolution involving a surgery center.
Learn moreShareholder Dispute
ASC Valuation for Shareholder Disputes
Independent, litigation-ready valuations when partners disagree about what the ASC is worth.
Learn moreSBA Loan
ASC Valuation for SBA Loans
Lender-ready business valuations that satisfy SBA SOP requirements without slowing your closing.
Learn moreGift & Estate Tax
ASC Gift & Estate Tax Valuation
IRS-defensible valuations for gifting, succession, and estate planning involving ASC interests.
Learn moreWho Buys ASCs — and Why It Matters to Value
The buyer universe for California surgery centers includes hospital systems (seeking outpatient migration and network capture), private equity and national ASC operators (seeking platform growth), and physician groups (seeking case capacity). Each buyer type prices the same center differently because each captures different synergies. Our valuations — and, when you’re ready, our sell-side representation — are built on knowing what each of these buyers will and won’t pay for.
Our Process
Discovery call → financial analysis and physician-owner interviews (1–2 week typical turnaround) → certified opinion of value with negotiation support. Confidential at every step.
- 1
Discovery Call
A confidential conversation about your surgery center, the interest being valued, your timeline, and the purpose of the valuation. We scope the right report tier before you commit to anything.
- 2
Financial Analysis & Interviews
We interview ownership and normalize the earnings base. Out-of-network revenue and related-party facility, management, and anesthesia arrangements all get restated. Typical turnaround: 1–2 weeks.
- 3
Certified Opinion of Value
You receive a defensible, USPAP-compliant conclusion of value for the specific interest being valued, whether controlling or minority. We walk you through it line by line, and the report is documented to withstand scrutiny from a buyer, a court, a partner, or a lender.
Three Engagement Tiers, One Standard
We scope the right tier on your discovery call — you never pay for more report than your purpose requires.
Hourly Consulting
Scoped on your call
A second opinion without commissioning a full valuation. Physicians use it for an independent read on a private equity offer, a partner buy-in, or a purchase they are weighing before signing a letter of intent.
Summary Report
Starting at $4,950
A professionally developed conclusion of value in a streamlined report, grounded in normalized financials and real market data, and prepared in compliance with USPAP. The right fit for exit planning, pricing a sale, or anchoring a partner buy-in. Our most common engagement.
Detailed Report
Starting at $8,950
The gold standard, with full documentation of data, methodology, and assumptions, prepared in compliance with USPAP. Required where the number will be challenged: divorce, shareholder disputes, and gift & estate tax filings.
What is your interest in the center really worth?
Controlling or minority, buy-in or exit — we’ll scope the right analysis in one confidential call.
Trusted by physicians across California
Real Google reviews from physicians and practice owners we have served. Read them on Google
“As a physician with partnership transaction of medical practice, he was an exceptional to guide me and advise me. He showed not only professionalism but also his eagerness to help and guide me through. Highly recommend him for any business valuation and transaction.”
Dr. Kyong Kim
Partnership transaction
“Fantastic valuation/appraisal specialist. I reached out to Alexey to help me evaluate a medical practice buy-in on short notice. He was able to work me into his schedule and accommodate my timeline despite how busy he was and provided crucial insight into helping me decide my next steps.”
Dr. Xuan Cao
Medical practice buy-in
“They get 5 stars across the board. Alexey was extremely thorough and detailed oriented. He did a deep dive into my practice’s financials, coding and practice history. He was easily approachable and prompt in answering questions and in completing the Appraisal. I am confident in the results and I would highly recommend him to any physician/practice for an appraisal.”
Dr. Robert Sacks
Ophthalmology practice
“I called Nechay as I was navigating the potential of selling my practice, and I had a lot of questions about my various offers for sale. Nechay was so responsive, methodical, and educational. He really allowed me to understand the landscape of selling my practice. He is an effective communicator, very patient on the phone and obviously extremely knowledgeable. I will be hiring him to help complete my transactions!”
Dr. Garima Lal
Evaluating sale offers
“I hired Nechay Appraisals to value my ophthalmology practice last year and couldn’t have been more impressed. From start to finish, Alexey was fantastic to work with. The end result was a highly professional and polished valuation report that provided valuable insights on the current state of my business.”
Dr. David Salvay
Ophthalmology practice valuation
“Alexey has been an excellent asset in evaluating our practice. His experience and practice suggestions have helped us tremendously. His working knowledge of medical practice evaluation and application of these skills is second to none. He is always readily available at a moment’s notice.”
Dr. Elio Vento
Practice evaluation
“Very attentive. Quick to respond. Knowledgeable.”
Dr. Betty Daniels
“Very professional, responsive and creates an excellent report and is accessible. Thank you!”
Dr. Daniel Laroche
“Alexey is very professional and a pleasure to work with. I was under time constraints and he completed his review on time despite those additional pressures.”
Dr. Charles Jackson
“Nechay listened carefully and provided objective feedback tailored to my specific situation. His honest communication and expertise made a complex process much easier. I highly recommend him.”
Dr. Maria Soledad Romero
“Highly recommend! From start to finish, he demonstrated expertise, professionalism, and genuine care. Not only did he deliver a thorough, well-researched valuation report, but he also took the time to explain key findings, offer strategic advice, and answered all our questions — even talked to our accountant and bookkeeper to dig deep into our situation.”
Dr. Alicia Sanchez
Medical practice valuation
“We hired Nechay Appraisals to value our ophthalmology practice the year before last and couldn’t have been more impressed. From start to finish, Alexey was fantastic to work with. He was very organized and very patient with us as we gathered what he needed. Every week he would check in to make sure everything was on track. We are getting ready to utilize his services again and are looking forward to working with him.”
Jenna Keller
Ophthalmology practice valuation
“I greatly appreciate the help from Alexey. The process was easy and the information was invaluable. The data provided was comprehensive and gave me perspective of my company that I was not aware of. I highly recommend Alexey and his company.”
Dr. Linh Ngo
Medical practice valuation
ASC valuation questions
There is no "should" without analysis. Controlling interests in diversified, in-network, multi-specialty centers command the strongest multiples of normalized EBITDA; minority interests in concentrated, OON-dependent centers trade far lower. We’ll tell you where your center genuinely sits — and what would move it up.
There are two ways to do this: a direct method and an indirect method. The direct method values minority-level cash flow, so no separate discount for lack of control is required. The indirect method values control-level cash flow first, then applies a discount for lack of control to arrive at the minority level of value. In every case, we start by reviewing the operating agreement — if one exists, it may govern how the valuation should be performed.
We can approach this two ways. One is to project out-of-network revenues and build the associated risk into the discount rate. The other is to model earnings under sustainable in-network assumptions alongside historic results. Buyers may not pay full multiples on OON earnings they expect to lose; a credible valuation gets ahead of that rather than letting diligence discover it.
The business valuation excludes owned real estate, which is typically appraised separately and either sold alongside or retained with a market lease. We restate any related-party rent to market so the center’s earnings are clean.
Often yes — but the valuation must be honest about concentration risk, and the exit strategy usually involves recruitment, ramped earnouts, or seller transition commitments.
Sellers usually prefer stock sales for tax reasons; buyers may prefer asset purchases to avoid assumed liabilities — but in an ASC the decision often turns on transferability. Payer contracts and the center’s accreditation can be difficult to get in an asset sale, while a stock sale often lets them carry over to the new owner so the center stays grandfathered in.
Summary Reports for a surgery center start at $4,950, and Detailed Reports (for divorce, disputes, and gift & estate tax) start at $8,950. Hourly consulting is available for a second opinion on an offer. ASC fees scale with complexity: number of physician-owners, JV structure, and out-of-network exposure. We confirm the exact fee on a free discovery call.
We can do that. When the client and the appraiser agree in advance on the methods and procedures to be used, the engagement is called a calculation engagement, and it produces a calculated value rather than an independent conclusion of value. It is a legitimate tool, common when a buy-sell or operating agreement prescribes a valuation formula the parties want applied. On the discovery call we will talk through what you need the number for and tell you honestly whether a calculation fits the purpose or whether it calls for a full appraisal.
Yes. Valuation engagements are handled remotely from our California office. We work from your financials, interview you by phone or video, and send you the finished report. We have completed valuations in more than 35 states, and an on-site visit can be arranged when an engagement calls for it. Very few appraisers anywhere focus on ambulatory surgery centers, so working with an ASC specialist remotely often serves you better than hiring a generalist nearby.
Don’t Price Your ASC Off a Rumor
Get a certified valuation built on payer mix, concentration, and real comps.
All inquiries are kept strictly confidential.