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.
San Francisco · Northern California
ASC Valuation in San Francisco
Bay Area surgery centers are scarce, expensive to replicate, and reimbursed at premium rates — three reasons their valuations reward rigor.
- CVA Certified NACVA Valuation Analyst
- USPAP Compliant Appraisal Reports
- 500+ Valuations 45+ specialties
Scarcity Economics in the Bay Area
San Francisco and the surrounding Bay Area host fewer surgery centers per capita than Southern California — real estate costs, buildout economics, and system dominance have constrained supply for decades. The centers that exist operate with premium commercial rates and high replacement cost, which gives Bay Area ASC interests a scarcity floor most markets lack. It also means thin local comp sets: valuing a Bay Area center off Southern California multiples misses the structural differences in both directions. Our ASC methodology handles it with income-approach discipline — normalized distributable cash flow at risk rates reflecting the actual center — and comps adjusted for market structure, not just specialty.
Bay Area Specifics in the Analysis
- Replacement cost is a live number. Where buildout costs are extreme, the asset approach stops being a formality — Bay Area centers often carry meaningful floor value from licensure and physical plant alone.
- High rates, concentrated payers. Premium commercial reimbursement with employer-driven payer concentration; durability analysis examines contract terms and the regional benefits cycle.
- System-relationship gravity. UCSF and Sutter ambulatory strategies shape every center's competitive position and eventual buyer list; JV terms, where present, get read line by line.
- Physician succession pressure. Bay Area housing costs complicate surgeon recruitment; centers with credible succession pipelines deserve — and get — different risk rates than those without.
Engagements
Buy-ins and redemptions; pre-sale valuations (continuing into SF ASC brokerage); divorce and shareholder dispute interests; lender appraisals — all USPAP-compliant, 1–2 week turnaround from complete documents.
Three Engagement Tiers, One Standard
We scope the right tier on your discovery call, so you never pay for more report than your purpose requires.
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.
Valuations by Purpose
The purpose of a valuation changes the standard of value, the report depth, and sometimes the conclusion itself. Choose your situation:
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 moreA clear, three-step process
- 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.
Scarce asset. Thin comps. Real rigor required.
Bay Area ASC valuations done the disciplined way.
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
Frequently asked questions
As a concentration-and-succession risk premium in the discount rate — quantified, not vibes. Centers that pair strong earnings with credible recruitment evidence (pipeline, housing-adjusted packages, academic relationships) defend materially better values.
Sometimes — scarcity, rates, and replacement cost argue up; succession risk and payer concentration argue down. The reconciliation is center-specific, which is precisely why headline multiples mislead here more than anywhere.
Yes — enterprise value, then interest-level conclusions under your operating agreement with documented discounts. Multi-partner admissions are an efficient single engagement.
More in San Francisco and statewide
ASC Valuation — Statewide Our full California service page San Francisco Overview All services in San Francisco Medical Practice Valuation in San Francisco Certified opinions of value with high-cost-market normalization done right. Sell Your Medical Practice in San Francisco Confidential sales into a market where scarce independents command attention.
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