Surgery Partners' same-facility cases grew 0.3% in Q2. Price did the rest.

Surgery Partners’ same-facility surgical cases grew 0.3% in the second quarter of 2026. Same-facility revenue over the same period grew 5.0%. Nearly all of the gap is price and acuity: revenue per case rose 4.8%, according to the second-quarter results the company filed on August 10.

Consolidated revenue rose 2.7% to $848.9 million from $826.2 million a year earlier. Adjusted EBITDA fell to $125.2 million from $129.0 million. Net loss attributable to Surgery Partners was $15.0 million for the quarter.

That is the second consecutive quarter in which revenue grew and adjusted EBITDA did not. In the first quarter, as we reported, revenue rose 4.5% to $810.9 million while adjusted EBITDA slipped to $102.3 million from $103.9 million. Year to date, revenue is up 3.6% to $1,659.8 million and adjusted EBITDA is $227.5 million against $232.9 million in the same period last year. The year-to-date same-facility split runs the same direction as the quarter — 4.0% revenue per case, 0.8% cases.

Cash generation moved with it. Operating cash flow was $59.3 million in the quarter, down from $81.3 million a year earlier; year to date it is $71.0 million against $87.3 million. Net debt to EBITDA, as calculated under the company’s credit agreement, was approximately 4.4x at quarter end, up from about 4.3x at the end of the first quarter. The company reported $216.7 million of cash and $617.8 million of borrowing capacity under its revolver as of June 30.

Guidance was reaffirmed: 2026 revenue of $3.35 billion to $3.45 billion and adjusted EBITDA of at least $530 million, explicitly “excluding the impact of the recently disclosed pending divestiture of our facilities in Idaho Falls, Idaho.” Holding that line requires a back half unlike the first. Against $227.5 million of adjusted EBITDA booked through June, the low end of the full-year target leaves about $302.5 million to earn in the final two quarters — roughly a third more than the company produced in the first two. On the revenue line, the range implies $1.69 billion to $1.79 billion in the back half against $1.66 billion booked so far.

CEO Eric Evans said the quarter “reflects disciplined execution against our key strategic priorities to support a return to growth and reinforces our conviction in our short stay surgical platform.” He called the Idaho Falls sale to Intermountain Health “a key achievement” and “an important step forward in our portfolio optimization strategy,” saying the transaction “will further strengthen our financial position, through improved cash conversion and deleveraging.” It remains subject to closing conditions, including physician member and governing board approvals.

For anyone reading Surgery Partners as a proxy for the sector — more than 200 locations in 30 states, per the company — the useful signal is the composition, not the total. Revenue per case near 5% growth says the case mix is moving toward higher-acuity work and that rates are holding. A 0.3% case count says the growth did not come from doing more operations in the facilities the company already owned.