Ambulatory Surgery Center Nurse Salary 2026: What ASC RNs Earn in a $45 Billion Industry That's Reshaping Surgical Care

By NurseCompensation Research Team · 2026-06-20 · 11 min read

ASC nurses earn approximately $40-$48/hour ($84,000-$108,000 annually) in a sector that has grown to 12,294 facilities and $45.6 billion in market value. Here is the full compensation picture for nurses working outside the traditional hospital OR.

Ambulatory Surgery Center Nursing: The Compensation Data

Ambulatory Surgery Centers represent one of healthcare's most significant structural shifts — moving surgical volume out of hospitals and into outpatient facilities that operate with lower overhead, shorter patient stays, and different staffing models. For nurses, this means different compensation structures, schedules, and career tradeoffs.

The ASC Industry in 2026

Before examining nurse pay, understanding the scale of this sector matters:

• Total ASCs in the U.S.: 12,294 (Q2 2025, ASC Data)
• Medicare-certified ASCs: 6,504
• Non-Medicare-certified: 5,790
• Market value: $45.6 billion (2025)
• Projected growth: $72.7 billion by 2033 (Grand View Research), CAGR of 6.1%
• Average ORs per Medicare-certified ASC: 2.89

For comparison, in 1981, hospital-owned facilities handled 93% of all surgical procedures. By 2005, that had dropped to 45%. The shift continues to accelerate.

ASC Nurse Compensation

Registered nurses working in ambulatory surgery centers earn:

• Glassdoor average (2026): $108,093 total compensation ($94,145 base pay)
• Vivian Health average hourly: $40.48/hour ($84,198 annualized)
• Salary.com (preop/PACU): $64,669 (lower-cost markets)
• National average range: $75,000-$110,000 depending on geography, role, and experience
• Compared to nursing national average: 6-21% below acute hospital OR nurse pay

The gap between ASC and hospital OR nurse pay exists for specific structural reasons — but so do compensating advantages.

ASC vs. Hospital OR Nurse Compensation

The schedule tradeoff is the primary value proposition. ASC nurses overwhelmingly cite predictable Monday-Friday hours, no nights, and minimal call as the reason they accept lower base pay.

Roles Within an ASC

ASC nursing encompasses several distinct positions:

Pre-operative nurse:

• Patient assessment, IV starts, consent verification
• $38-$46/hour

Circulating nurse (intraoperative):

• Highest-paid floor RN role in most ASCs
• $42-$52/hour
• Requires perioperative training and CNOR preferred

PACU/Recovery nurse:

• Post-anesthesia care
• $40-$48/hour
• CPAN certification valued

Clinical Director/Nurse Manager (ASC):

• $90,000-$130,000 salary
• Often a working manager role (scrubs in when needed)
• Smaller span of control than hospital equivalents

Ownership Structure Impacts Pay

ASC ownership type significantly affects nurse compensation:

Physician-owned (majority of ASCs):

• Tend to pay market rate or slightly below
• May offer profit-sharing or bonus structures
• Smaller teams, closer physician-nurse relationships
• 51.2% of ASCs are single-specialty physician-owned

Hospital-affiliated/joint ventures:

• Often pay hospital-scale wages (highest ASC wages)
• Better benefits packages
• More structured advancement

Corporate-owned (USPI/Tenet, SCA Health/Optum, AmSurg/Envision):

• Standardized pay bands
• More structured benefits
• Career mobility across facilities
• SCA Health (now part of Optum) operates one of the largest networks

CMS Payment Updates Impact Nurse Wages

ASC reimbursement directly affects what facilities can pay staff:

• CY 2024 market basket increase: 3.1% (ASC payment rate update)
• CY 2026 proposed update: 2.4%
• Medicare Payment Advisory Commission (MedPAC): Noted in March 2026 report that ASC volumes and FFS Medicare payments rose substantially in 2024
• MedPAC recommendation: ASCs should submit cost data (currently not required), which could lead to payment methodology changes

When CMS increases ASC payment rates, facilities have more revenue to allocate to staff wages. The 3.1% increase in 2024 was among the highest in recent years.

The Procedures Driving ASC Growth (and Nurse Demand)

The shift of higher-acuity procedures into ASCs is expanding the need for experienced nurses:

• Orthopedics: Total joint replacements (knee, hip) — the largest growth driver
• Cardiovascular: Cardiac catheterization, certain structural heart procedures
• Spine: Laminectomies, discectomies, even some fusions
• Ophthalmology: Highest volume (but lower nursing intensity)
• GI/Endoscopy: Colonoscopy, upper endoscopy (high volume, lower acuity)

As more complex procedures move to ASCs, facilities are increasingly willing to pay premiums for nurses with ICU or high-acuity backgrounds.

Geographic Variation

ASC concentration varies dramatically by state (MedPAC 2026 data):

• Highest ASC density: Maryland (36+ per 100,000 Part B beneficiaries)
• Lowest ASC density: DC, West Virginia, Vermont (3 or fewer per 100,000)
• States with most ASCs: California, Texas, Florida, Georgia

Higher ASC density generally correlates with more competitive nurse wages in the outpatient surgery sector.

When ASC Nursing Pays More Than Expected

1. No overtime penalty for the employer means some ASCs build "bonus hours" into slow periods rather than sending nurses home
2. Production bonuses — some physician-owned ASCs offer quarterly bonuses tied to case volume
3. Per diem ASC work — $50-$65/hour without benefits
4. Multi-site coverage — nurses willing to float between ASCs in a network often earn $3-$5/hour more
5. CNOR/CPAN certification — $2,000-$5,000 annual premium in most ASCs

The Career Math

For a hospital OR nurse considering ASC work:

• You may lose $10,000-$25,000 in annual gross pay
• You gain M-F schedule, no nights, minimal call
• Value of schedule (childcare savings, quality of life): Highly individual but nurses frequently cite $15,000-$20,000 in reduced childcare costs alone

For a new grad considering ASC vs. hospital:

• Most ASCs require 1-2 years acute care OR experience before hiring
• The hospital-first path remains the standard pipeline
• Some large ASC networks (SCA Health, USPI) now offer perioperative residency programs

Sources

• ASC Data, Q2 2025 Industry Overview Report
• Grand View Research, U.S. Ambulatory Surgery Center Market Size Report 2025-2033
• Medicare Payment Advisory Commission (MedPAC), March 2026 Report to Congress, Chapter 11
• CMS, Ambulatory Surgical Center Payment System CY 2026 Proposed Rule
• Glassdoor, ASC Registered Nurse Salary Data 2026
• Vivian Health, Outpatient Surgery Nurse Salary (May 2025)
• Becker's ASC Review, ASC Nurse Pay Trends 2025
• Dialog Health, Latest Ambulatory Surgery Center Statistics 2025
• ASC Association, Salary & Benefits Survey