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Full Year 2024 Results

Full year revenues for 2024 increased 13.5% to $3.1 billion as compared to $2.7 billion for the full year 2023. Same-facility revenues for the full year 2024 increased 8.0% as compared to the same period in prior year, with a 4.0% increase in revenue per case and a 3.9% increase in same-facility cases. For the full year 2024, the Company’s Adjusted EBITDA was $508.2 million, compared to $438.1 million in 2023.

Liquidity

Surgery Partners had cash and cash equivalents of $269.5 million and $501.5 million of borrowing capacity under its revolving credit facility as of December 31, 2024. Cash flows from operating activities was $111.4 million for the fourth quarter of 2024, compared to $62.6 million for the same period in 2023. The year-over-year change is due to operational growth and working capital improvements.

Full year 2024 operating cash flows were $300.1 million compared to $293.8 million in 2023.

The Company’s ratio of total net debt to EBITDA, as calculated under the Company’s credit agreement, was approximately 3.7x at the end of the fourth quarter of 2024.

2025 Outlook

The Company projects full year 2025 revenue to be in the range of $3.30 billion to $3.45 billion and Adjusted EBITDA to be in the range of $555 million to $565 million. Our guidance reflects approximately $11 million of Adjusted EBITDA related to divestitures that occurred late in the fourth quarter of 2024.

Conference Call Information

Surgery Partners will hold a conference call today, March 3, 2025 at 8:30 a.m. (Eastern Time). The conference call can be accessed live over the phone by dialing 1-877-451-6152, or for international callers, 1-201-389-0879. A replay will be available three hours after the call and can be accessed by dialing 1-844-512-2921, or for international callers, 1-412-317-6671. The passcode for the live call and the replay is 13751533. The replay will be available until March 17, 2025.

Interested investors and other parties may also listen to a simultaneous webcast of the conference call by logging onto the Investor Relations section of the Company's website at www.surgerypartners.com. The replay will also be available on this same website for a limited time following the call.

To learn more about Surgery Partners, please visit the Company's website at www.surgerypartners.com. Surgery Partners uses its website as a channel of distribution for material Company information. Financial and other material information regarding Surgery Partners is routinely posted on the Company's website and is readily accessible.

About Surgery Partners

Headquartered in Brentwood, Tennessee, Surgery Partners is a leading healthcare services company with a differentiated outpatient delivery model focused on providing high quality, cost effective solutions for surgical and related ancillary care in support of both patients and physicians. Founded in 2004, Surgery Partners is one of the largest and fastest growing surgical services businesses in the country, with more than 200 locations in 31 states, including ambulatory surgery centers, surgical hospitals, multi-specialty physician practices and urgent care facilities. For additional information, visit www.surgerypartners.com.

Forward-Looking Statements

This press release contains forward-looking statements, including those regarding growth, our anticipated operating results for future periods and other similar statements. These statements can be identified by the use of words such as "believes," "anticipates," "expects," "intends," "plans," "continues," "estimates," "predicts," "projects," "forecasts," "may," "could," and similar expressions. All forward-looking statements are based on current expectations and beliefs as of the date of this release and are subject to risks, uncertainties and other factors that may cause actual results to differ materially from the expectations discussed in, or implied by, the forward-looking statements. Many of these factors are beyond our ability to control or predict including, without limitation, reductions in payments from government health care programs and private insurance payors, such as health maintenance organizations, preferred provider organizations, and other managed care organizations and employers; our ability to contract with private insurance payors; changes in our payor mix or surgical case mix; failure to maintain or develop relationships with physicians on beneficial or favorable terms, or at all; the impact of payor controls designed to reduce the number of surgical procedures; our efforts to integrate operations of acquired or developed businesses and surgical facilities, attract new physician partners, or acquire additional surgical facilities; supply chain issues, including shortages or quality control issues with surgery-related products, equipment and medical supplies; competition for physicians, nurses, strategic relationships, acquisitions and managed care contracts; our ability to attract and retain qualified health care professionals; our ability to enforce non-compete restrictions against our physicians; our ability to manage material liabilities whether known or unknown incurred as a result of acquiring or operating surgical facilities; the impact of future legislation and other health care regulatory reform actions, and the effect of that legislation and other regulatory actions on our business; our ability to comply with current health care laws and regulations; the outcome of legal and regulatory proceedings that have been or may be brought against us; the impact of cybersecurity attacks or intrusions, changes in the regulatory, economic and other conditions of the states where our surgical facilities are located; our indebtedness; the social and economic impact of a pandemic, epidemic or outbreak of a contagious disease on our business; and the risks and uncertainties identified and discussed from time to time in the Company’s reports filed with the SEC, including in Item 1A under the heading "Risk Factors" in the Company’s Annual Report on Form 10-K for the year ended December 31, 2023 and other reports filed with the SEC. Except as required by law, the Company undertakes no obligation to revise or update publicly any forward-looking statements to reflect events or circumstances after the date of this report, or to reflect the occurrence of unanticipated events or circumstances.

Use of Non-GAAP Financial Measures

In addition to the results prepared in accordance with generally accepted accounting principles in the United States ("GAAP") provided throughout this press release, Surgery Partners has presented the following non-GAAP financial measures: Adjusted net income (loss) attributable to common stockholders, Adjusted net income (loss) per share attributable to common stockholders, Adjusted EBITDA, and Adjusted EBITDA related to unconsolidated affiliates, which exclude various items detailed in the "Reconciliation of Non-GAAP Financial Measures" below.

These non-GAAP financial measures are not intended to replace financial performance measures determined in accordance with GAAP. Rather, they are presented as supplemental measures of the Company's performance that management believes may enhance the evaluation of the Company's ongoing operating results. These non-GAAP financial measures are not presented in accordance with GAAP, and the Company’s computation of these non-GAAP financial measures may vary from similar measures used by other companies. These measures have limitations as an analytical tool and should not be considered in isolation or as a substitute or alternative to revenue, net income or loss, operating income or loss, cash flows from operating activities, total indebtedness or any other measures of operating performance, liquidity or indebtedness derived in accordance with GAAP.

_{⁽¹⁾  The impact of potentially dilutive securities for all periods was not considered because the effect would be anti-dilutive.}

_{⁽¹⁾  A reconciliation of these non-GAAP financial measures appears below. 
⁽²⁾  Defined as Adjusted EBITDA as a % of Revenues.}

_{⁽¹⁾  Same-facility information includes cases and revenues from our consolidated and non-consolidated surgical facilities (excluding facilities acquired in new markets or divested during the current and prior periods).}

_{⁽¹⁾  This amount includes transaction and integration costs of $34.0 million and $24.4 million for the three months ended December 31, 2024 and 2023, respectively. The $34.0 million for the three months ended December 31, 2024, includes approximately $7.9 million of costs associated with evaluating strategic alternatives. This amount further includes start-up costs related to de novo surgical facilities of $2.8 million and $1.7 million for the three months ended December 31, 2024 and 2023, respectively.
This amount includes transaction and integration costs of $100.1 million and $61.7 million for the year ended December 31, 2024 and 2023, respectively. The $100.1 million for the year ended December 31, 2024, includes approximately $10.7 million of costs associated with evaluating strategic alternatives. This amount further includes start-up costs related to de novo surgical facilities of $7.9 million and $3.2 million for the year ended December 31, 2024 and 2023, respectively. 
⁽²⁾  This amount includes a litigation settlement loss of $2.5 million for the three months ended December 31, and 2023. This amount also includes other litigation costs of $1.6 million and $1.1 million for the three months ended December 31, 2024 and 2023, respectively.
This amount includes a litigation settlements gain of $0.8 million and a loss of $10.6 million for the year ended December 31, 2024 and 2023, respectively. This amount also includes other litigation costs of $3.9 million and $2.5 million for the year ended December 31, 2024 and 2023, respectively. Additionally, the year ended December 31, 2023 includes $4.4 million related to the impact of recent changes in Florida law regarding the use of letters of protection. 
⁽³⁾  For the three months ended December 31, 2024 and 2023, this amount includes fair value changes of undesignated derivatives.
This amount includes fair value changes of undesignated derivatives for the years ended December 31, 2024 and 2023. 
⁽⁴⁾  We use Adjusted EBITDA as a measure of financial performance. Adjusted EBITDA is a key measure used by management to assess operating performance, make business decisions and allocate resources. Non-controlling interests represent the interests of third parties, such as physicians, and in some cases, healthcare systems that own an interest in surgical facilities that we consolidate for financial reporting purposes. We believe that it is helpful to investors to present Adjusted EBITDA as defined above because it excludes the portion of net income attributable to these third-party interests and clarifies for investors our portion of Adjusted EBITDA generated by our surgical facilities and other operations. Adjusted EBITDA is not a measurement of financial performance under GAAP and should not be considered in isolation or as a substitute for net income, operating income or any other measure calculated in accordance with GAAP. The items excluded from Adjusted EBITDA are significant components in understanding and evaluating our financial performance. We believe such adjustments are appropriate, as the magnitude and frequency of such items can vary significantly and are not related to the assessment of normal operating performance. Our calculation of Adjusted EBITDA may not be comparable to similarly titled measures reported by other companies.}

The following table provides supplemental information for Adjusted EBITDA related to unconsolidated affiliates:

_{⁽¹⁾  Includes management and administrative service fees derived from the non-consolidated facilities that the Company accounts for under the equity method and management of surgical facilities in which it does not own an interest. Management fee revenues are included in Revenues on the Consolidated Statements of Operations. 
⁽²⁾  Included as a component of income before income taxes in the Adjusted EBITDA reconciliation table above. 
⁽³⁾  Start-up costs related to de novo surgical facilities are included in Transaction, integration and acquisition costs in the Adjusted EBITDA reconciliation table above.}

From time to time, the Company incurs certain non-recurring gains or losses that are normally non-operational in nature and management does not consider relevant in assessing its ongoing operating performance. When significant, Surgery Partners’ management and the Company's Board of Directors typically exclude these gains or losses when evaluating the Company’s operating performance and in certain instances when evaluating performance for incentive compensation purposes. Additionally, management believes that certain investors and equity analysts exclude these or similar items when evaluating the Company’s current or future operating performance and in making informed investment decisions regarding the Company. Accordingly, the Company provides adjusted net income attributable to common stockholders and adjusted net income per share attributable to common stockholders as supplements to the comparable GAAP financial measures. Adjusted net income attributable to common stockholders and adjusted net income per share attributable to common stockholders should not be considered measures of financial performance under GAAP, and the items excluded from such measures are significant components in understanding and assessing financial performance. These measures should not be considered in isolation or as an alternative to the comparable GAAP measures as presented in the consolidated financial statements.

The following table reconciles net income as reflected in the consolidated statements of operations to adjusted net income attributable to common stockholders used to calculate adjusted net income per share attributable to common stockholders:

_{⁽¹⁾  This amount includes the impact of changes in the valuation allowance on deferred tax assets as of December 31, 2024, related to technical accounting requirements. The Company made income tax payments of $1.6 million and $1.4 million for the years ended December 31, 2024 and 2023, respectively.   In each of these periods the income tax payments related to states in which the Company does not have a NOL to offset taxable income. During the years ended December 31, 2024 and 2023, the Company made no federal income tax payments due to the utilization of its NOL carryforwards.}

Contact

Surgery Partners Investor Relations
(615) 234-8940
IR@surgerypartners.com