Ambulatory Surgery Center (ASC) Accounting
Fairlight Accounting does the bookkeeping, payroll, and tax for ambulatory surgery centers — facilities that live or die on case-level economics. Facility fees, implant costs, OR minutes, and owner distributions all get accounted at the level decisions are made: the case.
✓ Books closed by the 15th ✓ Fixed monthly fees ✓ cross-border tax team
The numbers problems surgery centers actually have
A case is the unit of profit, but books track months
Facility-fee reimbursement minus implants, supplies, and staffed minutes is the real margin — and it varies wildly by specialty and payer. Monthly blur hides money-losing case types.
Implants and high-cost supplies decide margins
A spine case's hardware can exceed its entire reimbursement if carve-outs aren't negotiated and tracked; implant invoices must match to cases, not to months.
Multi-specialty scheduling competes for OR time
Ortho, GI, ophtho, and pain cases produce very different revenue per OR minute; block allocation deserves that data.
Physician-owner distributions need clean waterfalls
Surgeon-owners expect distributions computed on books they trust, with per-ownership-class clarity and tax reporting to match.
What Fairlight takes off your plate
The core engagement is the same discipline we run for every client — monthly close by the 15th, payroll, tax, and CFO-level reporting — built around how surgery centers actually make and spend money.
- Case-level costing: facility fee, implants, supplies, and staffed minutes per case
- Implant and supply invoice matching with carve-out tracking
- Revenue per OR minute by specialty for block decisions
- Monthly close by the 15th; distribution waterfalls and K-1 support
- Payroll, business tax prep, and CFO reporting for equipment and expansion
The three numbers we keep in front of you
No fabricated benchmarks — your own numbers, measured the same way every month, so trends are real and decisions have a floor under them.
Margin per case by specialty
the number that should drive block allocation
Implant cost ratio
hardware against facility fee, case by case — carve-out discipline
Revenue per OR minute
throughput economics across specialties
Revenue cycle & tax notes
Revenue & reconciliation
Facility-fee remittances reconcile per case against the surgical log, implant invoices match to the same cases, and out-of-network or carve-out payments get tracked where they're negotiated.
Tax & entity
Multi-owner ASC structures mean partnership allocations, K-1s, and distribution planning alongside equipment depreciation — we keep the entity and owner layers coordinated.
Simple, published pricing
Bookkeeping from $310/mo · All-In-One (books + tax + advisory) from $1,955/mo. Every fee is quoted and fixed in writing before any work begins.
Surgery Centers accounting FAQs
Can you really cost every case?
To the practical level that matters: implants and trackable supplies matched per case, staffing applied per OR minute, overhead allocated transparently. Case-type margin emerges quickly and reshapes scheduling conversations.
Who handles our K-1s and distributions?
We do — the monthly books feed distribution waterfalls owners can verify, and the same records produce the partnership return and K-1s without a year-end scramble.
What does it cost?
Bookkeeping from $310/month; All-In-One (books + tax + advisory) from $1,955/month. Exact fee fixed in writing after a short call.
Related healthcare specialties
Get the financial side handled
A free 15-minute call — bring your current setup, leave knowing exactly what clean, specialty-aware books look like for surgery centers.
The content on this page is for informational purposes only and does not constitute professional tax advice. Accounting and tax considerations for healthcare practices depend on individual facts and circumstances and are subject to change. See our full legal disclaimer.