How do I get an ASC construction loan in 2026?

How do I get an ASC construction loan in 2026?

Yes—ASC owners can get a 2026 construction loan with a 740+ FICO, 12‑month revenue track, and ≥70% occupancy.

Check rates

The specifics

Construction loans for outpatient surgery centers cover land acquisition, site work, building, and interior build‑out. According to BuilderMuse, the average APR in 2026 is about 8.4%, with loan‑to‑value (LTV) caps reaching 90% for qualified ASCs. Lenders’ll often require a 15–20% down payment, a debt‑service coverage ratio (DSCR) of 1.25×, and a minimum occupancy of 70% to secure the best terms. Draws are tied to construction milestones—land purchase, foundation, framing, and interior fit‑out—so you retain paid‑in‑full control without a single large upfront outflow.

The approval window typically spans 30–45 days once you submit revenue statements, operating budgets, and a detailed construction plan. For a quick estimate, use the affordability calculator and enter your projected monthly gross revenue.

In practice, ASC borrowers often pair the construction loan with a short‑term bridge line, then refinance into a permanent operating loan once the facility is up and running. Lenders may also consider refinancing the construction loan into an SBA‑style 7(a) facility if you meet the 1.25× DSCR and LTV ≤90% criteria.

Qualification & edge cases

• Credit: A 740+ FICO ensures the standard 8.4% APR. Fair‑credit buyers (620–679) typically receive a 3–5% higher APR CoFi Lending.
• Business age: ASCs operating fewer than 12 months or with less than 70% occupancy risk higher down payments, personal guarantees, or collateral‑based APR reductions of 1–3%.
• Revenue history: At least 12 months of verifiable revenue is required to demonstrate cash flow sustainability.
• Collateral: Pledging the construction site or future revenue streams can lower your rate by up to 3%.

If your metrics fall short, consider a second‑chance lender designed for newer ASCs, or boost your application with a co‑sponsor or guarantor.

Background & how it works

The ASC construction financing process mirrors commercial real‑estate borrowing: lenders first assess your financial health, then establish a commitment letter for the projected project cost. Loan amounts are typically disbursed in stages tied to construction milestones, and the lender maintains control over the draw schedule via a construction master service agreement. Once the facility is operational, borrowers may refinance into a long‑term ASC loan with amortization of 10–20 years, or structure the deal under an SBA 7(a) program that offers favorable terms for qualified small businesses.

Construction financing remains a key driver of ASC expansion, especially as the market size is projected to hit $80.6 billion by 2035 Grand View Research. Lenders are increasingly tailoring draw schedules and LTV structures to match each ASC’s revenue profile, keeping construction costs manageable while preserving capital for equipment upgrades.

Bottom line

ASC owners with solid credit, steady revenue, and ≥70% occupancy can secure a 2026 construction loan at roughly 8.4% APR in 30–45 days. See your rate now.

Disclosures

This content is for educational purposes only and is not financial advice. surgerycenterfinancing.com may receive compensation from partner lenders, which may influence which products are featured. Rates, terms, and availability vary by lender and applicant qualifications.

Sources

• BuilderMuse
• CoFi Lending
• Grand View Research
• TrendX Insights