How can I finance construction for my outpatient surgery center in 2026?

Yes—an ASC can get construction financing with a 7(a) SBA loan if you have 24+ months in business, FICO ≥620, and 70%+ occupancy.

See if you qualify now — no credit‑score hit.

The specifics

An SBA 7(a) construction loan for an outpatient surgery center typically requires:

• Operating history of 24 months or more
• FICO of 620 or higher (fair‑credit) or 740 + (good‑credit)
• Occupancy projected at 70% or more
• Debt‑service coverage ratio (DSCR) of at least 1.25×
• Debt‑to‑income must not exceed 40% of gross monthly revenue
• Down payment of 15 – 20% of the loan principal
• Loan term 48 – 84 months
• APR 8 – 10% for good‑credit applicants and 10 – 13% for fair‑credit borrowers, with a 1 – 3% origination fee.

Typical construction projects for a full‑service ASC average $1.8 million this year, according to the ASC News 2026 outlook ascnews.com. MedPAC’s 2026 report confirms the average capital outlay ranges from $1.7 million to $1.9 million medpac.gov. With a 15% down payment, the loan would be roughly $1.5 million; at an 8% APR over 60 months, the monthly payment would be about $23,000, representing ~9% of a $50,000 gross monthly revenue—well within the SBA’s recommended 8–12% ceiling ascassociation.org.

Qualification & edge cases

If your ASC has less than 24 months of history, or a FICO below 620, you’ll likely need to turn to private‑lender or lease‑purchase options. Private lenders such as Live Oak Bank offer construction financing with APRs of 15–18% and often require a personal guarantee liveoak.bank. For businesses with occupancy under 70%, the SBA can still approve but at a premium, and you might need additional collateral. If projected revenue falls below the 40% debt‑to‑income threshold, consider securing a short‑term working‑capital line or pursuing a phased‑construction approach to demonstrate stronger cash flow. For comparison, MRI financing in Huntington Beach shows how equipment‑specific loans can be structured alongside real‑estate financing MRI financing in Huntington Beach.

Background & how it works

The ASC sector is expanding fast: the 2026 MedPAC report notes that outpatient centers contributed over 12% of total surgical revenue and are projected to grow by 5% annually, creating a stable debt‑service base. CMS’s 2026 OPPS final rule cms.gov provides higher reimbursement rates for many procedures, boosting cash flow. Medical equipment financing continues to grow, with the market expected to exceed $400 billion by 2035 according to precedent research precedenceresearch.com. The SBA’s construction loan is secured by both the facility and the equipment you purchase, and with the 2026 Section 179 deduction limit of $1,220,000 irs.gov, you can claim a full tax write‑down on new equipment. You can run an affordability calculator to see how much you can borrow and check out our real‑estate‑construction guide to plan your build. Additionally, dust‑off orthopedic equipment strategies are illustrated in the dental practice financing guide for Boise, showing how practice owners can secure capital for both construction and equipment Dental practice financing in Boise.

Bottom line

If your ASC meets the 24‑month history, 620+ FICO, 70%+ occupancy, and 1.25× DSCR criteria, you can secure an SBA 7(a) construction loan in 30–45 days with competitive rates. Quick pre‑qualification is available in just 2 minutes, and there’s no credit impact.

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

• crestmontcapital.com
• ascnews.com
• medpac.gov
• ascassociation.org
• liveoak.bank