Plastic Surgery Practice Valuation (2026 Benchmarks)
Plastic surgery has become one of the fastest-growing segments in physician services M&A. Compared with specialties tied closely to Medicare or Medicaid, plastic surgery benefits from a strong cash-pay and commercial payor base, creating margin stability and multiples that sit between traditional physician groups and medical spa operators.
Transaction volume surged from 5 deals in 2022 to 27 in 2024, reflecting growing buyer appetite for consumer-facing, cash-pay healthcare platforms. Private equity continues to chase practices with diversified revenue, multi-provider depth, and scalable ancillary services.
Key Takeaways:
Plastic surgery transaction volume rose from 5 deals in 2022 to 27 in 2024, making it a top-quartile category within physician services M&A.
Cash-pay aesthetics plus commercial payer mix stabilize margins and create a valuation midpoint between physician groups and medical spas.
Platform multiples sit at 9–12× EBITDA, while cosmetic-heavy practices can reach 12–15×+ in rare, multi-state cases.
Multi-provider leverage, ancillary revenue, and facility ownership are the premium drivers private equity buyers reward the most.
Single-surgeon concentration, compliance gaps, and weak add-backs remain the most common valuation detractors.
2026 Valuation Benchmarks: Plastic Surgery
The 2026 benchmark range reflects a hybrid valuation profile: platforms trade closer to traditional physician multiples, while aesthetics-focused add-ons bookend the upside.
| 2026 Plastic Surgery Valuation Ranges | ||||
|---|---|---|---|---|
| Category | Platform (EV / EBITDA) | Add-On (EV / EBITDA) | Typical Revenue Multiple | Notes |
| Plastic Surgery | 9–12× | 5–9× | ~1.0–2.5× | Cash-pay aesthetics, multi-provider leverage, strong commercial revenue mix |
Source: works cited combined with guidance from internal bankers, based generally on knowledge and experience. Actual pricing varies with each transaction based on many factors. Intended for educational purposes only and not a guarantee of any outcome.
Market Momentum: Plastic Surgery Transaction Trends
According to the VMG Health 2025 M&A Report, plastic surgery transaction volume rose from 5 deals in 2022 to 6 in 2023 and then to 27 in 2024, a 440% increase over two years.
This acceleration places plastic surgery among the “large movers” alongside cardiology. Private equity is drawn to cash-pay, consumer-facing models where reimbursement risk is offset by elective services.
The blend of insurance-based reconstructive procedures and elective aesthetics creates diversified revenue appealing to sponsors seeking recession-resistant earnings.
Valuation Benchmarks: Where Plastic Surgery Practices Price
Plastic surgery practices fall between traditional physician group multiples and medical spa/aesthetics multiples depending on their revenue mix.
Traditional Physician Group Range
For plastic surgery practices operating primarily on insurance reimbursement (reconstructive procedures, post-mastectomy breast reconstruction, hand surgery, burn reconstruction), valuations generally follow physician medical group norms:
Small groups (<$1M EBITDA): ~5×–6× EBITDA
Mid-size groups ($1M–$3M EBITDA): ~5×–9× EBITDA
Emerging platforms ($3M–$7M EBITDA): ~7×–11× EBITDA
Established platforms ($7M+ EBITDA): ~9×–12×+ EBITDA
The $3 million EBITDA threshold remains a critical inflection point, shifting the buyer pool from “local add-on” to “platform-ready,” where multiples can increase by 2–4 turns.
Aesthetic/Cash-Pay Component Premium
Practices with significant aesthetic revenue (body contouring, facial rejuvenation, injectables, non-surgical procedures) often command higher multiples:
Small practices (<$1M EBITDA): ~3×–6× EBITDA
Mid-size practices ($1M–$3M EBITDA): ~5×–8× EBITDA
Scaled, multi-site operations ($3M+ EBITDA): ~7×–12× EBITDA
Elite brands with multi-state footprint: 12×–15×+ EBITDA (rare outliers)
For plastic surgery practices that blend reconstructive and aesthetic services, the aesthetic revenue component can act as a multiple enhancer, adding 1–2 turns to what a purely insurance-based practice might command.
Value Drivers: What Pushes Plastic Surgery Practices to the High End
Certain operational characteristics consistently earn premium multiples.
| Value Driver | Why It Commands a Premium | Examples / Indicators |
|---|---|---|
| Revenue Diversification: Aesthetic + Reconstructive | Diversified demand creates downside protection; buyers reward mix of cash-pay and insurance-based services. | Insurance reconstructive + elective aesthetic volume; consistent patient flow |
| Commercial Payer Mix | Higher commercial/cash mix lowers denials and stabilizes cash collections. | ≥70% commercial with minimal Medicaid; varied payor contracts |
| Multi-Provider Leverage | Reduces key-person risk and supports scalability for platform buyers. | 2+ surgeons, APPs, documented succession, centralized onboarding |
| Ancillary Revenue Streams | Ancillaries enlarge EBITDA that often trades at higher multiples. | In-house ORs, med spa, skincare retail, post-op recovery services |
| Accreditation & Facility Ownership | Owned, accredited facilities improve control, margins, and defensibility. | AAAASF/state-licensed ORs, ASC ownership, facility investments |
| Brand Equity & Marketing | Strong marketing converts demand efficiently and supports premium pricing. | Digital engine, CRM, membership programs, multi-market brand |
| Geographic Density & Expansion Potential | Clusters of locations unlock shared services and cross-sell, attracting higher bids. | Presence in FL/TX/CA, proven roll-up infrastructure |
Valuation Detractors: Common Discounts in Plastic Surgery Transactions
Certain red flags consistently depress valuations.
Single-Surgeon Concentration
Over 70% of revenue tied to one surgeon shrinks the buyer pool and forces add-on multiples, as sponsors seek scalable manpower depth.
Flat or Declining Case Volumes
Buyers underwrite growth, so stagnation or slide in case volumes can shave several turns off valuation conversations.
Weak or Unvetted Add-Backs
Only defensible adjustments survive diligence. Unsupported add-backs reduce normalized EBITDA and dampen multiples.
Heavy Medicaid / High Bad Debt
Payer instability and bad debt drag on multiples even when cosmetic revenue is strong; buyers prefer cleaner commercial/cash mixes.
Compliance / Clinical Risk Flags
Licensure issues, inconsistent charting, or malpractice history immediately suppress bids and often trigger price reductions.
Lack of Systems & Infrastructure
Practices reliant on owner-operator knowledge without documented processes trade at add-on multiples instead of platform prices.
The Platform Premium: Why Scale Matters in Plastic Surgery
Multiples step-change as practices build platform characteristics.
Investors pay more for platforms with management depth, infrastructure, and growth potential. A practice with $2.8M EBITDA at 8× ($22.4M) could move to $3.2M EBITDA at 10× ($32M) with disciplined growth, representing nearly $10M in additional value.
| EBITDA Band | Common Buyer View | Example Valuation |
|---|---|---|
| <$1M | Physician-to-physician or local tuck-in | Value ~5×–6× |
| $1M–$3M | Add-on for existing platform | ~5×–9× |
| $3M–$7M | Emerging platform with partial infrastructure | ~7×–11× |
| $7M+ | Established platform w/ scale & systems | ~9×–13×+ |
Payer Mix and Ancillaries: Common Levers That Can Move Your Multiple
Buyers price durability—strong payer mix and ancillaries increase multiple elasticity.
| Factor | Directional Impact | Why It Moves Value |
|---|---|---|
| ≥70% commercial + cash-pay | ↑↑ | Better rates, fewer denials, steadier collections. |
| Heavy Medicaid / state funding | ↓ | Rate ceilings, budget risk. |
| In-network vs out-of-network | ↑ for in-network | Contracted reimbursement is auditable and scalable. |
| Owned surgical facility | ↑↑ (+1–2 turns) | Procedure margin stabilizes EBITDA. |
| Ancillaries (med spa, retail, injectables) | ↑ | Revenue diversity boosts blended margin. |
| Over-reliance on one star provider | ↓ | Concentration and succession risk. |
Looking Ahead: Market Conditions and 2026 Outlook
VMG reports that physician medical group M&A faced headwinds in 2024, with deal volume down about 20% from 2023, but tailwinds are emerging for 2026.
Federal Reserve Rate Cuts
Interest rate reductions in late 2024 improved financing conditions, making leveraged buyouts more attractive.
Regulatory Clarity
The court’s rejection of the FTC’s non-compete ban removed a major overhang for PE investors.
Continued Fragmentation
The physician medical group sector remains highly fragmented, providing plenty of targets for consolidators.
Preparing Your Practice for a Premium Valuation
Practice owners can invest in these focus areas to capture top-quartile pricing.
| Focus Area | What To Do | Why It Matters |
|---|---|---|
| Clean Auditable Financials | Produce GAAP-compliant statements, transparently calculate EBITDA, document add-backs. | Clean numbers reduce diligence friction and support higher multiples. |
| Multi-Provider Transition Plan | Recruit partners, formalize equity tracks, document transferability of referrals. | Lowers key-person risk and supports durability for buyers. |
| Growth Documentation | Track case volumes, revenue per procedure, patient acquisition, referral sources. | Documented growth lifts valuations and tightens earnout assumptions. |
| Ancillary Revenue Buildout | Stand up med spas, skincare retail, injectables; operationalize pricing and staffing. | Ancillaries add incremental EBITDA that often trades at higher multiples. |
| Facility Investment | Acquire or build accredited surgical facilities, migrate cases in-house. | Ownership improves control, margins, defensibility, and multiples. |
| Brand & Marketing | Invest in digital marketing, CRM, reviews, patient experience; track CAC / LTV. | Strong brands convert demand efficiently and support premium pricing. |
Requesting a Copy of This Report
FOCUS Investment Banking specializes in maximizing transaction value for healthcare practice owners through our quarterback approach to M&A advisory.
To learn more about our services contact Eric Yetter ([email protected]) or Andy Snyder ([email protected]).
Sources:
VMG Health, “2025 Healthcare M&A Report,” VMG Health, December 2024
Scope Research, “Healthcare M&A Valuation Report 2024,” Scope Research, December 2024
Internal banker guidance and FOCUS team insights (2025)
