Medical Practice Valuation Multiples by Specialty: 2026

5 days ago

7 min read

We compiled private-market valuation multiples for 13 medical specialty groups from nine reports by FOCUS Investment Banking, HealthFMV, and Scope Research, published between June 2025 and May 2026, and paired them with PitchBook's 2025 deal counts. The result shows what US physician practices sell for as of the fourth quarter of 2026, by deal type and practice size.

Key Findings

Ophthalmology platform deals carried the widest EBITDA multiple range of eight specialties tracked, 12x to 20x, in 2024 and 2025 transactions.
Oncology and urology platforms had the highest platform midpoint, 16.5x EBITDA, in 2024 to 2025 deals.
Large primary care platforms priced at 10x to 20x EBITDA in 2026 valuation data, against 3x to 8x for small and midsize primary care practices.
Single-location urgent care centers listed at 3.3x to 5x owner cash flow in 2026 data, against 1.5x to 3.1x for small primary care practices.
Gastroenterology practice deals fell 85.7% in 2025 from 2024, while oncology practice deals rose 66.7%.

Physician practices became one of private equity's favorite purchases during the low-interest-rate years. According to VMG Health data reported by Becker's ASC, buyers closed 607 physician group deals in 2022 and 430 in 2024, and private equity's share of those deals fell to 59%, its lowest since 2018. At the small end of the market, medical practices sold through BizBuySell in 2025 had a median sale price of $537,000 and an average earnings multiple of 2.58.

Our analysts pulled every specialty-level multiple these firms published for US practices, kept each figure in the form its source reported it, and computed midpoints and gaps so specialties can be compared side by side. We left out dental, behavioral health, and veterinary practices, and every figure describes private deals, not public companies.

In the following sections, we compare platform and add-on multiples by specialty, the jump in multiples from smaller practices to large platforms, owner cash flow multiples for small practices, and how 2025 deal counts shifted across specialties.

Platform vs Add-On EBITDA Multiples by Specialty

Private equity firms usually buy one large group as a platform, then fold smaller practices into it as add-ons. Those two kinds of deals price very differently, and the distance between them is not the same in every specialty.

EV/EBITDA Multiples for Platform and Add-On Practice Deals (2024 to 2025)

Specialty	Platform range	Add-on range	Platform midpoint	Add-on midpoint	Gap (turns)
Oncology / urology	14x to 19x	8x to 12x	16.5x	10x	6.5
Ophthalmology (incl. retina)	12x to 20x	7x to 11x	16x	9x	7
Cardiology	12x to 15x	8x to 12x	13.5x	10x	3.5
Gastroenterology	10x to 14x	7x to 9x	12x	8x	4
OB-GYN / women's health	10x to 14x	5x to 8x	12x	6.5x	5.5
Orthopedics & sports medicine	9x to 13x	6x to 9x	11x	7.5x	3.5
Primary care	8x to 12x	3x to 6x	10x	4.5x	5.5
Plastic surgery & aesthetics	8x to 12x	4x to 8x	10x	6x	4

Source: FOCUS Investment Banking, Physician Practice M&A Multiples 2025, published November 19, 2025

Range bar chart of platform and add-on EV/EBITDA multiples for eight physician specialties, with oncology and urology platforms at 14x to 19x and primary care add-ons at 3x to 6x

Source: FOCUS Investment Banking, Physician Practice M&A Multiples 2025, published November 19, 2025

Key Findings

Ophthalmology platforms sit 7 turns, or 7x EBITDA, above ophthalmology add-ons at the midpoint, the largest gap of the eight specialties. Cardiology and orthopedics show the smallest gap, 3.5 turns each.
Primary care add-ons priced at 3x to 6x, the lowest add-on range in the table. A primary care group bought as a platform priced at more than twice that midpoint.
For a physician owner, the type of deal can move the price as much as the specialty does. A cardiology group sold as an add-on at the 10x midpoint brings in less per dollar of EBITDA than one sold as a platform at 13.5x, and whether platform pricing holds in 2026 depends on how many new platforms buyers choose to open.

How Practice Size Changes EBITDA Multiples by Specialty

Valuation firms publish separate ranges for small practices and for large platforms. Reading the two side by side shows how much scale adds to the price in each field.

Smaller Practice vs Large Platform EBITDA Multiples (2025 to 2026)

Specialty	Smaller practices	Large platforms	Platform size cutoff	Midpoint jump (turns)
Primary care	3x to 8x	10x to 20x	Fast-growing platforms	9.5
Dermatology	4x to 8x	12x to 15x	Over $10M EBITDA	7.5
Urgent care	4x to 8x	12x to 15x	Fast-growing platforms	7.5
Gastroenterology	5x to 9x	12x to 15x	Over $10M EBITDA	6.5
Physical therapy	3x to 10x	10x to 16x	Over $5M EBITDA	6.5
Ophthalmology	4x to 8x	10x to 15x	Over $10M EBITDA	6.5
ENT (otolaryngology)	4x to 8x	10x to 15x	Over $10M EBITDA	6.5
Imaging centers	3x to 6x	8x to 14x	Large platforms	6.5

Sources: HealthFMV valuation guides for primary care, dermatology, urgent care, gastroenterology, physical therapy, ophthalmology, and ENT, published July 2025 to May 2026; Scope Research, Imaging Center Valuation Multiples and M&A Trends 2025

Dumbbell chart comparing midpoint EBITDA multiples for smaller practices and large platforms in eight specialties, from 5.5x to 15x in primary care

Key Findings

Primary care shows the biggest jump of the eight specialties, 9.5 turns from the smaller-practice midpoint to the large-platform midpoint. Its large-platform range also runs the widest, up to 20x.
Imaging centers have the lowest midpoints at both ends, 4.5x for single centers and 11x for large platforms. Outside primary care, each specialty jumps 6.5 to 7.5 turns with scale.
A small dermatology practice at the 6x midpoint more than doubles its value per dollar of EBITDA if it grows into a platform at 13.5x. HealthFMV notes that some of the high urgent care platform figures date from the mid-2010s boom, so newer urgent care deals may land lower.

Owner Cash Flow Multiples for Small Medical Practices

Most independent practices are too small to draw a private equity buyer. When they sell, usually to another physician or a local group, brokers and appraisers price them on owner cash flow instead of EBITDA.

Small-Practice Owner Cash Flow Multiples (2025 to 2026)

Practice type	25th percentile	75th percentile	Spread (turns)
Imaging centers (small)	3.89x	5.17x	1.28
Urgent care (single location)	3.3x	5x	1.7
Physical therapy (1 to 5 providers)	2.12x	3.56x	1.44
Primary care (1 to 4 providers)	1.5x	3.1x	1.6
Dermatology (1 to 4 providers)	2.1x	3x	0.9
ENT (small)	1.16x	2.95x	1.79
Ophthalmology (small)	1.76x	2.82x	1.06

Sources: HealthFMV valuation guides for urgent care, physical therapy, primary care, dermatology, ENT, and ophthalmology, published July 2025 to May 2026; Scope Research, Imaging Center Valuation Multiples and M&A Trends 2025

Range bar chart of 25th to 75th percentile owner cash flow multiples for small practices in seven specialties, from 1.16x in ENT to 5.17x for small imaging centers

Key Findings

Small imaging centers and single-location urgent care centers carry the highest cash flow multiples, both topping out near 5x. Their 25th percentiles, 3.89x and 3.3x, sit above the 75th percentile of four of the five physician specialties in the table.
ENT shows the widest spread, 1.79 turns between its 25th and 75th percentiles. Dermatology shows the tightest, at 0.9 turns.
For a solo physician planning a sale, these ranges set expectations. A primary care practice earning $300,000 a year for its owner would list for roughly $450,000 to $930,000, and because HealthFMV and Scope Research draw these figures from current and recently removed listings, final sale prices can come in lower.

Medical Practice Deal Volume by Specialty in 2025

Multiples describe the price of each deal. Deal counts show where buyers chose to spend in 2025, and the mix shifted sharply from one year to the next.

Change in Physician Practice Deal Count by Specialty (2025 vs 2024)

Specialty	Category	Change in deal count
Podiatry & hand specialists	Musculoskeletal	+200.0%
Oncology	Oncology	+66.7%
Optometry	Vision	+66.7%
Orthopedics	Musculoskeletal	+40.0%
Pain, spine & chiropractic	Musculoskeletal	+33.3%
Physical therapy	Musculoskeletal	+22.2%
Medical & cosmetic dermatology	Dermatology	+9.1%
Dermatology (all)	Dermatology	-20.7%
Ophthalmology	Vision	-35.7%
ENT	ENT	-38.9%
Aesthetic dermatology	Dermatology	-38.9%
Fertility	Fertility	-50.0%
Retina	Vision	-80.0%
Gastroenterology	Gastroenterology	-85.7%

Source: PitchBook, Q4 2025 Healthcare Services Report

Diverging bar chart of the change in physician practice deal count from 2024 to 2025 by specialty, from plus 200% for podiatry and hand specialists to minus 85.7% for gastroenterology

Source: PitchBook, Q4 2025 Healthcare Services Report

Key Findings

Retina and ophthalmology deals fell 80% and 35.7%, while optometry deals rose 66.7%. Across all specialties, physician practice deal count fell 18% in 2025.
Musculoskeletal care grew on several fronts at once. Podiatry and hand specialists tripled their deal count, and orthopedics, pain and spine, and physical therapy all rose.
Owners in gastroenterology and retina faced fewer active buyers in 2025 than a year earlier, even where published multiples stayed high. PitchBook counted 57.1% more practice exits in 2025 and reads that as a possible early sign of more deals in 2026.

For physicians weighing a sale, the spread between deal types stands out most. The same practice can be worth very different amounts depending on whether it sells to another doctor, joins an existing platform, or becomes the platform itself.

Across the market, buyers have grown more selective since the 2022 peak. Fewer physician group deals are closing, private equity holds a smaller share of them, and new money has moved toward oncology and musculoskeletal care.

So if you are pricing a medical practice, start with the range for your specialty and deal type, then adjust for the practice's size.

Sources

Methodology

We collected the EBITDA and owner cash flow multiples that FOCUS Investment Banking, HealthFMV, and Scope Research published for US physician practices, using the version of each page live on November 4, 2026.
Figures are kept as each source reported them. FOCUS ranges describe platform and add-on transactions from 2024 to 2025. HealthFMV and Scope Research ranges describe smaller practices, large platforms, and small-practice listings at the 25th and 75th percentiles.
Midpoints are the average of the low and high ends of each range. Gaps, jumps, and spreads are differences between those values, in turns, where one turn equals 1x EBITDA or 1x owner cash flow.
Large-platform cutoffs follow each source: over $10 million in EBITDA for dermatology, gastroenterology, ophthalmology, and ENT; over $5 million for physical therapy; fast-growing platforms for primary care and urgent care; and large platforms for imaging centers.
Deal count changes come from PitchBook's Q4 2025 Healthcare Services Report and compare 2025 with 2024. Context figures come from VMG Health, as reported by Becker's ASC, and from BizBuySell sold-practice data.
Dental, behavioral health, and veterinary practices and public company multiples are excluded.
Derived figures were calculated from these data.

Medical Practice Valuation Multiples by Specialty: 2026

Platform vs Add-On EBITDA Multiples by Specialty

Key Findings

How Practice Size Changes EBITDA Multiples by Specialty

Key Findings

Owner Cash Flow Multiples for Small Medical Practices

Key Findings

Medical Practice Deal Volume by Specialty in 2025

Key Findings

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