Free cash flow remains highly erratic, swinging from a $90.6 million surplus in 2025Q4 to a $4.3 million deficit in 2026Q1, highlighting the difficulty in managing capital intensity.
| Metric | TTM | Dec'25 | Dec'24 | Dec'23 | Dec'22 | Dec'21 | Dec'20 | Dec'19 | Dec'18 | Dec'17 | Dec'16 | Dec'15 | Dec'14 | Dec'13 |
|---|
| Cash from Operations | 280M | 274.3M | 300.1M | 293.8M | 158.8M | 87.1M | 246.9M | 129.5M | 144.6M | 120.94M | 125.24M | 84.48M | 21.95M | 49.08M |
| Operating CF Margin % | - | 8.29% | 9.64% | 10.71% | 6.25% | 3.91% | 13.27% | 7.07% | 8.16% | 9.02% | 10.93% | 8.8% | 5.44% | 17.24% |
| Operating CF Growth % | 114.23% | -8.6% | 2.14% | 85.01% | 82.32% | -64.72% | 90.66% | -10.44% | 19.56% | -3.43% | 48.25% | 284.9% | -55.28% | - |
| Net Income | -76.1M | 98.9M | 12.5M | 135.3M | 87M | 70.7M | 1.3M | 45.1M | -95.63M | -52.98M | 85.08M | 72.84M | -27.05M | 17.73M |
| Depreciation & Amortization | 78M | 176M | 152.6M | 118.1M | 114.8M | 98.8M | 94.8M | 76.5M | 67.44M | 51.93M | 39.55M | 34.55M | 15.06M | 11.66M |
| Stock-Based Compensation | 8.4M | 14.8M | 33.3M | 17.7M | 18.4M | 17.4M | 13.2M | 10.2M | 9.34M | 5.6M | 2.02M | 7.5M | 942K | 455K |
| Deferred Taxes | 5.1M | 16.7M | 131.5M | -1.7M | 21.9M | 8.9M | -21.9M | 8.5M | 25.27M | 6.88M | 6.88M | -149.89M | 14.09M | 7.14M |
| Other Non-Cash Items | 252.6M | 78.3M | 89.1M | 86.7M | 19M | 40.4M | 214.8M | 58M | 105.01M | 28.11M | 35.12M | 163.82M | 38.65M | 22.13M |
| Working Capital Changes | -53.5M | -110.4M | -118.9M | -62.3M | -102.3M | -149.1M | -55.3M | -68.8M | 33.16M | 84.99M | -43.42M | -44.34M | -19.74M | -10.04M |
| Change in Receivables | -58.6M | -53.8M | -72.1M | -47.2M | -35.3M | -32.1M | -46.6M | -23.5M | -22.82M | -60.62M | -60.62M | -48.78M | -20.16M | -9.72M |
| Change in Inventory | 0 | 0 | 0 | 0 | 0 | 0 | 0 | 0 | 0 | 0 | 0 | 0 | 0 | 0 |
| Change in Payables | 0 | 0 | 0 | 0 | 0 | 0 | 0 | 0 | 0 | 0 | 0 | 0 | 0 | 0 |
| Cash from Investing | -183.6M | -246.6M | -488.5M | -225.6M | -307.9M | -331.7M | -88.4M | -85.2M | -128.86M | -783.45M | -184.75M | -134.84M | -271.02M | -3.62M |
| Capital Expenditures | -72M | -78.7M | -90.4M | -88.8M | -80.6M | -57.6M | -42.9M | -73.6M | -39.8M | -29.6M | -39.11M | -33.44M | -9.44M | -4.15M |
| CapEx % of Revenue | 2.15% | 2.38% | 2.9% | 3.24% | 3.17% | 2.59% | 2.31% | 4.02% | 2.25% | 2.21% | 3.41% | 3.48% | 2.34% | 1.46% |
| Acquisitions | -118.5M | -162.1M | -378.8M | -128.9M | -228.7M | -280.4M | -104.6M | -11.4M | -87.6M | -755.1M | -145.64M | -101.4M | -261.58M | 528K |
| Investments | - | - | - | - | - | - | - | - | - | - | - | - | - | - |
| Other Investing | 6.8M | 7.5M | -22.2M | -7.9M | 1.4M | 6.3M | 59.1M | -200K | -1.46M | 1.25M | -145.64M | -101.4M | -1.7M | 1.01M |
| Cash from Financing | -143.4M | -57.3M | 262M | -155.2M | 42.1M | 316.3M | 66.7M | -135.9M | -6.3M | 767.72M | 71.28M | 33.37M | 310.96M | -37.66M |
| Debt Issued (Net) | 66M | 158.7M | 450.4M | 19.5M | -644.2M | -43.8M | 213.1M | -1.7M | 125.1M | 565.13M | 171.45M | -135.71M | 449.5M | 123.08M |
| Equity Issued (Net) | 0 | 0 | 0 | 0 | 882.9M | 581.8M | 0 | 0 | -2M | -2M | 0 | 250.98M | -3.14M | 0 |
| Dividends Paid | 0 | 0 | 0 | 0 | 0 | -5.1M | 0 | 0 | -7.8M | -1.32M | 0 | 0 | -93M | -131.01M |
| Share Repurchases | 0 | 0 | 0 | 0 | 0 | 0 | 0 | 0 | -2M | -2M | 0 | 0 | -3.14M | 0 |
| Other Financing | -209.4M | -216M | -188.4M | -174.7M | -196.6M | -216.6M | -146.4M | -134.2M | -121.6M | 205.91M | -100.17M | -81.89M | -42.4M | -29.72M |
| Net Change in Cash | -47M | -29.6M | 73.6M | -87M | -107M | 71.7M | 225.2M | -91.6M | 9.39M | 11.77M | 11.77M | -16.99M | 61.89M | 7.79M |
| Free Cash Flow | 208M | 195.6M | 209.7M | 205M | 78.2M | 29.5M | 204M | 55.9M | 104.8M | 91.34M | 86.13M | 51.04M | 12.51M | 44.93M |
| FCF Margin % | 6.22% | 5.91% | 6.73% | 7.47% | 3.08% | 1.33% | 10.97% | 3.05% | 5.92% | 6.81% | 7.52% | 5.32% | 3.1% | 15.79% |
| FCF Growth % | 20.02% | -6.72% | 2.29% | 162.15% | 165.08% | -85.54% | 264.94% | -46.66% | 14.73% | 6.05% | 68.74% | 307.91% | -72.15% | - |
| FCF per Share | 1.62 | 1.54 | 1.66 | 1.63 | 0.85 | 0.41 | 4.18 | 1.16 | 2.18 | 1.86 | 1.79 | 1.36 | 0.26 | 0.93 |
| FCF Conversion (FCF/Net Income) | -2.73x | -3.52x | -1.79x | -24.69x | -2.91x | -1.23x | -2.13x | -1.73x | -0.70x | -2.28x | 13.25x | 59.12x | -0.33x | -5.42x |
| Interest Paid | 0 | 0 | 199.7M | 169.6M | 218.7M | 194.3M | 203.6M | 180.3M | 145.4M | 0 | 79.26M | 96.8M | 50.38M | 31.1M |
| Taxes Paid | 0 | 0 | 1.6M | 1.4M | 1.8M | 1.5M | 1.7M | 1.6M | 2.2M | 0 | 661K | 1.09M | 676K | 538K |
Persistent Net Income Deficits
According to the provided cash flow statements, SGRY consistently reports negative net income while generating positive operating cash flow, with the OCF/NI ratio frequently reaching extreme levels, such as -62.60 in 2023Q4, indicating that non-cash charges like depreciation are the primary drivers of reported cash generation.
The persistent gap between net losses and positive operating cash flow suggests that the company's reported cash generation is heavily reliant on accounting add-backs rather than true operational profitability. Investors should monitor whether this divergence indicates an inability to achieve sustainable margins after accounting for the high capital intensity of its facility-based model.
As reported in financial statements, SGRY's free cash flow trajectory remains highly erratic, swinging from a peak of $90.6M in 2025Q4 to a negative $4.3M in 2026Q1, reflecting the company's ongoing struggle to maintain consistent cash conversion amidst its aggressive acquisition-led growth strategy.
The volatility in FCF margins suggests that the company's cash flow profile is highly sensitive to the timing of acquisitions and the associated integration costs. This inconsistency warrants further investigation into whether the business can generate self-sustaining cash flow without relying on external financing to bridge periodic shortfalls.
Based on SGRY's reported figures, capital expenditures have remained a consistent drag on cash flow, with CapEx/Revenue ratios hovering between 1.4% and 3.5% over the last ten quarters, reflecting the ongoing requirement to invest in medical equipment and facility upgrades to remain competitive.
The necessity of continuous capital investment to support high-acuity surgical procedures suggests that the company's cash flow is structurally burdened by maintenance and growth-related spending. This capital intensity may limit the company's ability to deleverage its balance sheet effectively in the near term.
Analysis of recent quarterly filings reveals that working capital changes have been a persistent use of cash, with outflows reaching as high as $65.7M in 2023Q4, suggesting that the company faces significant challenges in managing its cash conversion cycle and accounts receivable collections.
The recurring negative impact of working capital changes on operating cash flow may indicate inefficiencies in billing or collection processes, particularly as the company navigates complex payer environments. Investors should monitor whether these outflows are a structural feature of the business model or a result of temporary operational friction.
Quick answers to the most common questions about buying SGRY stock.
Surgery Partners, Inc. (SGRY) generated $274.3M in net cash from operating activities in 2025. This reflects the cash generated directly from core business operations.
Surgery Partners, Inc. (SGRY) generated $195.6M in free cash flow in 2025. Free cash flow is the cash left over after capital expenditures, which can be used to pay dividends, repurchase shares, or pay down debt.
Surgery Partners, Inc. (SGRY) spent $78.7M on capital expenditures in 2025. CapEx represents the cash invested in physical assets like property, plant, and equipment to maintain or grow the business.