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Document and Entity Information - USD ($) $ in Millions	12 Months Ended
Document and Entity Information - USD ($) $ in Millions	Dec. 31, 2016	Mar. 09, 2017	Jun. 30, 2016
Document and Entity Information [Abstract]
Entity Registrant Name	Surgery Partners, Inc.
Entity Central Index Key	0001638833
Current Fiscal Year End Date	--12-31
Entity Filer Category	Accelerated Filer
Document Type	10-K
Document Period End Date	Dec. 31, 2016
Document Fiscal Year Focus	2016
Document Fiscal Period Focus	FY
Amendment Flag	false
Entity Common Stock, Shares Outstanding		48,625,166
Entity Well-known seasoned issuer	No
Entity Voluntary Filers	No
Entity Current Reporting Status	Yes
Entity Public Float			$ 255.7

Consolidated Balance Sheets - USD ($) $ in Thousands	Dec. 31, 2016	Dec. 31, 2015
Current assets:
Cash and cash equivalents	$ 69,699	$ 57,933
Accounts receivable, less allowance for doubtful accounts of $29,872 and $18,322, respectively	220,594	177,757
Inventories	28,777	25,591
Prepaid expenses and other current assets	32,014	34,620
Acquisition escrow deposit	10,871	13,984
Indemnification receivable due from seller	0	1,072
Total current assets	361,955	310,957
Property and equipment, net	204,253	184,550
Intangible assets, net	48,023	53,568
Goodwill	1,555,204	1,407,927
Investments in and advances to affiliates	34,980	34,103
Restricted invested assets	315	316
Long-term deferred tax assets	83,793	94,105
Acquisition escrow deposit	0	8,408
Other long-term assets	16,435	10,509
Total assets	2,304,958	2,104,443
Current liabilities:
Accounts payable	49,766	45,341
Accrued payroll and benefits	29,273	26,307
Acquisition escrow liability	10,871	13,984
Other current liabilities	68,993	68,410
Current maturities of long-term debt	27,822	27,247
Total current liabilities	186,725	181,289
Long-term debt, less current maturities	1,414,421	1,228,112
Long-term tax receivable agreement liability	122,351	119,655
Acquisition escrow liability	0	8,408
Other long-term liabilities	76,266	85,613
Non-controlling interests—redeemable	180,521	183,439
Stockholders' equity:
Preferred stock, $0.01 par value, 20,000,000 shares authorized, no shares issued or outstanding	0	0
Common stock, $0.01 par value, 300,000,000 shares authorized, 48,488,616 shares issued and outstanding at December 31, 2016; 48,156,990 shares issued and outstanding at December 31, 2015	485	482
Additional paid-in capital	320,543	316,294
Retained deficit	(311,351)	(320,804)
Total Surgery Partners, Inc. stockholders' equity (deficit)	9,677	(4,028)
Non-controlling interests—non-redeemable	314,997	301,955
Total stockholders' equity	324,674	297,927
Total liabilities and stockholders' equity	$ 2,304,958	$ 2,104,443

Consolidated Balance Sheets (Parenthetical) - USD ($) $ in Thousands	Dec. 31, 2016	Dec. 31, 2015
Statement of Financial Position [Abstract]
Accounts receivable, allowance for doubtful accounts	$ 29,872	$ 18,322
Preferred stock, par value (USD per share)	$ 0.01	$ 0.01
Preferred stock, shares authorized (shares)	20,000,000	20,000,000
Preferred stock, shares issued (shares)	0	0
Preferred stock, shares outstanding (in shares)	0	0
Common stock, par value (USD per share)	$ 0.01	$ 0.01
Common stock, shares authorized (shares)	300,000,000	300,000,000
Common stock, shares issued (in shares)	48,488,616	48,156,990
Common stock, shares outstanding (in shares)	48,488,616	48,156,990

Consolidated Statements of Operations - USD ($)
$ in Thousands

12 Months Ended

Dec. 31, 2016

Dec. 31, 2015

Dec. 31, 2014

Income Statement [Abstract]

Revenues

$ 1,145,438

$ 959,891

$ 403,289

Operating expenses:

Salaries and benefits

357,175

261,685

101,976

Supplies

269,239

242,083

94,224

Professional and medical fees

81,185

66,583

18,028

Lease expense

52,147

44,848

19,389

Other operating expenses

61,450

54,127

20,561

Cost of revenues

821,196

669,326

254,178

General and administrative expenses (includes contingent acquisition compensation expense of $5,092 for the year ended December 31, 2016)

60,246

55,992

31,452

Depreciation and amortization

39,551

34,545

15,061

Provision for doubtful accounts

24,212

23,578

9,509

Income from equity investments

(4,764)

(3,777)

(1,264)

Loss (gain) on disposal or impairment of long-lived assets, net

2,355

(2,097)

1,804

Loss on debt refinancing

11,876

16,102

23,414

Merger transaction and integration costs

8,738

17,920

21,690

Gain on litigation settlement

(14,101)

Termination of management agreement and IPO costs

5,834

Electronic health records incentive income

(408)

(1,761)

(3,356)

Other expenses (income)

(525)

(6)

Total operating expenses

948,956

815,137

352,482

Operating income

196,482

144,754

50,807

Tax receivable agreement expense

(3,733)

(119,911)

Interest expense, net

(100,571)

(100,980)

(62,101)

Income (loss) before income taxes

92,178

(76,137)

(11,294)

Income tax expense (benefit)

7,095

(148,982)

15,758

Net income (loss)

85,083

72,845

(27,052)

Less: Net income attributable to non-controlling interests

(75,630)

(71,416)

(38,845)

Net income (loss) attributable to Surgery Partners, Inc.

$ 9,453

$ 1,429

$ (65,897)

Net income (loss) per share attributable to common stockholders

Basic (in USD per share)

$ 0.20

$ 0.04

$ (2.04)

Diluted (in USD per share)

^[1]

$ 0.20

$ 0.04

$ (2.04)

Weighted average common shares outstanding

Basic (in shares)

48,018,944

36,066,233

32,295,364

Diluted (in shares)

^[1],[2]

48,190,738

37,464,387

32,295,364

[1]	The impact of potentially dilutive securities for the year ended December 31, 2014 was not considered because the effect would be anti-dilutive for the period.
[2]	Effect of the Reorganization in 2015, as defined in Note 1, has been retrospectively applied to all periods presented.

Consolidated Statements of Operations (Parenthetical) - USD ($) $ in Thousands	12 Months Ended
	Dec. 31, 2016	Dec. 31, 2015	Dec. 31, 2014
Income Statement [Abstract]
Contingent acquisition compensation expense	$ 5,092	$ 0	$ 0

Consolidated Statements of Comprehensive Income (Loss) - USD ($) $ in Thousands	12 Months Ended
	Dec. 31, 2016	Dec. 31, 2015	Dec. 31, 2014
Statement of Comprehensive Income [Abstract]
Net income (loss)	$ 85,083	$ 72,845	$ (27,052)
Other comprehensive income	0	0	0
Comprehensive income (loss)	85,083	72,845	(27,052)
Less: Comprehensive income attributable to non-controlling interests	(75,630)	(71,416)	(38,845)
Comprehensive income (loss) attributable to Surgery Partners, Inc.	$ 9,453	$ 1,429	$ (65,897)

Consolidated Statements of Stockholders' Equity (Deficit) - USD ($)
$ in Thousands

Total

Common Stock

Additional Paid-in Capital

Retained Deficit

Non-Controlling Interests— Non-Redeemable

Beginning Balance, stockholders' equity (in shares) at Dec. 31, 2013

^[1]

1,000

Beginning Balance, stockholders' equity at Dec. 31, 2013

$ (14,375)

$ 0

^[1]

$ 59,719

$ (163,336)

$ 89,242

Increase (Decrease) in Stockholders' Equity [Roll Forward]

Net (loss) income

(31,131)

(65,897)

34,766

Equity-based compensation

942

Acquisition and disposal of shares of non-controlling interests, net

202,657

633

202,024

Distributions to owners

(93,000)

Distributions to non-controlling interest—non-redeemable holders

(32,414)

Repurchase of units

(3,143)

Ending Balance, stockholders' equity (in shares) at Dec. 31, 2014

^[1]

1,000

Ending Balance, stockholders' equity at Dec. 31, 2014

29,536

$ 0

^[1]

58,151

(322,233)

293,618

Increase (Decrease) in Stockholders' Equity [Roll Forward]

Net (loss) income

55,229

1,429

53,800

Equity-based compensation

7,502

Acquisition and disposal of shares of non-controlling interests, net

3,486

(835)

4,321

Distributions to non-controlling interest—non-redeemable holders

(49,784)

Initial public offering (in shares)

^[1]

14,285,000

Initial public offering

250,979

$ 143

^[1]

250,836

Effect of Reorganization (in shares)

^[1],[2]

33,870,990

Effect of Reorganization

^[2]

339

$ 339

^[1]

Other

$ 640

640

Ending Balance, stockholders' equity (in shares) at Dec. 31, 2015

48,156,990

^[1]

Ending Balance, stockholders' equity at Dec. 31, 2015

$ 297,927

$ 482

^[1]

316,294

(320,804)

301,955

Increase (Decrease) in Stockholders' Equity [Roll Forward]

Net (loss) income

67,060

57,607

Issuance of restricted stock, net of forfeitures (in shares)

^[1]

331,626

Issuance of restricted stock, net of forfeitures

$ 3

^[1]

(3)

Equity-based compensation

2,021

Acquisition and disposal of shares of non-controlling interests, net

6,284

2,231

4,053

Distributions to non-controlling interest—non-redeemable holders

$ (48,618)

(48,618)

Ending Balance, stockholders' equity (in shares) at Dec. 31, 2016

48,488,616

^[1]

Ending Balance, stockholders' equity at Dec. 31, 2016

$ 324,674

$ 485

^[1]

$ 320,543

$ (311,351)

$ 314,997

[1]	As described in Note 1 herein, the common stock of the Company is that of Surgery Partners, Inc. as of December 31, 2016 and 2015 and that of Surgery Center Holdings, Inc. as of December 31, 2014.
[2]	As a result of the Reorganization that occurred on September 30, 2015 (as further described in Note 1), Surgery Center Holdings, Inc, became an indirect wholly owned subsidiary of Surgery Partners, Inc. and the common stock of Surgery Center Holdings, Inc. is eliminated in consolidation.

Consolidated Statements of Cash Flows - USD ($) $ in Thousands	12 Months Ended
	Dec. 31, 2016	Dec. 31, 2015	Dec. 31, 2014
Cash flows from operating activities:
Net income (loss)	$ 85,083	$ 72,845	$ (27,052)
Adjustments to reconcile net income (loss) to net cash provided by operating activities:
Depreciation and amortization	39,551	34,545	15,061
Amortization of debt issuance costs and discounts	7,199	6,263	3,746
Amortization of unfavorable lease liability	(431)	(431)	(72)
Equity-based compensation	2,021	7,502	942
Loss (gain) on disposal or impairment of long-lived assets, net	2,355	(2,097)	1,804
Gain on legal settlement	(14,101)	0	0
Loss on debt extinguishment	11,876	16,102	23,414
Tax receivable agreement expense	3,733	119,911	0
Deferred income taxes	6,882	(149,891)	14,089
Interest on contingent consideration obligation	1,124	1,041	964
Provision for doubtful accounts	24,212	23,578	9,509
Income from equity investments, net of distributions received	(846)	(543)	(713)
Changes in operating assets and liabilities, net of acquisitions and divestitures:
Accounts receivable	(60,622)	(48,783)	(20,161)
Other operating assets and liabilities	17,203	4,439	418
Net cash provided by operating activities	125,239	84,481	21,949
Cash flows from investing activities:
Purchases of property and equipment, net	(39,109)	(33,439)	(7,736)
Payments for acquisitions, net of cash acquired	(146,405)	(112,596)	(263,280)
Proceeds from divestitures	765	11,193	0
Net cash used in investing activities	(184,749)	(134,842)	(271,016)
Cash flows from financing activities:
Proceeds from initial public offering, net of offering costs	0	250,979	0
Principal payments on long-term debt	(473,437)	(328,329)	(1,009,874)
Borrowings of long-term debt	650,707	196,366	1,477,288
Payments of debt issuance costs	(14,296)	0	(7,496)
Penalty on prepayment of debt	(4,900)	0	0
Payment of premium of debt extinguishment	0	(7,305)	(17,840)
Distributions to non-controlling interest holders	(65,778)	(69,720)	(35,182)
Distribution to owners	0	0	(93,000)
Payments related to ownership transactions with consolidated affiliates	(20,096)	(12,175)	278
Repurchase of units	0	0	(3,143)
Financing lease obligation	(924)	3,558	(70)
Net cash provided by financing activities	71,276	33,374	310,961
Net (decrease) increase in cash and cash equivalents	11,766	(16,987)	61,894
Cash and cash equivalents at beginning of period	57,933	74,920	13,026
Cash and cash equivalents at end of period	69,699	57,933	74,920
Non-cash transactions:
Notes payable issued in connection with an acquisition	325	7,430	0
Interest paid, net of interest income received	7,866	5,443	3,252
Cash payments:
Interest paid, net of interest income received	79,262	96,799	50,377
Cash paid for income taxes	$ 661	$ 1,093	$ 676

Organization	12 Months Ended
Organization	Dec. 31, 2016
Organization, Consolidation and Presentation of Financial Statements [Abstract]
Organization	Organization Surgery Partners, Inc., a Delaware corporation (together with its subsidiaries, the “Company”), was formed April 2, 2015, as a holding company for the purpose of facilitating an initial public offering (the “IPO”) of shares of common stock. Prior to September 30, 2015, the Company conducted business through Surgery Center Holdings, Inc. and its subsidiaries. Surgery Center Holdings, LLC was and is the sole direct owner of the equity interests of Surgery Center Holdings, Inc. and had no other material assets. On September 30, 2015, Surgery Partners, Inc. became the direct parent and sole member of Surgery Center Holdings, LLC (the "Reorganization"). In the Reorganization, all of the equity interests held by the pre-IPO Owners of Surgery Center Holdings, LLC were contributed to Surgery Partners, Inc. in exchange for 33,871,990 shares of common stock of Surgery Partners, Inc. and certain rights to additional payments under a tax receivable agreement. After giving effect to the Reorganization, Surgery Partners, Inc. is a holding company, and its sole material asset is an equity interest in Surgery Center Holdings, LLC. The Company's consolidated financial statements for periods prior to the Reorganization represent the historical operating results and financial position of Surgery Center Holdings, Inc. and certain of its subsidiaries. On October 1, 2015, the Company completed its IPO of 14,285,000 shares of common stock at an offering price of $19.00 per share. On October 6, 2015, the Company received net proceeds from the sale of common stock in this offering of $255.8 million, after deducting underwriting discounts and other fees of $15.6 million. These net proceeds were used to repay a portion of the borrowings outstanding under the 2014 Second Lien and to pay fees associated with this offering. The Company also incurred an additional $4.8 million in costs directly related to the IPO. On November 3, 2014, the Company completed the acquisition of Symbion Holdings Corp. ("Symbion") ("the Merger"), which added 55 surgical facilities, including 49 ambulatory surgery centers ("ASCs") and six surgical hospitals, to its network of existing facilities. The Company acquired Symbion for a purchase price of $792.0 million pursuant to the terms of an Agreement and Plan of Merger dated as of June 13, 2014. The Symbion acquisition was financed through the issuance of approximately $1.4 billion under the Company's Term Loans and Revolving Facility. As of December 31, 2016, the Company owned and operated a national network of surgical facilities and ancillary services in 29 states. The surgical facilities, which include ASCs and surgical hospitals, primarily provide non-emergency surgical procedures across many specialties, including, among others, gastroenterology ("GI"), general surgery, ophthalmology, orthopedics and pain management. The Company's surgical hospitals provide services such as diagnostic imaging, laboratory, obstetrics, oncology, pharmacy, physical therapy and wound care. Ancillary services are comprised of a diagnostic laboratory, multi-specialty physician practices, urgent care facilities, anesthesia services, optical services and specialty pharmacy services. As of December 31, 2016, the Company owned or operated a portfolio of 104 surgical facilities, comprised of 99 ASCs and five surgical hospitals. The Company owns these facilities in partnership with physicians and, in some cases, healthcare systems in the markets and communities it serves. The Company owned a majority interest in 74 of the surgical facilities and consolidated 94 of these facilities for financial reporting purposes. In addition, the Company owned or operated a network of 56 physician practices.

Significant Accounting Policies

12 Months Ended

Dec. 31, 2016

Organization, Consolidation and Presentation of Financial Statements [Abstract]

Significant Accounting Policies

Principles of Consolidation

The consolidated financial statements include the accounts of the Company and its wholly-owned subsidiaries, as well as interests in partnerships and limited liability companies controlled by the Company through its ownership of a majority voting interest or other rights granted to the Company by contract to manage and control the affiliate's business. All significant intercompany balances and transactions are eliminated in consolidation.

Non-Controlling Interests

The physician limited partners and physician minority members of the entities that the Company controls are responsible for the supervision and delivery of medical services. The governance rights of limited partners and minority members are restricted to those that protect their financial interests. Under certain partnership and operating agreements governing these partnerships and limited liability companies, the Company could be removed as the sole general partner or managing member for certain events such as material breach of the partnership or operating agreement, gross negligence or bankruptcy. These protective rights do not preclude consolidation of the respective partnerships and limited liability companies.

Ownership interests in consolidated subsidiaries held by parties other than the Company are identified and generally presented in the consolidated financial statements within the equity section but separate from the Company's equity. However, in instances in which certain redemption features that are not solely within the control of the Company are present, classification of non-controlling interests outside of permanent equity is required. Consolidated net income attributable to the Company and to the non-controlling interests are identified and presented on the consolidated statements of operations; changes in ownership interests are accounted for as equity transactions assuming the Company continues to consolidate related entities. Certain transactions with non-controlling interests are classified within financing activities in the consolidated statements of cash flows.

The consolidated financial statements of the Company include all assets, liabilities, revenues and expenses of surgical facilities in which the Company has sufficient ownership and rights to allow the Company to consolidate the surgical facilities. Similar to its investments in non-consolidated affiliates, the Company regularly engages in the purchase and sale of ownership interests with respect to its consolidated subsidiaries that do not result in a change of control.

Non-Controlling Interests — Redeemable. Each of the partnerships and limited liability companies through which the Company owns and operates its surgical facilities is governed by a partnership or operating agreement. In certain circumstances, the partnership and operating agreements for the Company's surgical facilities provide that the facilities will purchase all of the physicians’ ownership if certain adverse regulatory events occur, such as it becoming illegal for the physicians to own an interest in a surgical facility, refer patients to a surgical facility or receive cash distributions from a surgical facility. The non-controlling interests - redeemable are reported outside of stockholders' equity in the consolidated balance sheets.

A summary of activity related to the non-controlling interests—redeemable follows (in thousands):



Balance at December 31, 2014	$	192,589
Net income attributable to non-controlling interests—redeemable	17,616
Acquisition and disposal of shares of non-controlling interests, net—redeemable	(6,830		)
Distributions to non-controlling interest —redeemable holders	(19,936		)
Balance at December 31, 2015	183,439
Net income attributable to non-controlling interests—redeemable	18,023
Acquisition and disposal of shares of non-controlling interests, net—redeemable	(3,781		)
Distributions to non-controlling interest —redeemable holders	(17,160		)
Balance at December 31, 2016	$	180,521

Variable Interest Entities

The consolidated financial statements include the accounts of variable interest entities in which the Company is the primary beneficiary under the provisions of Accounting Standards Codification ("ASC") Topic 810, Consolidation. At December 31, 2016, the variable interest entities include five surgical facilities, three anesthesia practices and two physician practices. At December 31, 2015, the variable interest entities included five surgical facilities, three anesthesia practices and one physician practice. There was an additional one acquisition at December 31, 2016. The Company has the power to direct the activities that most significantly impact the variable interest entity's economic performance. Additionally, the Company would absorb the majority of the expected losses of these entities should they occur. As of December 31, 2016 and December 31, 2015, the consolidated balance sheets of the Company included total assets of $99.5 million and $104.2 million, respectively, and total liabilities of $10.7 million and $13.2 million, respectively, related to the Company's variable interest entities.

Equity Method Investments

The Company has non-consolidating investments in surgical facilities and management companies that own or manage surgical facilities. These investments are accounted for using the equity method of accounting. The total amount of these investments included in investments in and advances to affiliates in the consolidated balance sheets was $35.0 million and $34.1 million as of December 31, 2016 and December 31, 2015, respectively.

Use of Estimates

The consolidated financial statements have been prepared in accordance with U.S. generally accepted accounting principles ("GAAP"). The preparation of financial statements in conformity with GAAP requires management to make estimates and assumptions that affect the amounts reported in the consolidated financial statements and footnotes. Examples include, but are not limited to, estimates of accounts receivable allowances, professional and general liabilities and the estimate of deferred tax assets or liabilities. In the opinion of management, all adjustments considered necessary for a fair presentation have been included. All adjustments are of a normal, recurring nature. Actual results could differ from those estimates.

Reclassifications

Certain reclassifications have been made to the comparative periods' financial statements to conform to the current year presentation.

Fair Value of Financial Instruments

The fair value of a financial instrument is the amount at which the instrument could be exchanged in an orderly transaction between market participants to sell the asset or transfer the liability. The Company uses fair value measurements based on quoted prices in active markets for identical assets or liabilities (Level 1), inputs other than quoted prices in active markets that are either directly or indirectly observable (Level 2), or unobservable inputs in which little or no market data exists, therefore requiring an entity to develop its own assumptions (Level 3), depending on the nature of the item being valued.

The carrying amounts reported in the consolidated balance sheets for cash and cash equivalents, accounts receivable, restricted invested assets and accounts payable approximate their fair values.

A summary of the carrying amounts and fair values of the Company's long-term debt follows (in thousands):



	Carrying Amount				Fair Value
	December 31, 2016		December 31, 2015		December 31, 2016		December 31, 2015

2014 First Lien Credit Agreement, net of debt issuance and discount	$	911,784	$	839,701	$	917,528	$	827,458
2014 Second Lien Credit Agreement, net of debt issuance and discount	$	—	$	237,532	$	—	$	224,617
Senior Unsecured Notes, net of debt issuance costs and discount	$	387,942	$	—	$	412,189	$	—

The fair values of the 2014 First Lien Credit Agreement, 2014 Second Lien Credit Agreement and Senior Unsecured Notes, as defined in Note 5 on Long-Term Debt, were based on a Level 2 computation using quoted prices for identical liabilities in inactive markets at December 31, 2016 and 2015, as applicable. The carrying amounts related to the Company's other long-term debt obligations approximate their fair values.

The Company maintains a supplemental executive retirement savings plan (the "SERP") for certain former Symbion executive officers. The SERP is a non-qualified deferred compensation plan for eligible executive officers and other key employees of the Company that allows participants to defer portions of their compensation. The fair value of the SERP asset and liability was based on a quoted market price, or a Level 1 computation. As of December 31, 2016 and 2015, the fair value of the assets in the SERP were $1.7 million and $1.6 million, respectively, and were included in other long-term assets in the consolidated balance sheets. The Company had a liability related to the SERP of $1.7 million and $1.6 million as of December 31, 2016 and 2015, respectively, which was included in other long-term liabilities in the consolidated balance sheets.

Revenues

The Company recognizes revenues in the period in which the services are performed. Patient service revenues and receivables from third-party payors are recorded net of estimated contractual adjustments and allowances, which the Company estimates based on the historical trend of its cash collections and contractual write-offs, accounts receivable agings, established fee schedules, contracts with payors and procedure statistics.

A summary of revenues by service type as a percentage of total revenues follows:



	Year Ended December 31,
	2016		2015		2014
Patient service revenues:
Surgical facilities revenues	90.3	%	91.6	%	83.9	%
Ancillary services revenues	7.9	%	6.4	%	12.3	%
	98.2	%	98.0	%	96.2	%
Other service revenues:
Optical services revenues	1.1	%	1.5	%	3.5	%
Other	0.7	%	0.5	%	0.3	%
	1.8	%	2.0	%	3.8	%
Total revenues	100.0	%	100.0	%	100.0	%

Patient service revenues. The fee charged for healthcare procedures performed in surgical facilities varies depending on the type of service provided, but usually includes all charges for usage of an operating room, a recovery room, special equipment, medical supplies, nursing staff and medications. The fee does not normally include professional fees charged by the patient’s surgeon, anesthesiologist or other attending physician, which are billed directly by such physicians to the patient or third-party payor. However, in several surgical facilities, the Company charges for anesthesia services. Ancillary service revenues include fees for patient visits to the Company's physician practices, pharmacy services and diagnostic tests ordered by physicians. Patient service revenues are recognized on the date of service, net of estimated contractual adjustments and discounts from third-party payors, including Medicare and Medicaid. Changes in estimated contractual adjustments and discounts are recorded in the period of change. During the year ended December 31, 2016, the Company recognized an increase to patient service revenues as a result of changes in estimates to third-party settlements related to prior years of approximately $6.8 million compared to $2.3 million during the year ended December 31, 2015.

The following table sets forth patient service revenues by type of payor and as a percentage of total patient service revenues for the Company's consolidated surgical facilities (dollars in thousands):



	Year Ended December 31,
	2016				2015				2014
	Amount		%		Amount		%		Amount		%
Patient service revenues:
Private insurance	$	579,662	51.5	%	$	516,739	55.0	%	$	202,172	52.1	%
Government	448,953		39.9	%	359,471		38.2	%	134,041		34.5	%
Self-pay	19,817		1.8	%	16,190		1.7	%	13,645		3.5	%
Other	76,172		6.8	%	48,311		5.1	%	38,215		9.9	%
Total patient service revenues	$	1,124,604	100.0	%	$	940,711	100.0	%	$	388,073	100.0	%
Other service revenues:
Optical service revenues	$	12,505			$	14,572			$	14,193
Other revenues	8,329				4,608				1,023
Total net revenues	$	1,145,438			$	959,891			$	403,289

Other service revenues. Optical service revenues consist of product sales from the Company's optical laboratories as well as handling charges billed to the members of the Company's optical products purchasing organization. The Company's optical products purchasing organization negotiates volume buying discounts with optical products manufacturers. The buying discounts and any handling charges billed to the members of the buying group represent the revenue recognized for financial reporting purposes. Revenue is recognized as orders are shipped to members. The Company bases its estimates for sales returns and discounts on historical experience and has not experienced significant fluctuations between estimated and actual return activity and discounts given. The Company's optical laboratories manufacture and distribute corrective lenses and eyeglasses to ophthalmologists and optometrists. Revenue is recognized when product is shipped, net of allowance for discounts. The Company's marketing products and services businesses recognize revenue when product is shipped or services are rendered.

Other revenues include management and administrative service fees derived from the non-consolidated facilities that the Company accounts for under the equity method, management of surgical facilities in which it does not own an interest, and management services provided to physician practices for which the Company is not required to provide capital or additional assets. The fees derived from these management arrangements are based on a predetermined percentage of the revenues of each facility or practice and are recognized in the period in which services are rendered.

Cash and Cash Equivalents

The Company considers all highly liquid investments with a maturity of three months or less when purchased to be cash equivalents. The Company maintains its cash and cash equivalent balances at high credit quality financial institutions.

Accounts Receivable and Allowances for Contractual Adjustments and Doubtful Accounts

Accounts receivable are recorded net of contractual adjustments and allowances for doubtful accounts to reflect accounts receivable at net realizable value. Accounts receivable consists of receivables from federal and state agencies (under the Medicare and Medicaid programs), managed care health plans, commercial insurance companies, employers and patients. Management recognizes that revenues and receivables from government agencies are significant to the Company's operations, but it does not believe that there is significant credit risk associated with these government agencies. Concentration of credit risk with respect to other payors is limited because of the large number of such payors. As of December 31, 2016, the Company had a net third-party Medicaid settlements receivable of $454,000 compared to a third-party Medicaid settlements liability of $5.2 million at December 31, 2015.

The Company recognizes that final reimbursement of accounts receivable is subject to final approval by each third-party payor. However, because the Company has contracts with its third-party payors and also verifies insurance coverage of the patient before medical services are rendered, the amounts that are pending approval from third-party payors are not significant. The Company's policy is to collect co-payments and deductibles prior to providing medical services. It is also the Company's policy to verify a patient’s insurance 72 hours prior to the patient’s procedure. Patient services of the Company are primarily non-emergency, which allows the surgical facilities to control the procedures for which third-party reimbursement is sought and obtained. The Company does not require collateral from self-pay patients.

The Company analyzes accounts receivable at each of its facilities to ensure the proper aged category and collection assessment. At a consolidated level, the Company's policy is to review accounts receivable aging, by facility, to determine the appropriate allowance for doubtful accounts. Patient account balances are reviewed for delinquency based on contractual terms. This review is supported by an analysis of the actual revenues, contractual adjustments and cash collections received. An account balance is written off only after the Company has pursued collection with legal or collection agency assistance or otherwise has deemed an account to be uncollectible.

A summary of the changes in the allowance for doubtful accounts receivable follows (in thousands):



Balance at December 31, 2013	$	5,028
Provision for doubtful accounts	9,509
Accounts written off, net of recoveries	(9,208		)
Balance at December 31, 2014	5,329
Provision for doubtful accounts	23,578
Accounts written off, net of recoveries	(10,585		)
Balance at December 31, 2015	18,322
Provision for doubtful accounts	24,212
Accounts written off, net of recoveries	(12,662		)
Balance at December 31, 2016	$	29,872

The Company records an estimate for doubtful accounts based on the aging category and historical collection experience of each product sales or other business included in other service revenues, as discussed in the note above.

The receivables related to the Company's optical products purchasing organization are recognized separately from patient accounts receivable, as discussed above, and are included in other current assets in the consolidated balance sheets. Such receivables were $7.0 million and $8.4 million at December 31, 2016 and 2015, respectively.

Inventories

Inventories, which consist primarily of medical and drug supplies, are stated at the lower of cost or market value. Cost is determined using the first-in, first-out method.

Prepaid Expenses and Other Current Assets

A summary of prepaid expenses and other current assets follows (in thousands):



	December 31,
	2016		2015

Prepaid expenses	$	11,158	$	7,409
Receivables - optical product purchasing organization	7,042		8,434
Acquisition escrow receivable	—		8,000
Insurance recoveries	2,476		2,363
Other current assets	11,338		8,414
Total	$	32,014	$	34,620

Property and Equipment

Property and equipment are stated at cost or, if obtained through acquisition, at fair value determined on the date of acquisition. Depreciation is recognized using the straight-line method over the estimated useful lives of the assets, generally three to five years for computers and software and five to seven years for furniture and equipment. Leasehold improvements are depreciated on a straight-line basis over the shorter of the lease term or the estimated useful life of the assets. Routine maintenance and repairs are expensed as incurred, while expenditures that increase capacities or extend useful lives are capitalized.

The Company also leases certain facilities and equipment under capital leases. Assets held under capital leases are stated at the present value of minimum lease payments at the inception of the related lease. Such assets are depreciated on a straight-line basis over the lesser of the lease term or the remaining useful life of the leased asset.

Goodwill and Intangible Assets

Goodwill represents the fair value of the consideration provided in an acquisition over the fair value of net assets acquired and is not amortized. The Company has indefinite-lived intangible assets related to the certificates of need held in jurisdictions where certain of its surgical facilities are located. The Company also has finite-lived intangible assets related to physician guarantee agreements, non-compete agreements, management agreements and customer relationships. Physician income guarantees are amortized into salaries and benefits costs in the consolidated statements of operations over the commitment period of the contract, generally three to four years. Non-compete agreements and management rights agreements are amortized into depreciation and amortization expense in the consolidated statements of operations over the service lives of the agreements, ranging from two years to 20 years for non-compete agreements and 15 years for the management rights agreements. Customer relationships are amortized into depreciation and amortization expense in the consolidated statements of operations over the estimated lives of the relationships, ranging from three to ten years.

Impairment of Long-Lived Assets, Goodwill and Intangible Assets

The Company evaluates the carrying value of long-lived assets when impairment indicators are present or when circumstances indicate that impairment may exist. The Company performs an impairment test by preparing an expected undiscounted cash flow projection. If the projection indicates that the recorded amount of the long-lived asset is not expected to be recovered, the carrying value is reduced to estimated fair value. The cash flow projection and fair value represents management’s best estimate, using appropriate and customary assumptions, projections and methodologies, at the date of evaluation. No impairment losses on long-lived assets were recognized during the years ended December 31, 2016, 2015 and 2014.

The Company tests its goodwill and indefinite-lived intangible assets for impairment annually, as of October 1, or more frequently if certain indicators arise. The Company performs its annual goodwill impairment assessment by developing a fair value estimate of the business enterprise as of October 1, 2016 using a discounted cash flows approach and comparing the fair value to the carrying value of the net assets of the individual reporting units as of October 1, or additionally if impairment indicators are present. The results of the Company's fair value estimate are then corroborated using a market-based approach. The result of the Company's annual goodwill impairment test at October 1, 2016 indicated no impairment. There were also no impairment charges recorded during the years ended December 31, 2015 and 2014.

Restricted Invested Assets

Restricted invested assets of $315,000 and $316,000 at December 31, 2016 and 2015, respectively, were related to a requirement under the operating lease agreement at the Company's Chesterfield, Missouri facility. In accordance with the provisions of the lease agreement, the Company has a deposit with the landlord that shall be held as security for performance under the Company's covenants and obligations within the agreement through January 2024.

Other Long-Term Assets

A summary of other long-term assets follows (in thousands):



	December 31,
	2016		2015

Notes receivable	$	716	$	212
Deposits	4,196		2,475
Assets of SERP	1,725		1,606
Debt issuance costs	1,488		2,005
Insurance recoveries	6,835		3,976
Other	1,475		235
Total	$	16,435	$	10,509

Other Current Liabilities

A summary of other current liabilities follows (in thousands):



	December 31,
	2016		2015

Interest payable	$	19,206	$	5,410
Current taxes payable	2,622		1,977
Insurance liabilities	6,625		5,476
Third-party settlements	179		5,222
Acquisition consideration payable	—		16,768
Amounts due to patients and payors	12,221		11,424
Tax receivable agreement liability	999		—
Contingent acquisition compensation liability	4,589		—
Other accrued expenses	22,552		22,133
Total	$	68,993	$	68,410

Other Long-Term Liabilities

A summary of other long-term liabilities follows (in thousands):



	December 31,
	2016		2015

Facility lease obligations	$	52,653	$	53,927
Medical malpractice liability	10,453		6,339
Liability of SERP	1,725		1,608
Contingent consideration obligation	—		14,049
Unfavorable lease liability	1,671		1,996
Other long-term liabilities	9,764		7,694
Total	$	76,266	$	85,613

The Company has facility lease obligations in connection with the surgical hospital located in Idaho Falls, Idaho and with a radiation oncology building at this facility. The obligation is payable to the lessor of this facility for the land, building and improvements. The current portion of the lease obligation was $1.1 million and $797,000 at December 31, 2016 and 2015, respectively, and was included in other current liabilities in the consolidated balance sheets. The total of the facility lease obligations related to the surgical hospital and radiation oncology building in Idaho Falls, Idaho was $50.0 million and $50.8 million at December 31, 2016 and 2015, respectively.

Additionally, the Company has a facility lease obligation in connection with the surgical facility located in Ocala, Florida payable to the lessor of this facility for the building. The current portion of the liability was $182,000 and $169,000 at December 31, 2016 and 2015, respectively, and was included in other current liabilities in the consolidated balance sheets. The total of the facility lease obligations related to the building in Ocala, Florida was $3.7 million and $3.9 million at December 31, 2016 and 2015, respectively.

Equity-Based Compensation

Transactions in which the Company receives employee and non-employee services in exchange for the Company’s equity instruments or liabilities that are based on the fair value of the Company’s equity securities or may be settled by the issuance of these securities are accounted for using a fair value method. Prior to the Reorganization, on the grant date, the Company employed a market approach to estimate the fair value of equity-based awards based on various considerations and assumptions, including implied earnings multiples and other metrics of relevant market participants, the Company’s operating results and forecasted cash flows and the Company’s capital structure. Such estimates require the input of highly subjective, complex assumptions. However, such assumptions are no longer required to determine fair value of shares of the Company’s common stock as its underlying shares began trading publicly during the fourth quarter of 2015. The Company applies the Black-Scholes-Merton method of valuation in determining share-based compensation expense for option awards.

The Company’s policy is to recognize compensation expense using the straight line method over the relevant vesting period for units that vest based on time. Prior to the Reorganization, employees held membership units in Surgery Center Holdings, LLC, and the associated expense was referred to as unit-based compensation; following the Reorganization, such expense is referred to as equity-based compensation.

Earnings Per Share

Basic and diluted earnings per share are calculated in accordance with ASC 260, Earnings Per Share, based on the weighted-average number of shares outstanding in each period and dilutive stock options, unvested shares and warrants, to the extent such securities exist and have a dilutive effect on earnings per share.

Professional, General and Workers' Compensation Insurance

The Company maintains general liability and professional liability insurance in excess of self-insured retentions through third party commercial insurance carriers in amounts that management believes is sufficient for the Company's operations, although, potentially, some claims may exceed the scope of coverage in effect. The professional and general insurance coverage is on a claims-made basis. Workers' compensation insurance is on an occurrence basis.

The Company expenses the costs under the self-insured retention exposure for general and professional liability and workers compensation claims which relate to (i) claims made during the policy period, which are offset by insurance recoveries and (ii) an estimate of claims incurred but not yet reported that are expected to be reported after the policy period expires. Reserves and provisions are based upon actuarially determined estimates using individual case-basis valuations and actuarial analysis. Reserves for professional, general and workers' compensation claim liabilities are determined with no regard for expected insurance recoveries and are presented gross on the consolidated balance sheets. Total professional, general and workers' compensation claim liabilities as of December 31, 2016 and 2015 are $13.8 million and $9.5 million, respectively. The balance includes expected insurance recoveries of $9.3 million and $6.3 million as of December 31, 2016 and 2015, respectively.

Electronic Health Record Incentives

The American Recovery and Reinvestment Act of 2009 provides for Medicare and Medicaid incentive payments beginning in calendar year 2011 for eligible hospitals and professionals that implement and achieve meaningful use of certified Electronic Health Records ("EHR") technology. Several of the Company's surgical hospitals, which were acquired in connection with the acquisition of Symbion, have implemented plans to comply with the EHR meaningful use requirements of the Health Information Technology for Economic and Clinical Health Act ("HITECH") in time to qualify for the maximum available incentive payments.

Compliance with the meaningful use requirements has and will continue to result in significant costs including business process changes, professional services focused on successfully designing and implementing the Company's EHR solutions, along with costs associated with the hardware and software components of the project. The Company currently estimates that total costs incurred to comply will be recovered through the total EHR incentive payments over the projected life cycle of this initiative. The Company incurs both capital expenditures and operating expenses in connection with the implementation of its various EHR initiatives. The amount and timing of these expenditures do not directly correlate with the timing of the Company's cash receipts or recognition of the EHR incentives as other income. The Company expects to receive incentive payments and recognize corresponding revenue upon the completion of the EHR meaningful use requirements. The Company recorded incentive income of $408,000, $1.8 million and $3.4 million during the years ended December 31, 2016, 2015 and 2014, respectively.

Income Taxes

The Company uses the asset and liability method to account for income taxes. Under this method, deferred income tax assets and liabilities are recognized for the future tax consequences attributable to differences between the financial statement carrying amounts of existing assets and liabilities and their respective tax bases. Deferred tax assets and liabilities are measured using enacted tax rates expected to apply to taxable income in the years in which those temporary differences are expected to be recovered or settled. The effect on deferred tax assets and liabilities of a change in tax rates is recognized in income in the period that includes the enactment date. If a net operating loss carryforward exists, the Company makes a determination as to whether that net operating loss carryforward will be utilized in the future. A valuation allowance is established for certain net operating loss carryforwards when their recoverability is deemed to be uncertain. The carrying value of the net deferred tax assets assumes that the Company will be able to generate sufficient future taxable income in certain tax jurisdictions, based on estimates and assumptions. If these estimates and related assumptions change in the future, the Company may be required to adjust its deferred tax valuation allowances.

The Company, or one or more of its subsidiaries, files income tax returns in the U.S. federal jurisdiction and various state jurisdictions. With few exceptions, the Company is no longer subject to U.S. federal income tax examinations for years prior to 2013 or state income tax examinations for years prior to 2012.

Recent Accounting Pronouncements

In May 2014, the Financial Accounting Standards Board ("FASB") issued Accounting Standards Update ("ASU") 2014-09, "Revenue from Contracts with Customers," which outlines a single comprehensive model for recognizing revenue and supersedes most existing revenue recognition guidance, including guidance specific to the healthcare industry. This ASU provides companies the option of applying a full or modified retrospective approach upon adoption. This ASU was originally set to be effective for fiscal years beginning after December 15, 2016, and early adoption was not permitted. In July 2015, the FASB deferred the effective date for the standard to be effective for fiscal years beginning after December 15, 2017. The FASB will now permit companies to early adopt within one year of the new effective date. The Company will adopt this ASU on January 1, 2018 and currently plans to adopt using the full retrospective method. The Company continues to assess the impact of this ASU on its consolidated financial position, results of operations, cash flows and financial disclosures but anticipates the most significant change will be how the estimate for the allowance for doubtful accounts will be recognized under the new standard.

In February 2015, the FASB issued ASU 2015-02 “Amendments to the Consolidation Analysis,” which amends the current consolidation guidance, including introducing a separate consolidation analysis specific to limited partnerships and other similar entities. Under this analysis, limited partnerships and other similar entities will be considered a variable-interest entity unless the limited partners hold substantive kick-out rights or participating rights. The provisions of ASU 2015-02 are effective for annual reporting periods beginning after December 15, 2015. Early adoption is permitted. The Company adopted this ASU on January 1, 2016. The adoption of this ASU did not have a material impact on the Company's consolidated financial position, results of operations, cash flows and financial disclosures.

In April 2015, the FASB issued ASU 2015-03, “Simplifying the Presentation of Debt Issuance Costs," which simplifies the presentation of debt issuance costs by requiring debt issuance costs related to a recognized debt liability be presented in the balance sheet as a direct deduction from the carrying amount of that debt liability, consistent with debt discounts. ASU 2015-03 is effective for fiscal years, and interim periods within those years, beginning after December 15, 2015. Early adoption is permitted, and the new guidance should be applied retrospectively. The Company adopted this ASU on January 1, 2016 retrospectively for all periods presented. As a result of the adoption of this ASU, the Company reclassified approximately $2.2 million at December 31, 2015 from deferred loan costs to long-term debt. The adoption of this ASU did not have a material impact on the Company's consolidated financial position, results of operations, cash flows and financial disclosures.

In August 2015, the FASB issued ASU 2015-15, “Presentation and Subsequent Measurement of Debt Issuance Costs Associated with Line-of-Credit Arrangements” which clarifies the Securities and Exchange Commission (“SEC”) staff’s position on presenting and measuring debt issuance costs incurred in connection with line-of-credit arrangements given the lack of guidance on this topic in ASU 2015-03. The SEC staff has announced that it would “not object to an entity deferring and presenting debt issuance costs as an asset and subsequently amortizing the deferred debt issuance costs ratably over the term of the line-of-credit arrangement.” The Company adopted this ASU on January 1, 2016 retrospectively for all periods presented. The adoption of this ASU did not have a material impact on the Company's consolidated financial position, results of operations, cash flows and financial disclosures.

In September 2015, the FASB issued ASU 2015-16, “Business Combinations: Simplifying the Accounting for Measurement-Period Adjustments” which eliminates the requirement for an acquirer to retrospectively adjust its financial statements for changes to provisional amounts that are identified during the measurement-period following the consummation of a business combination. Instead, ASU 2015-16 requires these types of adjustments to be made during the reporting period in which they are identified and would require additional disclosure or separate presentation of the portion of the adjustment that would have been recorded in the previously reported periods as if the adjustment to the provisional amounts had been recognized as of the acquisition date. ASU 2015-16 is effective prospectively for fiscal years beginning after December 15, 2015, including interim periods within those years. The Company adopted this ASU on January 1, 2016. The adoption of this ASU did not have a material impact on the Company's consolidated financial position, results of operations, cash flows and financial disclosures.

In February 2016, the FASB issued ASU 2016-02, “Leases,” which will require, among other items, lessees to recognize most leases as assets and liabilities on the balance sheet. Qualitative and quantitative disclosures will be enhanced to better understand the amount, timing and uncertainty of cash flows arising from leases. This guidance is effective for financial statements issued for fiscal years beginning after December 15, 2018, and interim periods within those fiscal years, with early adoption permitted. The Company believes the primary effect of adopting the new standard will be to record right-of-use assets and obligations for current operating leases.

In March 2016, the FASB issued ASU 2016-07, “Investments- Equity Method and Joint Ventures,” which allows investments that now meet equity method treatment that were previously accounted for under a different method to apply the equity method prospectively from the date the investment qualifies for equity method treatment. ASU 2016-07 is effective prospectively for fiscal years beginning after December 15, 2016, including interim periods within those years. Early adoption is permitted. The Company is currently evaluating the impact this new guidance may have on the consolidated financial position, results of operations and cash flows.

In March 2016, the FASB issued ASU 2016-09, “Improvements to Employee Share-Based Payment Accounting,” which simplifies the accounting for share-based payments including the income tax consequences, classification of certain awards and treatment of forfeitures. ASU 2016-09 is effective prospectively for fiscal years beginning after December 15, 2016, including interim periods within those years. Early adoption is permitted. The Company early adopted this ASU during the first quarter of 2016. The adoption of this ASU did not have a material impact on the Company's consolidated financial position, results of operation, cash flows and financial disclosures.

In August 2016, the FASB issued ASU 2016-15, “Classification of Certain Cash Receipts and Cash Payments,” which clarifies the classification of certain cash receipts and cash payments on the statement of cash flows. ASU 2016-15 is effective retrospectively for fiscal years beginning after December 15, 2017, including interim periods within those years. Early adoption is permitted. The Company is currently evaluating the impact this new guidance may have on the consolidated cash flows.

In October 2016, the FASB issued ASU 2016-17, “Interests Held through Related Parties That Are under Common Control,” which modifies existing guidance with respect to how a decision maker that holds an indirect interest in a VIE through a common control party determines whether it is the primary beneficiary of the VIE as part of the analysis of whether the VIE would need to be consolidated. Under the ASU, a decision maker would need to consider only its proportionate indirect interest in the VIE held through a common control party. Previous guidance had required the decision maker to treat the common control party’s interest in the VIE as if the decision maker held the interest itself. As a result of the ASU, in certain cases, previous consolidation conclusions may change. ASU 2016-17 is effective prospectively for fiscal years beginning after December 15, 2016, including interim periods within those years. Early adoption is permitted. The Company is currently evaluating the impact this new guidance may have on the consolidated financial position, results of operations and cash flows.

In November 2016, the FASB issued ASU 2016-18, “Statement of Cash Flows: Restricted Cash,” which will require the reconciliation of restricted cash in the statement of cash flows. ASU 2016-18 is effective retrospectively for fiscal years beginning after December 15, 2017, including interim periods within those years. Early adoption is permitted. The adoption of this ASU will not have a material impact on the Company's consolidated cash flows.

In January 2017, the FASB issued ASU 2017-01, “Business Combinations – Clarifying the Definition of a Business,” which narrows the definition of a business when evaluating whether transactions should be accounted for as asset acquisition or business combination. ASU 2017-01 is effective for fiscal years beginning after December 15, 2017, including interim periods within those years. Early adoption is permitted. The Company is currently evaluating the impact this new guidance may have on the consolidated financial position, results of operations and cash flows.

In January 2017, the FASB issued ASU 2017-04, “Simplifying the Test for Goodwill Impairment,” which eliminates the requirement to calculate the implied fair value of goodwill (i.e., Step 2 of the current goodwill impairment test) to measure a goodwill impairment charge. Instead, entities will record an impairment charge based on the excess of a reporting unit’s carrying amount over its fair value (i.e., measure the charge based on the current Step 1). ASU 2017-04 is effective for fiscal years beginning after December 15, 2019, including interim periods within those years. Early adoption is permitted for annual and interim periods after January 1, 2017. The Company is currently evaluating the impact this new guidance may have on the consolidated financial position, results of operations and cash flows. The adoption of ASU 2017-04 would only impact the Company's financial statements in situations where an impairment of a reporting unit’s assets is determined.

Acquisitions and Developments

12 Months Ended

Dec. 31, 2016

Business Combinations [Abstract]

Acquisitions and Developments

The Company accounts for its business combinations in accordance with the fundamental requirements of the acquisition method of accounting and under the premise that an acquirer can be identified for each business combination. The acquirer is the entity that obtains control of one or more businesses in the business combination and the acquisition date is the date the acquirer achieves control. The assets acquired, liabilities assumed and any non-controlling interests in the acquired business at the acquisition date are recognized at their fair values as of that date, and the direct costs incurred in connection with the business combination are recorded and expensed separately from the business combination. Acquisitions in which the Company is able to exert significant influence but does not have control are accounted for using the equity method.

2016 Transactions

During the year ended December 31, 2016, the Company acquired a controlling interest in two surgical facilities and two anesthesia practices in new markets and a surgical facility in an existing market which was merged into an existing facility and an anesthesia practice in an existing market for an aggregate purchase price of $36.5 million. The Company additionally completed acquisitions in existing markets of an urgent care facility, nine physician practices and two integrated physician practices which includes three ASCs, a lab and a pharmacy for a combined purchase price of $114.7 million, including $16.6 million of contingent acquisition consideration. In addition, the Company purchased an additional 7.04% interest in its hospital in Idaho Falls, Idaho for $20.3 million. The transactions were funded through cash from operations, proceeds from the 2014 First Lien Credit Agreement and revolver proceeds.

The aggregate amounts preliminarily recognized as of the acquisition date for each major class of assets and liabilities assumed in the acquisitions closed during the year ended December 31, 2016 are as follows:



Cash consideration	$	135,061
Fair value of non-controlling interests	27,164
Aggregate fair value of acquisitions	162,225
Net assets acquired:
Cash and cash equivalents	4,855
Accounts receivable	6,291
Other current assets	517
Property and equipment	3,921
Intangible assets	4,475
Long-term assets	56
Accounts payable and other current assets	(1,490		)
Current maturities of long-term debt	(3,926		)
Long-term deferred tax liability	(172		)
Long-term liabilities	(197		)
Net assets acquired	14,330
Excess of fair value over identifiable net assets acquired	$	147,895

The fair values assigned to certain assets and liabilities assumed by the Company have been estimated on a preliminary basis and are subject to change as new information emerges related to the facts and circumstances that were present at the date of acquisition.

In accordance with ASC 805, Business Combinations, contingent consideration with a continuing employment provision is recognized ratably over the defined performance period as compensation expense. As of December 31, 2016, the Company estimates it may have to pay $16.6 million in future contingent purchase compensation expense over the remaining performance periods. These payments will be made should the requirements for continuing employment agreed to in the respective acquisition agreements be met. The contingent acquisition compensation expense recognized for the year ended December 31, 2016 was $5.1 million and is included as a component of general and administrative expense (and parenthetically disclosed) in the results of the Company's operations.

Estimated contingent acquisition compensation expense subsequent to December 31, 2016 is as follows (in thousands):



2017	7,476
2018	6,754
2019	1,311
Total	$	15,541

2015 Transactions

Surgical Facility Acquisitions

During the year ended December 31, 2015, the Company acquired a controlling interest in two surgical facilities located in new markets and three surgical facilities, four anesthesia practices and an urgent care facility in existing markets for an aggregate purchase price of $84.2 million. The Company consolidates these facilities for financial reporting purposes. These transactions were funded with a combination of cash from operations, facility ownership, and proceeds from the refinancing of the Company's credit facilities in connection with the Symbion acquisition.

Ancillary Services

During the year ended December 31, 2015, through its recruiting efforts and capital-efficient acquisitions, the Company completed thirteen in-market physician practice transactions through an aggregate investment of $40.4 million. These transactions added a total of 17 physicians to the Company’s physician network and were funded with a combination of cash from operations and revolver proceeds.

Acquisition of Symbion

On June 13, 2014, the Company, through its wholly-owned subsidiary, SCH Acquisition Corp. (“Merger Sub”), entered into an Agreement and Plan of Merger (the “Merger Agreement”) with Symbion Holdings Corporation ("Symbion"). Pursuant to the terms of the Merger Agreement, Merger Sub merged with and into Symbion, with Symbion being the surviving corporation in the merger (the “Merger”). At the closing of the Merger, each share of common stock of Symbion, other than those held by Symbion or by the Company, Merger Sub or their subsidiaries and other than those shares with respect to which appraisal rights are properly exercised in accordance with the General Corporation Law of the State of Delaware, were converted into the right to receive a cash payment per share equal to (x) $792.0 million, subject to certain adjustments for Symbion’s cash, debt, transaction expenses, working capital and other items at closing, plus the aggregate exercise price of all vested options, minus certain escrowed amounts relating to post-closing purchase price adjustment and indemnity obligations, divided by (y) the number of shares outstanding on a fully-diluted basis assuming full exercise of vested options and exercise of rights to receive shares upon the exchange of the 8.00% Senior PIK Exchangeable Notes due 2017 issued by Symbion (the “Merger Consideration”). In addition, each outstanding option to purchase shares of Symbion’s common stock were cancelled, and the holders of vested options were paid an amount equal to the excess, if any, of the Merger Consideration over the per-share exercise price of such vested options.

The Company obtained financing commitments for the transactions contemplated by the Merger Agreement, the aggregate proceeds of which were sufficient for the Company to pay the aggregate Merger Consideration and all related fees and expenses.

The Company completed the Merger effective November 3, 2014. At closing, the Company paid approximately $300.1 million in cash, including $16.2 million funded to an escrow account, and assumed approximately $472.4 million of outstanding indebtedness of Symbion, plus related accrued and unpaid interest. On May 3, 2016, the Company paid $16.6 million to fully fund the required balance in the escrow account. The amounts funded were materially consistent with the amounts stated within the purchase agreement. Subsequent to this funding, the escrow balance was fully distributed to the prior owners of Symbion.

The Merger was financed through the issuance of $1.4 billion of Senior Secured Credit Facilities ("Facilities"), which includes an $870.0 million first lien term loan due November 3, 2020, a $490.0 million second lien term loan due November 3, 2021 and an $80.0 million revolving credit facility.

Fees associated with the Merger, which includes fees incurred related to the Company's debt financings, were approximately $93.3 million. Approximately $5.3 million was capitalized as deferred financing costs, $21.7 million related to legal and other transaction fees which were expensed as transaction costs, $42.9 million was recorded as a reduction of the carrying value of the Facilities and $23.4 million was recorded as debt extinguishment costs during the year ended December 31, 2014.

Acquired assets and assumed liabilities include, but are not limited to, fixed assets, intangible assets and professional liabilities. The valuations are based on appraisal reports, discounted cash flow analyses, actuarial analyses or other appropriate valuation techniques to determine the fair value of the assets acquired or liabilities assumed. A majority of the deferred income taxes recognized as a component of the Company's purchase price allocation is a result of the difference between the book and tax basis of the amortizable intangible assets recognized.

The purchase price amount related to the Merger has been allocated to the related assets acquired and liabilities assumed based upon their respective fair values as follows:



Cash consideration	$	298,857
Acquisition consideration payable	16,768
Fair value of non-controlling interests	395,663
Fair value of Symbion	711,288
Net assets acquired:
Cash	40,374
Accounts receivable, net	79,830
Inventories	18,389
Prepaid expenses and other current assets	9,876
Property and equipment	153,179
Investments in and advances to affiliates	32,728
Intangible assets	31,534
Restricted invested assets	316
Other long-term assets	6,239
Accounts payable	(20,419		)
Accrued payroll and benefits	(14,600		)
Other current liabilities	(47,229		)
Current maturities of long-term debt	(83,805		)
Long-term debt, less current maturities	(376,395		)
Long-term deferred tax liabilities	(19,853		)
Other long-term liabilities	(60,500		)
Net assets acquired	(250,336		)
Excess of fair value over identifiable net assets acquired	$	961,624

The entire amount of goodwill acquired in connection with the Merger was allocated to the Company's surgical facility services operating segment. The total amount of the goodwill related to the acquisition of Symbion that will be deductible for tax purposes is $142.5 million.

Fair value attributable to non-controlling interests was based on a Level 3 computation using significant inputs that are not observable in the market. Key inputs used to determine the fair value include financial multiples used in the purchase of non-controlling interests, primarily from acquisitions of surgical facilities. Such multiples, based on earnings, are used as a benchmark for the discount to be applied for the lack of control or marketability. Fair value attributable to the property and equipment acquired was based on Level 3 computations using key inputs such as cost trend data and comparable asset sales. Fair value attributable to the intangible assets acquired was based on Level 3 computations using key inputs such as the Company's internally-prepared financial projections. Fair values assigned to acquired working capital were based on carrying amounts reported by Symbion at the date of acquisition, which approximate their fair values.

The unaudited consolidated pro forma results for years ended ended December 31, 2014 and 2013, assuming the Symbion acquisition had been consummated on January 1, 2013, are as follows (in thousands):



	Year Ended December 31,
	2014			2013
Net revenues	$	873,683		$	820,186

Net income	31,557			42,714
Less: net income attributable to non-controlling interests	(68,973		)	(64,396		)
Net loss attributable to Surgery Partners, Inc.	$	(37,416	)	$	(21,682	)

These pro forma amounts for the year ended December 31, 2014, exclude expenses related to the Merger transaction of $21.7 million and the loss on debt extinguishment of $23.4 million. In addition, the year ended December 31, 2013 excludes $9.9 million of expense related to loss on debt extinguishment.

Other 2014 Transactions

Throughout 2014, the Company acquired three physician practices for an aggregate purchase price of $1.6 million. These transactions were funded with cash from continuing operations.

- Definition

The entire disclosure for a business combination (or series of individually immaterial business combinations) completed during the period, including background, timing, and recognized assets and liabilities. The disclosure may include leverage buyout transactions (as applicable).

+ References

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+ Details

Divestitures	12 Months Ended
Divestitures	Dec. 31, 2016
Discontinued Operations and Disposal Groups [Abstract]
Divestitures	Divestitures 2016 Transactions During the year ended December 31, 2016, the Company sold its interest in one surgical facility and received aggregate proceeds of $765,000 resulting in a pre-tax gain of approximately $763,000 in the consolidated statements of operations. 2015 Transactions During the year ended December 31, 2015, the Company sold its interest in three surgical facilities and received aggregate proceeds of $10.9 million resulting in a pre-tax gain of approximately $2.9 million in the consolidated statements of operations.

- Definition

The entire disclosure related to a disposal group. Includes, but is not limited to, a discontinued operation, disposal classified as held-for-sale or disposed of by means other than sale or disposal of an individually significant component.

+ References

Reference 1: http://www.xbrl.org/2003/role/presentationRef
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+ Details

Property and Equipment

12 Months Ended

Dec. 31, 2016

Property, Plant and Equipment [Abstract]

Property and Equipment

A summary of property and equipment follows (in thousands):



	December 31,
	2016			2015

Land	$	8,082		$	6,790
Buildings and improvements	118,172			104,971
Furniture and equipment	14,670			14,520
Computer and software	29,902			24,597
Medical equipment	117,418			96,291
Construction in progress	2,396			7,619
Property and equipment, at cost	290,640			254,788
Less: Accumulated depreciation	(86,387		)	(70,238		)
Property and equipment, net	$	204,253		$	184,550

The carrying values of assets under capital lease were $15.4 million and $12.3 million as of December 31, 2016 and 2015, respectively, which included accumulated depreciation of $11.6 million and $10.5 million, respectively.

Goodwill and Intangible Assets

12 Months Ended

Dec. 31, 2016

Goodwill and Intangible Assets Disclosure [Abstract]

Goodwill and Intangible Assets

A summary of activity related to goodwill for the year ended December 31, 2016 follows (in thousands):



Balance at December 31, 2014	$	1,298,753
Acquisitions	113,812
Divestitures	(8,399		)
Purchase price adjustments	3,761
Balance at December 31, 2015	$	1,407,927
Acquisitions	147,895
Divestitures	(552		)
Purchase price adjustments	(66		)
Balance at December 31, 2016	$	1,555,204

Additions to goodwill include new acquisitions and incremental ownership acquired in the Company's subsidiaries. A summary of the Company's acquisitions for the years ended December 31, 2016 and 2015 is included in Note 3, Acquisitions and Developments.

The Company tests its goodwill and indefinite-lived intangible assets for impairment annually, as of October 1, or more frequently if certain indicators arise. The Company reviews goodwill at the reporting unit level, which is defined as one level below an operating segment. The Company has determined that it has five reporting units, which include the following: 1) Surgical Facilities 2) Ancillary Services, 3) Midwest Labs, 4) The Alliance, including Optical Synergies and 5) Family Vision Care. When reviewing goodwill, the Company compares the carrying value of the net assets of the reporting unit to the estimated fair value of the reporting unit. If the carrying value exceeds the net present value of the estimated discounted future cash flows, an impairment indicator exists and an estimate of the possible impairment loss is calculated. The fair value calculation includes multiple assumptions and estimates, including the projected cash flows and discount rates applied.

The Company performed its annual goodwill impairment assessment by developing a fair value estimate of the business enterprise as of October 1, 2016 using a discounted cash flows approach. The results of the Company's fair value estimate were corroborated using a market-based approach. The result of the Company's annual goodwill impairment test at October 1, 2016 indicated no impairment. There were also no impairment charges recorded during the years ended December 31, 2015 and 2014.

A summary of the activity related to intangible assets as of December 31, 2016 follows (in thousands):



	Physician Income Guarantees			Management Rights			Non-Compete Agreements			Certificates of Need		Customer Relationships			Other			Total Intangible Assets

Balance at December 31, 2014	$	973		$	24,757		$	16,590		$	3,711	$	6,274		$	2,583		$	54,888
Additions	1,052			—			7,532			—		—			—			8,584
Recruitment expense	(813		)	—			—			—		—			—			(813		)
Amortization	—			(1,731		)	(5,551		)	—		(1,338		)	(471		)	(9,091		)
Balance at December 31, 2015	$	1,212		$	23,026		$	18,571		$	3,711	$	4,936		$	2,112		$	53,568
Additions	210			—			4,025			69		—			450			4,754
Disposals	—			—			—			—		(22		)	(113		)	(135		)
Recruitment expense	(609		)	—			—			—		—			—			(609		)
Amortization	—			(1,736		)	(6,139		)	—		(1,210		)	(470		)	(9,555		)
Balance at December 31, 2016	$	813		$	21,290		$	16,457		$	3,780	$	3,704		$	1,979		$	48,023

During the years ended December 31, 2016, 2015 and 2014, the Company had amortization expense of $9.6 million, $9.1 million and $5.2 million, respectively.

A summary of the scheduled amortization related to the Company's finite-lived intangible assets as of December 31, 2016 follows (in thousands):



	Amortization of Finite-Lived Intangible Assets

2016	$	9,042
2017	6,923
2018	6,393
2019	4,023
2020	2,960
Thereafter	14,660
Total	$	44,001

- Definition

The entire disclosure for the aggregate amount of goodwill and a description of intangible assets, which may include (a) for amortizable intangible assets (also referred to as finite-lived intangible assets), the carrying amount, the amount of any significant residual value, and the weighted-average amortization period, (b) for intangible assets not subject to amortization (also referred to as indefinite-lived intangible assets), the carrying amount, and (c) the amount of research and development assets acquired and written off in the period, including the line item in the income statement in which the amounts written off are aggregated, if not readily apparent from the income statement. Also discloses (a) for amortizable intangibles assets in total and by major class, the gross carrying amount and accumulated amortization, the total amortization expense for the period, and the estimated aggregate amortization expense for each of the five succeeding fiscal years, (b) for intangible assets not subject to amortization the carrying amount in total and by major class, and (c) for goodwill, in total and for each reportable segment, the changes in the carrying amount of goodwill during the period (including the aggregate amount of goodwill acquired, the aggregate amount of impairment losses recognized, and the amount of goodwill included in the gain (loss) on disposal of a reporting unit). If any part of goodwill has not been allocated to a reportable segment, discloses the unallocated amount and the reasons for not allocating. For each impairment loss recognized related to an intangible asset (excluding goodwill), discloses: (a) a description of the impaired intangible asset and the facts and circumstances leading to the impairment, (b) the amount of the impairment loss and the method for determining fair value, (c) the caption in the income statement or the statement of activities in which the impairment loss is aggregated, and (d) the segment in which the impaired intangible asset is reported. For each goodwill impairment loss recognized, discloses: (a) a description of the facts and circumstances leading to the impairment, (b) the amount of the impairment loss and the method of determining the fair value of the associated reporting unit, and (c) if a recognized impairment loss is an estimate not finalized and the reasons why the estimate is not final. May also disclose the nature and amount of any significant adjustments made to a previous estimate of an impairment loss.

+ References + Details

Long-Term Debt

12 Months Ended

Dec. 31, 2016

Debt Disclosure [Abstract]

Long-Term Debt

A summary of long-term debt follows (in thousands):



	December 31,
	2016			2015

2014 Revolver Loan	$	85,000		$	125,250
2014 First Lien Term Loans	932,000			861,300
2014 Second Lien Credit Agreement	—			246,500
Senior Unsecured Notes	400,000			—
Subordinated Notes	1,000			1,000
Notes payable and secured loans	42,521			40,615
Capital lease obligations	13,996			11,316
Less: Unamortized debt issuance costs and discounts	(32,274		)	(30,622		)
Total debt	1,442,243			1,255,359
Less: Current maturities	27,822			27,247
Total long-term debt	$	1,414,421		$	1,228,112

2014 Revolver Loan

The proceeds of the 2014 Revolver Loan (“Revolver”) may be used for working capital, acquisitions and development activities and general corporate purposes in an aggregate principal amount at any time outstanding not to exceed $150.0 million and matures on November 3, 2019. On October 7, 2015, the Company entered into an amendment to the 2014 First Lien Credit Agreement to increase certain lenders’ commitments under the Revolver from $80.0 million to an aggregate principal amount at any time outstanding not to exceed $150.0 million.

The Company has the option of classifying borrowings under the Revolver as either Alternate Base Rate ("ABR") loans or Eurodollar ("ED") loans. The interest base rate on an ABR loan is equal to the greatest of (a) the Prime Rate in effect on such day, (b) the Federal Funds Effective Rate in effect on such day plus 0.50% and (c) the adjusted LIBO Rate for a Eurodollar Borrowing with a one-month interest period plus 1.00%. In addition to the base rate, the Company is required to pay a 3.25% margin for ABR loans. The interest base rate on an ED loan is equal to (x) the LIBO Rate for such Eurodollar borrowing in effect for such Interest Period divided by (y) One minus the Statutory Reserves (if any) for such Eurodollar Borrowing for such interest period. In addition to the base rate, the Company is required to pay a 4.25% margin for ED loans.

The Company paid $2.3 million in connection with obtaining the Revolver and recorded this amount as debt issuance costs, which is presented as other assets, net of accumulated amortization of approximately $985,000 and $530,000, in the accompanying consolidated balance sheets as of December 31, 2016 and 2015, respectively.

The Company must also pay quarterly commitment fees of 0.50% per annum of the average daily unused amount of the Revolver. As of December 31, 2016, the Company's availability on the Revolver was $61.9 million (including outstanding letters of credit of $3.1 million).

The credit agreement that governs the Revolver contains various covenants that include limitations on the Company's indebtedness, liens, acquisitions and investments. It additionally includes the requirement that the Company maintain a net leverage ratio within a specified range. At December 31, 2016, the Company was in compliance with the covenants contained in the credit agreement.

2014 First Lien Credit Agreement

The 2014 First Lien Term Loans (“2014 First Lien”) is a senior secured obligation of Surgery Center Holdings, Inc. and is guaranteed on a senior secured basis by the Company and certain of its subsidiaries. The 2014 First Lien matures on November 3, 2020. On March 24, 2016, Surgery Center Holdings, Inc. and certain subsidiaries of the Company entered into an amendment to the 2014 First Lien to obtain an incremental senior secured term loan in an aggregate principal amount of $80.0 million, which increased the total term loan obligation under the 2014 First Lien to $950.0 million. The Company used the proceeds of the incremental term loan to fund certain proposed acquisitions and for other corporate purposes. On September 26, 2016, the Company entered into an amendment to the 2014 First Lien to reduce the interest margins for an ABR loan to 2.75% and for an ED loan to 3.75%.

The Company has the option of classifying the 2014 First Lien as either an ABR loan or an ED loan. The interest base rate on an ABR loan is equal to the greatest of (a) the Prime Rate in effect on such day, (b) the Federal Funds Effective Rate in effect on such day plus 0.50%, and (c) the Adjusted LIBO Rate for a Eurodollar Borrowing with a one-month interest period plus 1.00%; provided that the base rate shall not be less than 2.00% per annum. In addition to the base rate, the Company is required to pay a 2.75% margin for ABR loans. The interest base rate on an ED loan is equal to (x) the LIBO Rate for such Eurodollar borrowing in effect for such Interest Period divided by (y) One minus the Statutory Reserves (if any) for such Eurodollar Borrowing for such interest period; provided that the rate shall not be less than 1.00% per annum. In addition to the base rate, the Company is required to pay a 3.75% margin for ED loans. Accrued interest is payable in arrears on a quarterly basis. Within five business days after the earlier of (i) 90 days after the end of each fiscal year or (ii) the date on which financial statements have been delivered, the Company is required to make mandatory prepayments in amounts calculated in accordance with the excess cash flow provisions of the 2014 First Lien Credit Agreement. There were no excess cash flow payments required as of December 31, 2016.

The credit agreement that governs the 2014 First Lien contains various covenants that include limitations on the Company's indebtedness, liens, acquisitions and investments. At December 31, 2016, the Company was in compliance with the covenants contained in the credit agreement. The 2014 First Lien is collateralized by substantially all of the assets of the Company.

2014 Second Lien Credit Agreement

The 2014 Second Lien Credit Agreement (“2014 Second Lien”), entered into on November 3, 2014, was prepaid in full on March 31, 2016 as described below. The 2014 Second Lien was a senior secured obligation of Surgery Center Holdings, Inc. and was guaranteed on a senior secured basis by the Company and certain of its subsidiaries.

On October 6, 2015, we prepaid $243.5 million in principal, net of the write-off of discounts and issuance costs totaling $8.3 million, and $65,000 of accrued interest on the 2014 Second Lien. Further, we incurred a prepayment penalty of 3% of the aggregate principal amount or $7.3 million. The write-off of the discounts and issuance costs, the prepayment penalty as well as certain other costs are presented as a loss on debt extinguishment of $16.1 million in the accompanying consolidated statement of operations as of December 31, 2015. On March 31, 2016, the Company repaid the remaining principal of the 2014 Second Lien of $252.8 million with the proceeds of the issuance of the Senior Unsecured Notes, defined below, of which $1.3 million was accrued interest. In connection with the prepayment, the Company incurred a loss on debt refinancing of $8.3 million which included the write-off of loan costs and the original issue discount and a prepayment penalty.

Senior Unsecured Notes

Effective March 31, 2016, one of the Company's subsidiaries, Surgery Center Holdings, Inc., issued $400.0 million in gross proceeds of senior unsecured notes due April 15, 2021 (the "Senior Unsecured Notes"). The Senior Unsecured Notes bear interest at the rate of 8.875% per year, payable semi-annually on April 15 and October 15 of each year. The Senior Unsecured Notes are a senior unsecured obligation of Surgery Center Holdings, Inc. and are guaranteed on a senior unsecured basis by each of Surgery Center Holdings, Inc.'s existing and future domestic wholly owned restricted subsidiaries that guarantees the Revolver and the 2014 First Lien.

The Company may redeem up to 35% of the aggregate principal amount of the Senior Unsecured Notes, at any time before April 15, 2018, with the net cash proceeds of certain equity offerings at a redemption price equal to 108.875% of the principal amount to be redeemed, plus accrued and unpaid interest to, but excluding, the date of redemption, provided that at least 50% of the aggregate principal amount of the Senior Unsecured Notes remain outstanding immediately after the occurrence of such redemption and such redemption occurs within 180 days of the date of the closing of any such qualified equity offering.

The Company may redeem the Senior Unsecured Notes, in whole or in part, at any time prior to April 15, 2018 at a price equal to 100.000% of the principal amount of the notes redeemed plus an applicable make-whole premium, plus accrued and unpaid interest, if any, to, but excluding, the date of redemption. The Company may redeem the Senior Unsecured Notes, in whole or in part, at any time on or after April 15, 2018, plus accrued and unpaid interest, if any, to the date of redemption plus a redemption price equal to a percentage of the principal amount of the notes redeemed based on the following redemption schedule:



April 15, 2018 to April 14, 2019	106.656	%
April 15, 2019 to April 14, 2020	104.438	%
April 15, 2020 and thereafter	100.000	%

If one of the Company's subsidiaries, Surgery Center Holdings, Inc., experiences a change in control under certain circumstances, it must offer to purchase the notes at a purchase price equal to 101% of the principal amount, plus accrued and unpaid interest to, but excluding, the date of repurchase.

The Senior Unsecured Notes contain customary affirmative and negative covenants, which among other things, limit the Company’s ability to incur additional debt, pay dividends, create or assume liens, effect transactions with its affiliates, guarantee payment of certain debt securities, sell assets, merge, consolidate, enter into acquisitions and effect sale and leaseback transactions.

In connection with the offering of the Senior Unsecured Notes, the Company recorded debt issuance costs of $8.4 million.

Other Debt Transactions

On January 27, 2014, the Company obtained $90.0 million in additional borrowings on the Credit Facilities to return capital to shareholders. The Company recorded $1.4 million and $2.9 million as a reduction of the carrying value of the additional borrowings as original issue discount and amounts paid to lender for debt related issuance costs, respectively, which are accreted to interest expense over the term of the loan. During the year ended December 31, 2014, approximately $380,000 was accreted to interest expense. The $90.0 million in additional borrowings, including the related debt issuance costs, were included in the extinguishment of debt that was financed with the proceeds of the Facilities obtained in connection with the acquisition of Symbion on November 3, 2014.

Subordinated Notes

Effective April 11, 2013, the Company amended and reduced the size of its subordinated debt facility ("Subordinated Notes") to $1.0 million from $53.8 million. Through a separate transaction in April 2013, H.I.G. Surgery Centers, LLC, an affiliate of the Company, purchased the Subordinated Notes from an independent third party. At December 31, 2016 and 2015, the debt is payable to H.I.G. Surgery Centers, LLC. and mature on August 4, 2017. Effective January 1, 2014, the Subordinated Notes bear interest of 17.00% per annum.

Notes Payable and Secured Loans

Certain of the Company’s subsidiaries have outstanding bank indebtedness, which is collateralized by the real estate and equipment owned by the surgical facilities to which the loans were made. The various bank indebtedness agreements contain covenants to maintain certain financial ratios and also restrict encumbrance of assets, creation of indebtedness, investing activities and payment of distributions. At December 31, 2016, the Company was in compliance with its covenants contained in the credit agreement. The Company and its subsidiaries had notes payable to financial institutions of $42.5 million and $40.6 million as of December 31, 2016 and 2015, respectively.

Capital Lease Obligations

The Company is liable to various vendors for several equipment leases classified as capital leases. The carrying value of the leased assets was $15.4 million and $12.3 million as of December 31, 2016 and 2015, respectively.

Maturities

A summary of the scheduled maturities of our debt obligations as of December 31, 2016 follows (in thousands):



	Capital Lease Obligations		Other Long-Term Debt		Total

2017	$	4,860	$	22,963	$	27,823
2018	3,952		22,076		26,028
2019	2,960		100,911		103,871
2020	1,535		908,458		909,993
2021	633		402,219		402,852
Thereafter	56		3,894		3,950
Total debt	$	13,996	$	1,460,521	$	1,474,517

Operating Leases

12 Months Ended

Dec. 31, 2016

Leases [Abstract]

Operating Leases

The Company leases office space and equipment for its surgical facilities, including surgical facilities under development. The lease agreements generally require the lessee, or the Company, to pay all maintenance, property taxes, utilities and insurance costs. The Company accounts for operating lease obligations and sublease income on a straight-line basis. Contingent obligations of the Company, as defined by each lease agreement, are recognized when specific contractual measures have been met, typically the result of an increase in the Consumer Price Index. Lease obligations paid in advance are recorded as prepaid rent and included in prepaid expenses and other current assets on the consolidated balance sheets. The difference between actual lease payments and straight-line lease expense over the initial lease term, excluding optional renewal periods, is recorded as deferred rent and included in other current liabilities and other long-term liabilities on the consolidated balance sheets. As part of the Merger, the Company ceased use of four of their operating leases and accrued a liability of $4.6 million, net of discounting and sublease income during 2015. The Company expensed this through merger transaction and integration costs, as the leases related to offices shut down in connection with the Merger.

The future minimum lease payments under non-cancellable operating leases, net of sub-lease income, follows (in thousands):



2017	$	46,517
2018	42,917
2019	39,181
2020	34,415
2021	28,728
Thereafter	143,558
Total minimum operating lease payments	$	335,316

Total operating lease expense was $47.3 million, $40.1 million and $18.8 million for the years ended December 31, 2016, 2015 and 2014, respectively. Included in these amounts, the Company incurred lease expense of $14.4 million, $12.9 million and $6.9 million for years ended December 31, 2016, 2015 and 2014, respectively, under operating lease agreements with physician investors who are related parties.

The Company has various sub-lease arrangements and the future minimum lease payments to be received under these non-cancellable arrangements are as follows (in thousands):



2017	$	1,101
2018	1,137
2019	658
2020	468
2021	312
Thereafter	1,919
Total non-cancellable sub-lease income	$	5,595

- Definition

The entire disclosure for lessor entity's leasing arrangements for operating, capital and leveraged leases.

+ References + Details

Earnings Per Share

12 Months Ended

Dec. 31, 2016

Earnings Per Share [Abstract]

Earnings Per Share

The following is a reconciliation of the numerator and denominator of basic and diluted earnings per share for the years ended December 31, 2016, 2015 and 2014 (in thousands except share and per share amounts):



	Year Ended December 31,
	2016		2015		2014

Numerator:
Net income (loss) attributable to Surgery Partners, Inc.	$	9,453	$	1,429	$	(65,897	)

Denominator:
Weighted average shares outstanding- basic ⁽¹⁾	48,018,944		36,066,233		32,295,364
Effect of dilutive securities ⁽²⁾	171,794		1,398,154		—
Weighted average shares outstanding- diluted	48,190,738		37,464,387		32,295,364

Earnings (loss) per share:
Basic earnings (loss) per share	$	0.20	$	0.04	$	(2.04	)
Diluted earnings (loss) per share ⁽²⁾	$	0.20	$	0.04	$	(2.04	)

Securities outstanding not included in the computation of diluted loss per share as their effect is antidilutive:
Stock options	—		—		—
Restricted shares	—		—		1,386,805

⁽¹⁾ Effect of the Reorganization has been retrospectively applied to all periods presented.

⁽²⁾The impact of potentially dilutive securities for the year ended December 31, 2014 was not considered because the effect would be anti-dilutive in each of those periods.

Income Taxes and Tax Receivable Agreement

12 Months Ended

Dec. 31, 2016

Income Tax Disclosure [Abstract]

Income Taxes and Tax Receivable Agreement

As part of the Reorganization that was effective September 30, 2015, the Company entered into a Tax Receivable Agreement (“TRA”) under which generally the Company will be required to pay to its stockholders as of immediately prior to the IPO 85% of the cash savings, if any, in U.S. federal, state or local tax that the Company actually realizes (or is deemed to realize in certain circumstances) as a result of (i) certain tax attributes, including NOLs, capital losses, charitable deductions, alternative minimum tax credit carryforwards and federal and state tax credits of Surgery Partners, Inc. and its affiliates relating to taxable years ending on or before the date of the Reorganization (calculated by assuming the taxable year of the relevant entity closes on the date of the Reorganization) that are or become available to the Company and its wholly-owned subsidiaries as a result of the Reorganization, and (ii) tax benefits attributable to payments made under the TRA, together with interest accrued at a rate of LIBOR plus 300 basis points from the date the applicable tax return is due (without extension) until paid. The Company expects the payments it will be required to make under the TRA will be substantial.

The amounts payable under the TRA will vary depending upon a number of factors, including the amount, character and timing of the taxable income of Surgery Partners, Inc. in the future. The Company estimates the total amounts payable to be approximately $123.3 million, if the tax benefits of related deferred tax assets are ultimately realized. Of the total amount payable, the Company expects to pay approximately $1.0 million of the liability during the year ending December 31, 2017.

The Company and its subsidiaries file a consolidated federal income tax return. The partnerships, limited liability companies, and certain non-consolidated physician practice corporations file separate income tax returns. The Company's allocable portion of each partnership's and limited liability company's income or loss is included in taxable income of the Company. The remaining income or loss of each partnership and limited liability company is allocated to the other owners.

The Company made income tax payments of $661,000, $1.1 million and $676,000 for the years ended December 31, 2016, 2015 and 2014, respectively.

Income tax expense (benefit) is comprised of the following (in thousands):



	Year Ended December 31,
	2016			2015			2014

Current:
Federal	$	(31	)	$	—		$	—
State	244			909			1,669
Deferred:
Federal	7,326			(132,311		)	13,235
State	(444		)	(17,580		)	854
Total income tax expense (benefit)	$	7,095		$	(148,982	)	$	15,758

A reconciliation of the provision for income taxes as reported in the consolidated statements of operations and the amount of income tax expense (benefit) computed by multiplying consolidated income (loss) in each year by the U.S. federal statutory rate of 35% follows (in thousands):



	Year Ended December 31,
	2016			2015			2014

Tax expense (benefit) at U.S.federal statutory rate	$	32,263		$	(26,648	)	$	(3,840	)
State income tax, net of U.S. federal tax benefit	(86		)	1,059			1,402
Change in valuation allowance	354			(137,721		)	29,336
Expiration of carryforwards and stock option forfeitures	—			—			1,286
Net income attributable to non-controlling interests	(26,470		)	(24,996		)	(13,207		)
Changes in measurement of uncertain tax positions	(262		)	(10		)	589
Stock option compensation	(200		)	—			—
Nondeductible transaction costs	—			3,442			4,230
Tax return reconciling differences	1,635			(1,574		)	(4,419		)
Change in effective tax rate	—			(2,143		)	—
TRA liability	(327		)	39,428			—
Other	188			181			381
Total income tax expense (benefit)	$	7,095		$	(148,982	)	$	15,758

The components of temporary differences and the approximate tax effects that give rise to the Company’s net deferred tax asset are as follows (in thousands):



	December 31,
	2016			2015

Deferred tax assets:
Medical malpractice liability	$	4,194		$	869
Accrued vacation and incentive compensation	1,112			2,212
Net operating loss carryforwards	158,796			146,663
Allowance for bad debts	8,343			1,846
Capital loss carryforwards	2,785			2,052
Deferred rent	1,371			2,288
Depreciation on property and equipment	530			—
Deferred financing costs	—			3,083
TRA liability	4,542			2,750
Other deferred assets	4,879			3,286
Total gross deferred tax assets	186,552			165,049
Less: Valuation allowance	(7,358		)	(6,949		)
Total deferred tax assets	179,194			158,100
Deferred tax liabilities:
Deferred financing costs	(8,797		)	—
Depreciation on property and equipment	—			(806		)
Amortization of intangible assets	(15,241		)	(16,083		)
Basis differences of partnerships and joint ventures	(68,160		)	(46,494		)
Other deferred liabilities	(3,203		)	(612		)
Total deferred tax liabilities	(95,401		)	(63,995		)
Net deferred tax assets	$	83,793		$	94,105

The Company had federal net operating loss carryforwards of $390.6 million as of December 31, 2016, which expire between 2025 and 2036 and state net operating loss carryforwards of $542.7 million as of December 31, 2016, which expire between 2017 and 2036. The Company had capital loss carryforwards of $7.4 million as of December 31, 2016, which expire between 2018 and 2021. The Company had federal and state credit carryforwards of $714,000 as of December 31, 2016. The federal credits do not expire, and the state credits expire between 2017 and 2028.

The Company has recorded a valuation allowance against deferred tax assets at December 31, 2016 and 2015 totaling $7.4 million and $6.9 million, respectively, which represents an increase of $500,000. The valuation allowance continues to be provided for certain deferred tax assets for which the Company believes it is more likely than not that the tax benefits will not be realized, which are primarily certain state net operating losses and capital loss carryforwards.

Included in the increase in the valuation allowance for the year ended December 31, 2016 was an increase of approximately $336,000 that was recorded to additional-paid-in-capital as the result of the tax effect of the disposals of shares of noncontrolling interests. Approximately $2.4 million of the valuation allowance as of December 31, 2016 is recorded against deferred tax assets that, if subsequently recognized, will be credited directly to contributed capital.

A reconciliation of the beginning and ending liability for gross unrecognized tax benefits for the years ended December 31, 2016 and 2015 is as follows (in thousands):



	Year Ended December 31,
	2016			2015

Unrecognized tax benefits at beginning of year	$	1,403		$	2,755
Additions for tax positions of prior years	60			136
Reductions for tax positions of prior year	(398		)	(996		)
Settlements	(4		)	(492		)
Unrecognized tax benefits at end of year	$	1,061		$	1,403

The Company recognizes interest and penalties related to uncertain tax positions in its provision for income taxes in the consolidated statements of operations. For the years ended December 31, 2016 and 2015, the Company had approximately $163,000 and $322,000, respectively, of accrued interest and penalties related to uncertain tax positions. The total amount of accrued liabilities related to uncertain tax positions that would affect the Company's effective tax rate, if recognized, is $309,000 as of December 31, 2016. The reserves are included in long-term taxes payable and long-term deferred tax assets in the consolidated balance sheet as of December 31, 2016.

Equity-Based Compensation

12 Months Ended

Dec. 31, 2016

Disclosure of Compensation Related Costs, Share-based Payments [Abstract]

Equity-Based Compensation

Prior to the Reorganization, the Surgery Center Holdings, LLC’s ("Holdings LLC") Amended and Restated Limited Liability Company Agreement, dated December 24, 2009, provided, from time to time, as approved by the Holdings LLC's Board, for the issuance of a subordinate class of the Holdings LLC's nonvoting membership units to certain key persons, as defined, of the Company or its subsidiaries.

In April 2013, the Company modified the terms of the 2010 awards to allow for additional vesting in 2013 of its share-based awards with time-vesting conditions. In November 2014, the Holdings LLC issued to certain executives of Symbion who became employees of the Company following the Company’s acquisition of Symbion an additional 1,300,000 unvested B-Units, which are subject to vesting conditions to occur through November 2019.

Prior to the Reorganization, in the event of employee termination, the B-Units were subject to a 90-day repurchase option. Upon termination, all unvested B-Units were effectively forfeited. If the employee was terminated for cause, as defined, or resigned prior to the expiration of certain tenure periods specified in such employee’s agreement, the repurchase price for each vested B-Unit was zero, and was deemed automatically repurchased by the Company. The repurchase price for vested B-Units, should the Company elect to exercise the repurchase option, was at fair market value, as defined. If the Company did not exercise the repurchase option, the employee owned the vested B-Units pursuant to the Holdings LLC's LLC Agreement, which included restrictions on transfer, among other provisions. The fair value of each Holdings LLC issued B-Unit was estimated on the date of grant.

In September 2015, the Company adopted the Surgery Partners, Inc. 2015 Omnibus Incentive Plan ("2015 Omnibus Incentive Plan") from which all equity-based awards will be granted. Under this plan, the Company can grant stock options, SARs, restricted stock, unrestricted stock, stock units, performance awards, cash awards and other awards convertible into or otherwise based on shares of its common stock. As of December 31, 2016, 4,815,700 shares were authorized to be granted under the 2015 Omnibus Incentive Plan and 4,311,816 were available for future equity grants.

Equity Valuation

In applying the Black-Scholes-Merton option pricing model, the Company used the following assumptions:

▪ Risk-free interest rate. The risk-free interest rate is used as a component of the fair value of stock options to take into account the time value of money. For the risk-free interest rate, the Company uses the implied yield on United States Treasury zero-coupon issues with a remaining term equal to the expected life, in years, of the options granted.

▪ Expected volatility. Volatility, for the purpose of share-based compensation, is a measurement of the amount that a share price has fluctuated. Expected volatility involves reviewing historical volatility and determining what, if any, change the share price will have in the future. The Company used historical stock price information of certain peer group companies for a period of time equal to the expected option life period to determine estimated volatility.

▪ Expected life, in years. A clear distinction is made between the expected life of an option and the contractual term of the option. The expected life of an option is considered the amount of time, in years, that an option is expected to be outstanding before it is exercised. Whereas, the contractual term of the stock option is the term an option is valid before it expires.

▪ Expected dividend yield. Since issuing dividends will affect the fair value of a stock option, GAAP requires companies to estimate future dividend yields or payments. The Company has not historically issued dividends and does not intend to issue dividends in the future. As a result, the Company does not apply a dividend yield component to its valuation.

The following table sets forth the assumptions used by the Company to estimate the fair value of options granted under the 2015 Omnibus Incentive Plan:



Expected volatility		29% - 43%
Risk-free interest rate		0.54% - 1.36%
Expected dividends		—
Average expected term (years)		2.56
Fair value of stock options granted		$2.64 - $5.74

The estimated fair value of options is amortized to expense on a straight-line basis over the options’ vesting period.

Stock Option Activity

A summary of stock option activity during the year ended December 31, 2016 is as follows:



	Options	Weighted Average Exercise Price		Weighted Average Remaining Contractual Term (years)
Outstanding at December 31, 2014	—
Granted	8,448	$	20.03	3.0
Exercised	—
Forfeited	—
Outstanding at December 31, 2015	8,488	$	20.03	3.0
Granted	7,779	17.99		1.6
Exercised	—
Forfeited	—
Outstanding at December 31, 2016⁽¹⁾	16,267	$	19.05	1.8

⁽¹⁾ Of the outstanding options, 2,829 were exercisable as of December 31, 2016.

Restricted Share Activity

All units and per unit amounts in these consolidated financial statements and notes to the consolidated financial statements reflect the Reorganization that occurred in September 2015 (see Note 1). A summary of issued restricted stock activity for the years ended December 31, 2016, 2015, and 2014 follows:



	Total Shares		Vested Shares		Unvested Shares		Weighted-Average Grant Fair Value

Outstanding at January 1, 2014	3,234,664		1,788,780		1,445,884			$0.81
Granted	583,404		—		583,404		6.44
Forfeited/Terminated	(127,582	)	—		(127,582	)	1.27
Purchased	(803,336	)	(803,336	)	—		3.64
Vested	—		659,641		(659,641	)	1.43
Outstanding at December 31, 2014	2,887,150		1,645,085		1,242,065			$1.96
Granted	569,114		—		569,114		6.31
Forfeited/Terminated	—		—		—		—
Purchased	(11,742	)	(11,742	)	—		6.31
Vested	—		1,643,525		(1,643,525	)	3.79
Outstanding at December 31, 2015	3,444,522		3,276,868		167,654			$2.53
Granted	384,629		—		384,629		15.09
Forfeited/Terminated	(53,003	)	—		(53,003	)	11.85
Purchased	—		—		—		—
Vested	—		37,038		(37,038	)	6.31
Outstanding at December 31, 2016	3,776,148		3,313,906		462,242			$3.72

At December 31, 2016, unrecognized compensation cost related to unvested shares was approximately $4.7 million. Unrecognized compensation cost will be expensed annually based on the number of shares that vest during the year.

Employees forfeited 53,000, zero and 128,000 unvested shares as of December 31, 2016, 2015 and 2014, respectively, related to their termination.

The Company recorded compensation expense of $2.0 million, $7.5 million, and $942,000 to recognize the fair value of the restricted shares that vested and stock options granted through December 31, 2016, 2015, and 2014, respectively. In connection with the IPO, 1,632,626 restricted shares immediately vested which resulted in accelerated vesting of $6.2 million which is included within the $7.5 million of equity-based compensation expense for the year ended December 31, 2015.

Employee Benefit Plans	12 Months Ended
Employee Benefit Plans	Dec. 31, 2016
Compensation and Retirement Disclosure [Abstract]
Employee Benefit Plans	Employee Benefit Plans Surgery Partners 401(k) Plan The Surgery Partners 401(k) Plan is a defined contribution plan whereby certain employees who have completed at least one month of service, including at least one hour of service during that period of time, are eligible to participate. Employees may enroll in the plan immediately upon completion of the minimum service requirement. The Surgery Partners 401(k) Plan allows eligible employees to make contributions of varying percentages or flat dollar amounts of their annual compensation, up to the maximum allowable amounts by the Internal Revenue Service ("IRS"). Eligible employees may or may not receive a match by the Company of their contributions. Employee salary deferrals exceeding six percent of annual compensation are ineligible for a Company matching contribution. Employer contributions vest 20% after one year of service and continue vesting at 20% per year until fully vested. The Company's matching contribution expense for both the Surgery Partners 401(k) Plan and the Symbion, Inc. 401(k) Plan for the years ended December 31, 2016, 2015 and 2014 was $5.1 million, $2.2 million and $754,000, respectively. Supplemental Executive Retirement Savings Plan In connection with the Symbion acquisition, the Company acquired and continues to maintain a supplemental executive retirement savings plan (the "SERP") for certain former Symbion executives. The SERP provides supplemental retirement savings alternatives to eligible officers and key employees of the Company by allowing participants to defer portions of their compensation. Under the SERP, eligible employees may enroll in the plan before December 31 to be entered in the plan the following year. Eligible employees may defer into the SERP up to 25% of their normal period payroll and up to 50% of their annual bonus. If the enrolled employee contributes a minimum of 2% of his or her base salary into the SERP, the Company will contribute 2% of the enrolled employee’s base salary to the plan and has the option of contributing additional amounts. Periodically, the enrolled employee’s deferred amounts are transferred to a plan administrator. The plan administrator maintains separate non-qualified accounts for each enrolled employee to track deferred amounts. On May 1 of each year, the Company is required to make its contribution to each enrolled employee’s account. See Note 2 on Significant Accounting Policies for information about the fair value of the assets and liabilities in the SERP.

Related Party Transactions	12 Months Ended
Related Party Transactions	Dec. 31, 2016
Related Party Transactions [Abstract]
Related Party Transactions	Related Party Transactions On December 24, 2009, the Company and Bayside Capital, Inc. (or "Bayside"), an affiliate of H.I.G. Capital, LLC (or "H.I.G."), entered into a Management and Investment Advisory Services Agreement ("Management Agreement") pursuant to which the Company will receive certain management, consulting and financial advisory services. Effective May 4, 2011, the Management Agreement was amended pursuant to the NovaMed merger and the management fee was increased to $2.0 million annually. The Company recognized $2.0 million for the year ended December 31, 2014 related to the Management Agreement. Effective November 3, 2014, the Management Agreement was amended pursuant to the Symbion acquisition and the management fee was increased to $3.0 million annually. Fees related to the Management Agreement for the years ended December 31, 2015 and 2014 are recognized as general and administrative expense in the accompanying consolidated statements of operations. Additionally, the Company incurred additional advisory fees related to refinancing transactions of $17.6 million for the year ended December 31, 2014. During the year ended December 31, 2015, Bayside was paid a transaction fee pursuant to the Management Agreement of $5.4 million as a result of the IPO and the Management Agreement was terminated upon the completion of the IPO.

- Definition

The entire disclosure for related party transactions. Examples of related party transactions include transactions between (a) a parent company and its subsidiary; (b) subsidiaries of a common parent; (c) and entity and its principal owners; and (d) affiliates.

+ References + Details

Commitments and Contingencies	12 Months Ended
Commitments and Contingencies	Dec. 31, 2016
Commitments and Contingencies Disclosure [Abstract]
Commitments and Contingencies	Commitments and Contingencies Lease and Debt Guarantees of Non-Consolidated Facilities As of December 31, 2016 and 2015, the Company had guaranteed approximately $12,000 and $160,000, respectively, of operating lease payments for certain non-consolidated surgical facilities that were acquired in connection with the Symbion transaction. These operating leases typically have ten-year terms, with optional renewal periods. Professional, General and Workers' Compensation Liability Risks The Company is subject to claims and legal actions in the ordinary course of business, including claims relating to patient treatment, employment practices and personal injuries. To cover these claims, the Company maintains general liability and professional liability insurance in excess of self-insured retentions through third party commercial insurance carriers in amounts that management believes is sufficient for the Company's operations, although, potentially, some claims may exceed the scope of coverage in effect. The professional and general insurance coverage is on a claims-made basis. Workers' compensation insurance is on an occurrence basis. Plaintiffs in these matters may request punitive or other damages that may not be covered by insurance. The Company is not aware of any such proceedings that would have a material adverse effect on the Company's business, financial condition or results of operations. Laws and Regulations Laws and regulations governing the Company's business, including those relating to the Medicare and Medicaid programs, are complex and subject to interpretation. These laws and regulations govern every aspect of how the Company's surgical facilities conduct their operations, from licensing requirements to how and whether the Company's facilities may receive payments pursuant to the Medicare and Medicaid programs. Compliance with such laws and regulations can be subject to future government agency review and interpretation as well as legislative changes to such laws. Noncompliance with such laws and regulations may subject the Company to significant regulatory action including fines, penalties, and exclusion from the Medicare, Medicaid and other federal healthcare programs. From time to time, governmental regulatory agencies will conduct inquiries of the Company's practices, including, but not limited to, the Company's compliance with federal and state fraud and abuse laws, billing practices and relationships with physicians. It is the Company's current practice and future intent to cooperate fully with such inquiries. The Company is not aware of any such inquiry that would have a material adverse effect on the Company's business, financial condition, or results of operations. Acquired Facilities The Company, through its wholly-owned subsidiaries or controlled partnerships and limited liability companies, has acquired and will continue to acquire surgical facilities with prior operating histories. Such facilities may have unknown or contingent liabilities, including liabilities for failure to comply with healthcare laws and regulations, such as billing and reimbursement, fraud and abuse and similar anti-referral laws. Although the Company attempts to assure that no such liabilities exist, obtain indemnification from prospective sellers covering such matters and institute policies designed to conform centers to its standards following completion of acquisitions, there can be no assurance that the Company will not become liable for past activities that may later be asserted to be improper by private plaintiffs or government agencies. There can be no assurance that any such matter will be covered by indemnification or, if covered, that the liability sustained will not exceed contractual limits or the financial capacity of the indemnifying party. The Company cannot predict whether federal or state statutory or regulatory provisions will be enacted that would prohibit or otherwise regulate relationships which the Company has established or may establish with other healthcare providers or have materially adverse effects on its business or revenues arising from such future actions. Management believes, however, that it will be able to adjust the Company's operations so as to be in compliance with any statutory or regulatory provision as may be applicable. Potential Physician Investor Liability A majority of the physician investors in the partnerships and limited liability companies which operate the Company's surgical facilities carry general and professional liability insurance on a claims-made basis. Each partnership or limited liability company may, however, be liable for damages to persons or property arising from occurrences at the surgical facilities. Although the various physician investors and other surgeons generally are required to obtain general and professional liability insurance with tail coverage that extends beyond the period of any claims-made policies, such individuals may not be able to obtain coverage in amounts sufficient to cover all potential liability. Since most insurance policies contain exclusions, the physician investors will not be insured against all possible occurrences. In the event of an uninsured or underinsured loss, the value of an investment in the partnership interests or limited liability company membership units and the amount of distributions could be adversely affected. Contingent Consideration Pursuant to a purchase agreement dated December 24, 2009 (“the Purchase Agreement”), the Company acquired controlling interests in thirty-six business entities in various Florida locations which operate freestanding ASCs and provided anesthesia and pain management services (“the 2009 Acquisition”). Non-controlling interests in the ASCs were owned by certain physicians that remained partners/members in the ASCs and other operating entities. The Purchase Agreement provided for maximum potential contingent consideration of up to $10.0 million based on operating results subsequent to the acquisition for the period from January 1, 2010 to December 31, 2010. Pursuant to the Purchase Agreement, the contingent consideration is payable as principal under a Subordinated Promissory Note, the form of which was delivered concurrent with the Purchase Agreement. The balance is still outstanding due to ongoing litigation as a result of the civil claim discussed in detail below. The Subordinated Promissory Note bears interest at 8% and during the years ended December 31, 2016 and 2015, the Company recorded approximately $1.1 million and $1.0 million, respectively, of interest expense related to the note. As discussed below, the Company has made indemnification claims against the Seller exceeding the amount of the contingent consideration liability. The Company has a contractual right of offset against the contingent consideration. In conjunction with the 2009 Acquisition, an escrow account in the amount of $2.9 million was created to cover any contingencies. With the formation of this escrow account, the Company was indemnified against certain indemnification obligations. In 2010, $589,000 was paid to the Company in settlement of the acquisition price adjustment noted above. In December 2010, the Company filed an indemnification claim against the Seller alleging breaches of and inaccuracies in representations and warranties included in the Purchase Agreement. Pursuant to the Purchase Agreement, the escrow agent has not paid the remaining escrow funds due to the unresolved claim associated with this acquisition. Pursuant to the terms of the Purchase Agreement, in December 2010, the Company filed a claim for indemnification from the Seller for reimbursement of amounts to be repaid to payors for overpayment amounts received by the Seller prior to the date of acquisition, including other losses sustained, and submitted a withdrawal notice to the escrow agent in the amount of approximately $4.4 million. The indemnification claim asserts, among other allegations, that certain operating entities acquired from the Seller improperly recorded payments received from certain payors as income and that one acquired entity used improper billing, coding and collection practices for dates of service prior to acquisition date. The Seller submitted an objection to this claim and filed a civil claim requesting the court to dismiss the Company’s claim and release funds out of escrow. Subsequent to the acquisition date, the Company determined the acquired accounts receivable were not properly recorded at the net realizable value of the asset. The Company determined the fair value assigned in the initial acquisition accounting resulted in accounts receivable being recorded at an amount which was approximately $14.0 million in excess of the fair value. On June 10, 2013, the court issued a judgment in favor of the Company regarding its indemnification claim and its claim regarding the overstatement of accounts receivable. Specifically, the court ruled that the Company is entitled to recover approximately $454,000 for the indemnification claims which represents the amount of the original claim less the application of deductibles. The court also ruled that the Company is entitled to receive approximately $10.8 million for the overstated net accounts receivable. The Purchase Agreement provides for any award of damages to the Company to be offset first by the money in the escrow account and then by an offset to the contingent consideration. Therefore, the court ordered that the funds in the escrow account be paid to the Company and the balance of approximately $8.3 million be offset against the $10.0 million contingent consideration. To date, no final judgment has been made regarding the award of attorneys’ fees and interest. Following the judgment noted above, an appeal was filed by the Seller. and a cross-appeal was filed by the Company and, in December 2016, the appeals court found in favor of the Company that the trial court erred in calculating damages in the final judgment, in failing to award prejudgment interest on the liquidated damages, and in failing to award the appellees an offset of their costs and fees incurred in this litigation against amounts owing pursuant to the earnout note, as well as dismissing the arguments raised by the Seller in its appeal as without merit. The parties have since agreed to mediate the dispute and mediation is currently scheduled to begin on April 20, 2017. The funds from the escrow account have not been released to the Company but based on the court order, the Company has removed the contingent consideration liability and indemnification receivable on its consolidated balance sheets at December 31, 2016. Both amounts were written off to a gain on litigation settlement of $14.1 million on the consolidated statement of operations.

Segment Reporting

12 Months Ended

Dec. 31, 2016

Segment Reporting [Abstract]

Segment Reporting

A public company is required to report annual and interim financial and descriptive information about its reportable operating segments. Operating segments, as defined, are components of an enterprise about which separate financial information is available that is evaluated regularly by the chief operating decision maker, or "CODM," in deciding how to allocate resources and in assessing performance.

The Company operates in three major lines of business that are also the Company's reportable operating segments - the operation of surgical facilities, the operation of optical services and the operation of ancillary services, which includes physician practices, a diagnostic laboratory and a specialty pharmacy.

During the second quarter of 2016, the Company reassessed its segment reporting and realigned the disclosures to reflect the review and decision making made by the CODM. The purpose of these changes was to replace operating income with adjusted EBITDA as the primary profit/loss metric reviewed by the CODM in making key business decisions and on allocation of resources. The Company has revised the segment disclosures below to replace operating income with adjusted EBITDA and has provided a reconciliation from adjusted EBITDA back to net income in the reported condensed consolidated financial information. These changes had no effect on the Company’s reportable segments, which are presented consistent with prior periods.

The following tables present financial information for each reportable segment (in thousands):



	Year Ended December 31,
	2016		2015		2014
Net Revenues:
Surgical facility services	$	1,042,097	$	884,144	$	339,309
Ancillary services	90,836		61,175		49,787
Optical services	12,505		14,572		14,193
Total revenues	$	1,145,438	$	959,891	$	403,289



	Year Ended December 31,
	2016			2015			2014
Segment Adjusted EBITDA:
Surgical facility services	$	214,218		$	180,113		$	83,149
Ancillary services	12,685			18,715			18,354
Optical services	3,308			3,905			3,880
Total segment adjusted EBITDA ⁽³⁾	$	230,211		$	202,733		$	105,383

General and administrative expenses	$	(60,246	)	$	(55,992	)	$	(31,452	)
Non-cash stock compensation expense	2,021			7,502			942
Contingent acquisition compensation expense	5,092			—			—
Management fee⁽⁴⁾	—			2,250			2,161
Acquisition related costs	2,185			1,560			—
Total adjusted EBITDA ⁽³⁾	179,263			158,053			77,034

Net income attributable to non-controlling interests	75,630			71,416			38,845
Depreciation and amortization	(39,551		)	(34,545		)	(15,061		)
Interest and other expense, net	(100,571		)	(100,980		)	(62,101		)
Income tax (expense) benefit	(7,095		)	148,982			(15,758		)
Non-cash stock compensation expense	(2,021		)	(7,502		)	(942		)
Contingent acquisition compensation expense	(5,092		)	—			—
Termination of management agreement and IPO costs	—			(5,834		)	—
Management fee ⁽⁴⁾	—			(2,250		)	(2,161		)
Merger transaction, integration and practice acquisition costs ⁽⁵⁾	(11,617		)	(20,579		)	(21,690		)
Gain on litigation settlement	14,101			—			—
(Loss) gain on disposal or impairment of long-lived assets, net	(2,355		)	2,097			(1,804		)
Tax receivable agreement expense	(3,733		)	(119,911		)	—
Loss on debt refinancing	(11,876		)	(16,102		)	(23,414		)
Total net income (loss)	$	85,083		$	72,845		$	(27,052	)

⁽³⁾The above table reconciles adjusted EBITDA by segment to net income as reflected in the unaudited condensed consolidated statements of operations.

When the Company uses the term “Adjusted EBITDA,” it is referring to net income minus (a) net income attributable to non-controlling interests plus (b) income tax (benefit) expense, (c) interest and other expense, net, (d) depreciation and amortization, (e) termination of management agreement and IPO costs, (f) management fee, (g) merger transaction, integration and practice acquisition costs, (h) non-cash stock compensation expense, (i) loss on debt refinancing, (j) contingent acquisition compensation expense, (k) tax receivable agreement expense, (l) gain on litigation settlement and (m) (loss) gain on disposal or impairment of long-lived assets. Non-controlling interests represent the interests of third parties, such as physicians, and in some cases, healthcare systems that own an interest in surgical facilities that the Company consolidates for financial reporting purposes. The Company's operating strategy is to apply a market-based approach in structuring its partnerships with individual market dynamics driving the structure. The Company believes that it is helpful to investors to present Adjusted EBITDA as defined above because it excludes the portion of net income attributable to these third-party interests and clarifies for investors the Company's portion of Adjusted EBITDA generated by its surgical facilities and other operations.

The Company uses Adjusted EBITDA as a measure of liquidity. It is included because the Company believes that it provides investors with additional information about its ability to incur and service debt and make capital expenditures.

Adjusted EBITDA is not a measurement of financial performance or liquidity under GAAP. It should not be considered in isolation or as a substitute for net income, operating income, cash flows from operating, investing or financing activities, or any other measure calculated in accordance with generally accepted accounting principles. The items excluded from Adjusted EBITDA are significant components in understanding and evaluating financial performance and liquidity. The Company's calculation of Adjusted EBITDA may not be comparable to similarly titled measures reported by other companies.

⁽⁴⁾ Fee payable pursuant the Management and Investment Advisory Services Agreement between the Company and Bayside, which was terminated in connection with the Company's IPO.

⁽⁵⁾ This amount includes merger transaction and integration costs of $8.7 million and $17.9 million for the years ended December 31, 2016 and 2015, respectively, and practice acquisition costs of $2.9 million and $2.7 million for the years ended December 31, 2016 and 2015, respectively.



	December 31, 2016		December 31, 2015
Assets:
Surgical facility services	$	1,914,842	$	1,762,396
Ancillary services	184,002		118,198
Optical services	22,478		25,537
Total	$	2,121,322	$	1,906,131

General and administrative	$	183,636	$	198,312
Total assets	$	2,304,958	$	2,104,443



	Year Ended December 31,
	2016		2015		2014
Supplemental Information:
Cash purchases of property and equipment, net:
Surgical facility services	$	29,157	$	26,723	$	5,158
Ancillary services	5,388		1,051		1,034
Optical services	351		128		335
Total	$	34,896	$	27,902	$	6,527

General and administrative	$	4,213	$	5,537	$	1,209
Total cash purchases of property and equipment, net	$	39,109	$	33,439	$	7,736

- Definition

The entire disclosure for reporting segments including data and tables. Reportable segments include those that meet any of the following quantitative thresholds a) it's reported revenue, including sales to external customers and intersegment sales or transfers is 10 percent or more of the combined revenue, internal and external, of all operating segments b) the absolute amount of its reported profit or loss is 10 percent or more of the greater, in absolute amount of 1) the combined reported profit of all operating segments that did not report a loss or 2) the combined reported loss of all operating segments that did report a loss c) its assets are 10 percent or more of the combined assets of all operating segments.

+ References

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+ Details

Quarterly Financial Information (Unaudited)

12 Months Ended

Dec. 31, 2016

Quarterly Financial Information Disclosure [Abstract]

Quarterly Financial Information (Unaudited)

The following tables include a summary of certain information related to the Company's quarterly consolidated results of operations for each of the four quarters in the years ended December 31, 2016 and 2015. The amounts are as follows (in thousands and unaudited):



	Fiscal Quarter
	1Q16		2Q16		3Q16		4Q16
Revenues	267,074		289,681		282,682		306,001
Cost of revenues	196,703		208,852		201,394		214,247
Net income	10,357		22,293		14,334		38,100
Net income attributable to non-controlling interests	(17,547	)	(20,173	)	(16,672	)	(21,238	)
Net (loss) income attributable to Surgery Partners, Inc.	(7,190	)	2,120		(2,338	)	16,862
Basic net (loss) income per share of common stock	(0.15	)	0.04		(0.05	)	0.35
Diluted net (loss) income per share common stock	(0.15	)	0.04		(0.05	)	0.35



	Fiscal Quarter
	1Q15		2Q15		3Q15		4Q15
Revenues	224,143		232,827		239,599		263,322
Cost of revenues	155,773		161,558		168,821		183,174
Net income	10,488		12,479		13,784		36,094
Net income attributable to non-controlling interests	(17,250	)	(17,905	)	(16,906	)	(19,355	)
Net (loss) income attributable to Surgery Partners, Inc.	(6,762	)	(5,426	)	(3,122	)	16,739
Basic net (loss) income per share of common stock	(0.21	)	(0.17	)	(0.10	)	0.35
Diluted net (loss) income per share common stock	(0.21	)	(0.17	)	(0.10	)	0.35

Significant Accounting Policies (Policies)	12 Months Ended
Significant Accounting Policies (Policies)	Dec. 31, 2016
Organization, Consolidation and Presentation of Financial Statements [Abstract]
Principles of Consolidation	Principles of Consolidation The consolidated financial statements include the accounts of the Company and its wholly-owned subsidiaries, as well as interests in partnerships and limited liability companies controlled by the Company through its ownership of a majority voting interest or other rights granted to the Company by contract to manage and control the affiliate's business. All significant intercompany balances and transactions are eliminated in consolidation.
Non-Controlling Interests	Non-Controlling Interests The physician limited partners and physician minority members of the entities that the Company controls are responsible for the supervision and delivery of medical services. The governance rights of limited partners and minority members are restricted to those that protect their financial interests. Under certain partnership and operating agreements governing these partnerships and limited liability companies, the Company could be removed as the sole general partner or managing member for certain events such as material breach of the partnership or operating agreement, gross negligence or bankruptcy. These protective rights do not preclude consolidation of the respective partnerships and limited liability companies. Ownership interests in consolidated subsidiaries held by parties other than the Company are identified and generally presented in the consolidated financial statements within the equity section but separate from the Company's equity. However, in instances in which certain redemption features that are not solely within the control of the Company are present, classification of non-controlling interests outside of permanent equity is required. Consolidated net income attributable to the Company and to the non-controlling interests are identified and presented on the consolidated statements of operations; changes in ownership interests are accounted for as equity transactions assuming the Company continues to consolidate related entities. Certain transactions with non-controlling interests are classified within financing activities in the consolidated statements of cash flows. The consolidated financial statements of the Company include all assets, liabilities, revenues and expenses of surgical facilities in which the Company has sufficient ownership and rights to allow the Company to consolidate the surgical facilities. Similar to its investments in non-consolidated affiliates, the Company regularly engages in the purchase and sale of ownership interests with respect to its consolidated subsidiaries that do not result in a change of control. Non-Controlling Interests — Redeemable. Each of the partnerships and limited liability companies through which the Company owns and operates its surgical facilities is governed by a partnership or operating agreement. In certain circumstances, the partnership and operating agreements for the Company's surgical facilities provide that the facilities will purchase all of the physicians’ ownership if certain adverse regulatory events occur, such as it becoming illegal for the physicians to own an interest in a surgical facility, refer patients to a surgical facility or receive cash distributions from a surgical facility. The non-controlling interests - redeemable are reported outside of stockholders' equity in the consolidated balance sheets.
Variable Interest Entities	Variable Interest Entities The consolidated financial statements include the accounts of variable interest entities in which the Company is the primary beneficiary under the provisions of Accounting Standards Codification ("ASC") Topic 810, Consolidation. At December 31, 2016, the variable interest entities include five surgical facilities, three anesthesia practices and two physician practices. At December 31, 2015, the variable interest entities included five surgical facilities, three anesthesia practices and one physician practice. There was an additional one acquisition at December 31, 2016. The Company has the power to direct the activities that most significantly impact the variable interest entity's economic performance. Additionally, the Company would absorb the majority of the expected losses of these entities should they occur.
Equity Method Investments	Equity Method Investments The Company has non-consolidating investments in surgical facilities and management companies that own or manage surgical facilities. These investments are accounted for using the equity method of accounting.
Use of Estimates	Use of Estimates The consolidated financial statements have been prepared in accordance with U.S. generally accepted accounting principles ("GAAP"). The preparation of financial statements in conformity with GAAP requires management to make estimates and assumptions that affect the amounts reported in the consolidated financial statements and footnotes. Examples include, but are not limited to, estimates of accounts receivable allowances, professional and general liabilities and the estimate of deferred tax assets or liabilities. In the opinion of management, all adjustments considered necessary for a fair presentation have been included. All adjustments are of a normal, recurring nature. Actual results could differ from those estimates.
Reclassifications	Reclassifications Certain reclassifications have been made to the comparative periods' financial statements to conform to the current year presentation.
Fair Value of Financial Instruments	The fair values of the 2014 First Lien Credit Agreement, 2014 Second Lien Credit Agreement and Senior Unsecured Notes, as defined in Note 5 on Long-Term Debt, were based on a Level 2 computation using quoted prices for identical liabilities in inactive markets at December 31, 2016 and 2015, as applicable. The carrying amounts related to the Company's other long-term debt obligations approximate their fair values. The Company maintains a supplemental executive retirement savings plan (the "SERP") for certain former Symbion executive officers. The SERP is a non-qualified deferred compensation plan for eligible executive officers and other key employees of the Company that allows participants to defer portions of their compensation. The fair value of the SERP asset and liability was based on a quoted market price, or a Level 1 computation Fair Value of Financial Instruments The fair value of a financial instrument is the amount at which the instrument could be exchanged in an orderly transaction between market participants to sell the asset or transfer the liability. The Company uses fair value measurements based on quoted prices in active markets for identical assets or liabilities (Level 1), inputs other than quoted prices in active markets that are either directly or indirectly observable (Level 2), or unobservable inputs in which little or no market data exists, therefore requiring an entity to develop its own assumptions (Level 3), depending on the nature of the item being valued. The carrying amounts reported in the consolidated balance sheets for cash and cash equivalents, accounts receivable, restricted invested assets and accounts payable approximate their fair values.
Revenues	Patient service revenues. The fee charged for healthcare procedures performed in surgical facilities varies depending on the type of service provided, but usually includes all charges for usage of an operating room, a recovery room, special equipment, medical supplies, nursing staff and medications. The fee does not normally include professional fees charged by the patient’s surgeon, anesthesiologist or other attending physician, which are billed directly by such physicians to the patient or third-party payor. However, in several surgical facilities, the Company charges for anesthesia services. Ancillary service revenues include fees for patient visits to the Company's physician practices, pharmacy services and diagnostic tests ordered by physicians. Patient service revenues are recognized on the date of service, net of estimated contractual adjustments and discounts from third-party payors, including Medicare and Medicaid. Changes in estimated contractual adjustments and discounts are recorded in the period of change. Revenues The Company recognizes revenues in the period in which the services are performed. Patient service revenues and receivables from third-party payors are recorded net of estimated contractual adjustments and allowances, which the Company estimates based on the historical trend of its cash collections and contractual write-offs, accounts receivable agings, established fee schedules, contracts with payors and procedure statistics. Other service revenues. Optical service revenues consist of product sales from the Company's optical laboratories as well as handling charges billed to the members of the Company's optical products purchasing organization. The Company's optical products purchasing organization negotiates volume buying discounts with optical products manufacturers. The buying discounts and any handling charges billed to the members of the buying group represent the revenue recognized for financial reporting purposes. Revenue is recognized as orders are shipped to members. The Company bases its estimates for sales returns and discounts on historical experience and has not experienced significant fluctuations between estimated and actual return activity and discounts given. The Company's optical laboratories manufacture and distribute corrective lenses and eyeglasses to ophthalmologists and optometrists. Revenue is recognized when product is shipped, net of allowance for discounts. The Company's marketing products and services businesses recognize revenue when product is shipped or services are rendered. Other revenues include management and administrative service fees derived from the non-consolidated facilities that the Company accounts for under the equity method, management of surgical facilities in which it does not own an interest, and management services provided to physician practices for which the Company is not required to provide capital or additional assets. The fees derived from these management arrangements are based on a predetermined percentage of the revenues of each facility or practice and are recognized in the period in which services are rendered.
Cash and Cash Equivalents	Cash and Cash Equivalents The Company considers all highly liquid investments with a maturity of three months or less when purchased to be cash equivalents. The Company maintains its cash and cash equivalent balances at high credit quality financial institutions.
Accounts Receivable and Allowances for Contractual Adjustments and Doubtful Accounts	The Company records an estimate for doubtful accounts based on the aging category and historical collection experience of each product sales or other business included in other service revenues, as discussed in the note above. The receivables related to the Company's optical products purchasing organization are recognized separately from patient accounts receivable, as discussed above, and are included in other current assets in the consolidated balance sheets. Accounts Receivable and Allowances for Contractual Adjustments and Doubtful Accounts Accounts receivable are recorded net of contractual adjustments and allowances for doubtful accounts to reflect accounts receivable at net realizable value. Accounts receivable consists of receivables from federal and state agencies (under the Medicare and Medicaid programs), managed care health plans, commercial insurance companies, employers and patients. Management recognizes that revenues and receivables from government agencies are significant to the Company's operations, but it does not believe that there is significant credit risk associated with these government agencies. Concentration of credit risk with respect to other payors is limited because of the large number of such payors. As of December 31, 2016, the Company had a net third-party Medicaid settlements receivable of $454,000 compared to a third-party Medicaid settlements liability of $5.2 million at December 31, 2015. The Company recognizes that final reimbursement of accounts receivable is subject to final approval by each third-party payor. However, because the Company has contracts with its third-party payors and also verifies insurance coverage of the patient before medical services are rendered, the amounts that are pending approval from third-party payors are not significant. The Company's policy is to collect co-payments and deductibles prior to providing medical services. It is also the Company's policy to verify a patient’s insurance 72 hours prior to the patient’s procedure. Patient services of the Company are primarily non-emergency, which allows the surgical facilities to control the procedures for which third-party reimbursement is sought and obtained. The Company does not require collateral from self-pay patients. The Company analyzes accounts receivable at each of its facilities to ensure the proper aged category and collection assessment. At a consolidated level, the Company's policy is to review accounts receivable aging, by facility, to determine the appropriate allowance for doubtful accounts. Patient account balances are reviewed for delinquency based on contractual terms. This review is supported by an analysis of the actual revenues, contractual adjustments and cash collections received. An account balance is written off only after the Company has pursued collection with legal or collection agency assistance or otherwise has deemed an account to be uncollectible.
Inventories	Inventories Inventories, which consist primarily of medical and drug supplies, are stated at the lower of cost or market value. Cost is determined using the first-in, first-out method.
Property and Equipment	Property and Equipment Property and equipment are stated at cost or, if obtained through acquisition, at fair value determined on the date of acquisition. Depreciation is recognized using the straight-line method over the estimated useful lives of the assets, generally three to five years for computers and software and five to seven years for furniture and equipment. Leasehold improvements are depreciated on a straight-line basis over the shorter of the lease term or the estimated useful life of the assets. Routine maintenance and repairs are expensed as incurred, while expenditures that increase capacities or extend useful lives are capitalized. The Company also leases certain facilities and equipment under capital leases. Assets held under capital leases are stated at the present value of minimum lease payments at the inception of the related lease. Such assets are depreciated on a straight-line basis over the lesser of the lease term or the remaining useful life of the leased asset.
Goodwill and Intangible Assets	Goodwill and Intangible Assets Goodwill represents the fair value of the consideration provided in an acquisition over the fair value of net assets acquired and is not amortized. The Company has indefinite-lived intangible assets related to the certificates of need held in jurisdictions where certain of its surgical facilities are located. The Company also has finite-lived intangible assets related to physician guarantee agreements, non-compete agreements, management agreements and customer relationships. Physician income guarantees are amortized into salaries and benefits costs in the consolidated statements of operations over the commitment period of the contract, generally three to four years. Non-compete agreements and management rights agreements are amortized into depreciation and amortization expense in the consolidated statements of operations over the service lives of the agreements, ranging from two years to 20 years for non-compete agreements and 15 years for the management rights agreements. Customer relationships are amortized into depreciation and amortization expense in the consolidated statements of operations over the estimated lives of the relationships, ranging from three to ten years.
Impairment of Long-Lived Assets, Goodwill and Intangible Assets	Impairment of Long-Lived Assets, Goodwill and Intangible Assets The Company evaluates the carrying value of long-lived assets when impairment indicators are present or when circumstances indicate that impairment may exist. The Company performs an impairment test by preparing an expected undiscounted cash flow projection. If the projection indicates that the recorded amount of the long-lived asset is not expected to be recovered, the carrying value is reduced to estimated fair value. The cash flow projection and fair value represents management’s best estimate, using appropriate and customary assumptions, projections and methodologies, at the date of evaluation. No impairment losses on long-lived assets were recognized during the years ended December 31, 2016, 2015 and 2014. The Company tests its goodwill and indefinite-lived intangible assets for impairment annually, as of October 1, or more frequently if certain indicators arise. The Company performs its annual goodwill impairment assessment by developing a fair value estimate of the business enterprise as of October 1, 2016 using a discounted cash flows approach and comparing the fair value to the carrying value of the net assets of the individual reporting units as of October 1, or additionally if impairment indicators are present. The results of the Company's fair value estimate are then corroborated using a market-based approach.
Equity-Based Compensation	Equity-Based Compensation Transactions in which the Company receives employee and non-employee services in exchange for the Company’s equity instruments or liabilities that are based on the fair value of the Company’s equity securities or may be settled by the issuance of these securities are accounted for using a fair value method. Prior to the Reorganization, on the grant date, the Company employed a market approach to estimate the fair value of equity-based awards based on various considerations and assumptions, including implied earnings multiples and other metrics of relevant market participants, the Company’s operating results and forecasted cash flows and the Company’s capital structure. Such estimates require the input of highly subjective, complex assumptions. However, such assumptions are no longer required to determine fair value of shares of the Company’s common stock as its underlying shares began trading publicly during the fourth quarter of 2015. The Company applies the Black-Scholes-Merton method of valuation in determining share-based compensation expense for option awards. The Company’s policy is to recognize compensation expense using the straight line method over the relevant vesting period for units that vest based on time. Prior to the Reorganization, employees held membership units in Surgery Center Holdings, LLC, and the associated expense was referred to as unit-based compensation; following the Reorganization, such expense is referred to as equity-based compensation.
Earnings Per Share	Earnings Per Share Basic and diluted earnings per share are calculated in accordance with ASC 260, Earnings Per Share, based on the weighted-average number of shares outstanding in each period and dilutive stock options, unvested shares and warrants, to the extent such securities exist and have a dilutive effect on earnings per share.
Professional, General and Workers' Compensation Insurance	Professional, General and Workers' Compensation Insurance The Company maintains general liability and professional liability insurance in excess of self-insured retentions through third party commercial insurance carriers in amounts that management believes is sufficient for the Company's operations, although, potentially, some claims may exceed the scope of coverage in effect. The professional and general insurance coverage is on a claims-made basis. Workers' compensation insurance is on an occurrence basis. The Company expenses the costs under the self-insured retention exposure for general and professional liability and workers compensation claims which relate to (i) claims made during the policy period, which are offset by insurance recoveries and (ii) an estimate of claims incurred but not yet reported that are expected to be reported after the policy period expires. Reserves and provisions are based upon actuarially determined estimates using individual case-basis valuations and actuarial analysis. Reserves for professional, general and workers' compensation claim liabilities are determined with no regard for expected insurance recoveries and are presented gross on the consolidated balance sheets.
Electronic Health Record Incentives	Electronic Health Record Incentives The American Recovery and Reinvestment Act of 2009 provides for Medicare and Medicaid incentive payments beginning in calendar year 2011 for eligible hospitals and professionals that implement and achieve meaningful use of certified Electronic Health Records ("EHR") technology. Several of the Company's surgical hospitals, which were acquired in connection with the acquisition of Symbion, have implemented plans to comply with the EHR meaningful use requirements of the Health Information Technology for Economic and Clinical Health Act ("HITECH") in time to qualify for the maximum available incentive payments. Compliance with the meaningful use requirements has and will continue to result in significant costs including business process changes, professional services focused on successfully designing and implementing the Company's EHR solutions, along with costs associated with the hardware and software components of the project. The Company currently estimates that total costs incurred to comply will be recovered through the total EHR incentive payments over the projected life cycle of this initiative. The Company incurs both capital expenditures and operating expenses in connection with the implementation of its various EHR initiatives. The amount and timing of these expenditures do not directly correlate with the timing of the Company's cash receipts or recognition of the EHR incentives as other income. The Company expects to receive incentive payments and recognize corresponding revenue upon the completion of the EHR meaningful use requirements.
Income Taxes	Income Taxes The Company uses the asset and liability method to account for income taxes. Under this method, deferred income tax assets and liabilities are recognized for the future tax consequences attributable to differences between the financial statement carrying amounts of existing assets and liabilities and their respective tax bases. Deferred tax assets and liabilities are measured using enacted tax rates expected to apply to taxable income in the years in which those temporary differences are expected to be recovered or settled. The effect on deferred tax assets and liabilities of a change in tax rates is recognized in income in the period that includes the enactment date. If a net operating loss carryforward exists, the Company makes a determination as to whether that net operating loss carryforward will be utilized in the future. A valuation allowance is established for certain net operating loss carryforwards when their recoverability is deemed to be uncertain. The carrying value of the net deferred tax assets assumes that the Company will be able to generate sufficient future taxable income in certain tax jurisdictions, based on estimates and assumptions. If these estimates and related assumptions change in the future, the Company may be required to adjust its deferred tax valuation allowances. The Company, or one or more of its subsidiaries, files income tax returns in the U.S. federal jurisdiction and various state jurisdictions. With few exceptions, the Company is no longer subject to U.S. federal income tax examinations for years prior to 2013 or state income tax examinations for years prior to 2012.
Recent Accounting Pronouncements	Recent Accounting Pronouncements In May 2014, the Financial Accounting Standards Board ("FASB") issued Accounting Standards Update ("ASU") 2014-09, "Revenue from Contracts with Customers," which outlines a single comprehensive model for recognizing revenue and supersedes most existing revenue recognition guidance, including guidance specific to the healthcare industry. This ASU provides companies the option of applying a full or modified retrospective approach upon adoption. This ASU was originally set to be effective for fiscal years beginning after December 15, 2016, and early adoption was not permitted. In July 2015, the FASB deferred the effective date for the standard to be effective for fiscal years beginning after December 15, 2017. The FASB will now permit companies to early adopt within one year of the new effective date. The Company will adopt this ASU on January 1, 2018 and currently plans to adopt using the full retrospective method. The Company continues to assess the impact of this ASU on its consolidated financial position, results of operations, cash flows and financial disclosures but anticipates the most significant change will be how the estimate for the allowance for doubtful accounts will be recognized under the new standard. In February 2015, the FASB issued ASU 2015-02 “Amendments to the Consolidation Analysis,” which amends the current consolidation guidance, including introducing a separate consolidation analysis specific to limited partnerships and other similar entities. Under this analysis, limited partnerships and other similar entities will be considered a variable-interest entity unless the limited partners hold substantive kick-out rights or participating rights. The provisions of ASU 2015-02 are effective for annual reporting periods beginning after December 15, 2015. Early adoption is permitted. The Company adopted this ASU on January 1, 2016. The adoption of this ASU did not have a material impact on the Company's consolidated financial position, results of operations, cash flows and financial disclosures. In April 2015, the FASB issued ASU 2015-03, “Simplifying the Presentation of Debt Issuance Costs," which simplifies the presentation of debt issuance costs by requiring debt issuance costs related to a recognized debt liability be presented in the balance sheet as a direct deduction from the carrying amount of that debt liability, consistent with debt discounts. ASU 2015-03 is effective for fiscal years, and interim periods within those years, beginning after December 15, 2015. Early adoption is permitted, and the new guidance should be applied retrospectively. The Company adopted this ASU on January 1, 2016 retrospectively for all periods presented. As a result of the adoption of this ASU, the Company reclassified approximately $2.2 million at December 31, 2015 from deferred loan costs to long-term debt. The adoption of this ASU did not have a material impact on the Company's consolidated financial position, results of operations, cash flows and financial disclosures. In August 2015, the FASB issued ASU 2015-15, “Presentation and Subsequent Measurement of Debt Issuance Costs Associated with Line-of-Credit Arrangements” which clarifies the Securities and Exchange Commission (“SEC”) staff’s position on presenting and measuring debt issuance costs incurred in connection with line-of-credit arrangements given the lack of guidance on this topic in ASU 2015-03. The SEC staff has announced that it would “not object to an entity deferring and presenting debt issuance costs as an asset and subsequently amortizing the deferred debt issuance costs ratably over the term of the line-of-credit arrangement.” The Company adopted this ASU on January 1, 2016 retrospectively for all periods presented. The adoption of this ASU did not have a material impact on the Company's consolidated financial position, results of operations, cash flows and financial disclosures. In September 2015, the FASB issued ASU 2015-16, “Business Combinations: Simplifying the Accounting for Measurement-Period Adjustments” which eliminates the requirement for an acquirer to retrospectively adjust its financial statements for changes to provisional amounts that are identified during the measurement-period following the consummation of a business combination. Instead, ASU 2015-16 requires these types of adjustments to be made during the reporting period in which they are identified and would require additional disclosure or separate presentation of the portion of the adjustment that would have been recorded in the previously reported periods as if the adjustment to the provisional amounts had been recognized as of the acquisition date. ASU 2015-16 is effective prospectively for fiscal years beginning after December 15, 2015, including interim periods within those years. The Company adopted this ASU on January 1, 2016. The adoption of this ASU did not have a material impact on the Company's consolidated financial position, results of operations, cash flows and financial disclosures. In February 2016, the FASB issued ASU 2016-02, “Leases,” which will require, among other items, lessees to recognize most leases as assets and liabilities on the balance sheet. Qualitative and quantitative disclosures will be enhanced to better understand the amount, timing and uncertainty of cash flows arising from leases. This guidance is effective for financial statements issued for fiscal years beginning after December 15, 2018, and interim periods within those fiscal years, with early adoption permitted. The Company believes the primary effect of adopting the new standard will be to record right-of-use assets and obligations for current operating leases. In March 2016, the FASB issued ASU 2016-07, “Investments- Equity Method and Joint Ventures,” which allows investments that now meet equity method treatment that were previously accounted for under a different method to apply the equity method prospectively from the date the investment qualifies for equity method treatment. ASU 2016-07 is effective prospectively for fiscal years beginning after December 15, 2016, including interim periods within those years. Early adoption is permitted. The Company is currently evaluating the impact this new guidance may have on the consolidated financial position, results of operations and cash flows. In March 2016, the FASB issued ASU 2016-09, “Improvements to Employee Share-Based Payment Accounting,” which simplifies the accounting for share-based payments including the income tax consequences, classification of certain awards and treatment of forfeitures. ASU 2016-09 is effective prospectively for fiscal years beginning after December 15, 2016, including interim periods within those years. Early adoption is permitted. The Company early adopted this ASU during the first quarter of 2016. The adoption of this ASU did not have a material impact on the Company's consolidated financial position, results of operation, cash flows and financial disclosures. In August 2016, the FASB issued ASU 2016-15, “Classification of Certain Cash Receipts and Cash Payments,” which clarifies the classification of certain cash receipts and cash payments on the statement of cash flows. ASU 2016-15 is effective retrospectively for fiscal years beginning after December 15, 2017, including interim periods within those years. Early adoption is permitted. The Company is currently evaluating the impact this new guidance may have on the consolidated cash flows. In October 2016, the FASB issued ASU 2016-17, “Interests Held through Related Parties That Are under Common Control,” which modifies existing guidance with respect to how a decision maker that holds an indirect interest in a VIE through a common control party determines whether it is the primary beneficiary of the VIE as part of the analysis of whether the VIE would need to be consolidated. Under the ASU, a decision maker would need to consider only its proportionate indirect interest in the VIE held through a common control party. Previous guidance had required the decision maker to treat the common control party’s interest in the VIE as if the decision maker held the interest itself. As a result of the ASU, in certain cases, previous consolidation conclusions may change. ASU 2016-17 is effective prospectively for fiscal years beginning after December 15, 2016, including interim periods within those years. Early adoption is permitted. The Company is currently evaluating the impact this new guidance may have on the consolidated financial position, results of operations and cash flows. In November 2016, the FASB issued ASU 2016-18, “Statement of Cash Flows: Restricted Cash,” which will require the reconciliation of restricted cash in the statement of cash flows. ASU 2016-18 is effective retrospectively for fiscal years beginning after December 15, 2017, including interim periods within those years. Early adoption is permitted. The adoption of this ASU will not have a material impact on the Company's consolidated cash flows. In January 2017, the FASB issued ASU 2017-01, “Business Combinations – Clarifying the Definition of a Business,” which narrows the definition of a business when evaluating whether transactions should be accounted for as asset acquisition or business combination. ASU 2017-01 is effective for fiscal years beginning after December 15, 2017, including interim periods within those years. Early adoption is permitted. The Company is currently evaluating the impact this new guidance may have on the consolidated financial position, results of operations and cash flows. In January 2017, the FASB issued ASU 2017-04, “Simplifying the Test for Goodwill Impairment,” which eliminates the requirement to calculate the implied fair value of goodwill (i.e., Step 2 of the current goodwill impairment test) to measure a goodwill impairment charge. Instead, entities will record an impairment charge based on the excess of a reporting unit’s carrying amount over its fair value (i.e., measure the charge based on the current Step 1). ASU 2017-04 is effective for fiscal years beginning after December 15, 2019, including interim periods within those years. Early adoption is permitted for annual and interim periods after January 1, 2017. The Company is currently evaluating the impact this new guidance may have on the consolidated financial position, results of operations and cash flows. The adoption of ASU 2017-04 would only impact the Company's financial statements in situations where an impairment of a reporting unit’s assets is determined.

Significant Accounting Policies (Tables)

12 Months Ended

Dec. 31, 2016

Organization, Consolidation and Presentation of Financial Statements [Abstract]

Schedule of Rollforward of Non-Controlling Interests - Redeemable

A summary of activity related to the non-controlling interests—redeemable follows (in thousands):



Balance at December 31, 2014	$	192,589
Net income attributable to non-controlling interests—redeemable	17,616
Acquisition and disposal of shares of non-controlling interests, net—redeemable	(6,830		)
Distributions to non-controlling interest —redeemable holders	(19,936		)
Balance at December 31, 2015	183,439
Net income attributable to non-controlling interests—redeemable	18,023
Acquisition and disposal of shares of non-controlling interests, net—redeemable	(3,781		)
Distributions to non-controlling interest —redeemable holders	(17,160		)
Balance at December 31, 2016	$	180,521

Schedule of Carrying Values and Estimated Fair Values of Debt Instruments

A summary of the carrying amounts and fair values of the Company's long-term debt follows (in thousands):



	Carrying Amount				Fair Value
	December 31, 2016		December 31, 2015		December 31, 2016		December 31, 2015

2014 First Lien Credit Agreement, net of debt issuance and discount	$	911,784	$	839,701	$	917,528	$	827,458
2014 Second Lien Credit Agreement, net of debt issuance and discount	$	—	$	237,532	$	—	$	224,617
Senior Unsecured Notes, net of debt issuance costs and discount	$	387,942	$	—	$	412,189	$	—

Schedule of Revenues by Service Type

A summary of revenues by service type as a percentage of total revenues follows:



	Year Ended December 31,
	2016		2015		2014
Patient service revenues:
Surgical facilities revenues	90.3	%	91.6	%	83.9	%
Ancillary services revenues	7.9	%	6.4	%	12.3	%
	98.2	%	98.0	%	96.2	%
Other service revenues:
Optical services revenues	1.1	%	1.5	%	3.5	%
Other	0.7	%	0.5	%	0.3	%
	1.8	%	2.0	%	3.8	%
Total revenues	100.0	%	100.0	%	100.0	%

Schedule of Revenue Sources for Patient Service Revenues



	Year Ended December 31,
	2016				2015				2014
	Amount		%		Amount		%		Amount		%
Patient service revenues:
Private insurance	$	579,662	51.5	%	$	516,739	55.0	%	$	202,172	52.1	%
Government	448,953		39.9	%	359,471		38.2	%	134,041		34.5	%
Self-pay	19,817		1.8	%	16,190		1.7	%	13,645		3.5	%
Other	76,172		6.8	%	48,311		5.1	%	38,215		9.9	%
Total patient service revenues	$	1,124,604	100.0	%	$	940,711	100.0	%	$	388,073	100.0	%
Other service revenues:
Optical service revenues	$	12,505			$	14,572			$	14,193
Other revenues	8,329				4,608				1,023
Total net revenues	$	1,145,438			$	959,891			$	403,289

Schedules of Accounts Receivable

A summary of the changes in the allowance for doubtful accounts receivable follows (in thousands):



Balance at December 31, 2013	$	5,028
Provision for doubtful accounts	9,509
Accounts written off, net of recoveries	(9,208		)
Balance at December 31, 2014	5,329
Provision for doubtful accounts	23,578
Accounts written off, net of recoveries	(10,585		)
Balance at December 31, 2015	18,322
Provision for doubtful accounts	24,212
Accounts written off, net of recoveries	(12,662		)
Balance at December 31, 2016	$	29,872

Schedule of Prepaid Expenses and Other Current Assets

A summary of prepaid expenses and other current assets follows (in thousands):



	December 31,
	2016		2015

Prepaid expenses	$	11,158	$	7,409
Receivables - optical product purchasing organization	7,042		8,434
Acquisition escrow receivable	—		8,000
Insurance recoveries	2,476		2,363
Other current assets	11,338		8,414
Total	$	32,014	$	34,620

Schedule of Other Long-Term Assets

A summary of other long-term assets follows (in thousands):



	December 31,
	2016		2015

Notes receivable	$	716	$	212
Deposits	4,196		2,475
Assets of SERP	1,725		1,606
Debt issuance costs	1,488		2,005
Insurance recoveries	6,835		3,976
Other	1,475		235
Total	$	16,435	$	10,509

Schedule of Other Current Liabilities

A summary of other current liabilities follows (in thousands):



	December 31,
	2016		2015

Interest payable	$	19,206	$	5,410
Current taxes payable	2,622		1,977
Insurance liabilities	6,625		5,476
Third-party settlements	179		5,222
Acquisition consideration payable	—		16,768
Amounts due to patients and payors	12,221		11,424
Tax receivable agreement liability	999		—
Contingent acquisition compensation liability	4,589		—
Other accrued expenses	22,552		22,133
Total	$	68,993	$	68,410

Schedule of Other Long-Term Liabilities

A summary of other long-term liabilities follows (in thousands):



	December 31,
	2016		2015

Facility lease obligations	$	52,653	$	53,927
Medical malpractice liability	10,453		6,339
Liability of SERP	1,725		1,608
Contingent consideration obligation	—		14,049
Unfavorable lease liability	1,671		1,996
Other long-term liabilities	9,764		7,694
Total	$	76,266	$	85,613

Acquisitions and Developments (Tables)

12 Months Ended

Dec. 31, 2016

Business Combinations [Abstract]

Schedule of recognized identified assets acquired and liabilities assumed

The purchase price amount related to the Merger has been allocated to the related assets acquired and liabilities assumed based upon their respective fair values as follows:



Cash consideration	$	298,857
Acquisition consideration payable	16,768
Fair value of non-controlling interests	395,663
Fair value of Symbion	711,288
Net assets acquired:
Cash	40,374
Accounts receivable, net	79,830
Inventories	18,389
Prepaid expenses and other current assets	9,876
Property and equipment	153,179
Investments in and advances to affiliates	32,728
Intangible assets	31,534
Restricted invested assets	316
Other long-term assets	6,239
Accounts payable	(20,419		)
Accrued payroll and benefits	(14,600		)
Other current liabilities	(47,229		)
Current maturities of long-term debt	(83,805		)
Long-term debt, less current maturities	(376,395		)
Long-term deferred tax liabilities	(19,853		)
Other long-term liabilities	(60,500		)
Net assets acquired	(250,336		)
Excess of fair value over identifiable net assets acquired	$	961,624



Cash consideration	$	135,061
Fair value of non-controlling interests	27,164
Aggregate fair value of acquisitions	162,225
Net assets acquired:
Cash and cash equivalents	4,855
Accounts receivable	6,291
Other current assets	517
Property and equipment	3,921
Intangible assets	4,475
Long-term assets	56
Accounts payable and other current assets	(1,490		)
Current maturities of long-term debt	(3,926		)
Long-term deferred tax liability	(172		)
Long-term liabilities	(197		)
Net assets acquired	14,330
Excess of fair value over identifiable net assets acquired	$	147,895

Schedule of unaudited consolidated pro forma results

The unaudited consolidated pro forma results for years ended ended December 31, 2014 and 2013, assuming the Symbion acquisition had been consummated on January 1, 2013, are as follows (in thousands):



	Year Ended December 31,
	2014			2013
Net revenues	$	873,683		$	820,186

Net income	31,557			42,714
Less: net income attributable to non-controlling interests	(68,973		)	(64,396		)
Net loss attributable to Surgery Partners, Inc.	$	(37,416	)	$	(21,682	)

Property and Equipment (Tables)

12 Months Ended

Dec. 31, 2016

Property, Plant and Equipment [Abstract]

Schedule of Property and Equipment

A summary of property and equipment follows (in thousands):



	December 31,
	2016			2015

Land	$	8,082		$	6,790
Buildings and improvements	118,172			104,971
Furniture and equipment	14,670			14,520
Computer and software	29,902			24,597
Medical equipment	117,418			96,291
Construction in progress	2,396			7,619
Property and equipment, at cost	290,640			254,788
Less: Accumulated depreciation	(86,387		)	(70,238		)
Property and equipment, net	$	204,253		$	184,550

Goodwill and Intangible Assets (Tables)

12 Months Ended

Dec. 31, 2016

Goodwill and Intangible Assets Disclosure [Abstract]

Summary of activity related to goodwill

A summary of activity related to goodwill for the year ended December 31, 2016 follows (in thousands):



Balance at December 31, 2014	$	1,298,753
Acquisitions	113,812
Divestitures	(8,399		)
Purchase price adjustments	3,761
Balance at December 31, 2015	$	1,407,927
Acquisitions	147,895
Divestitures	(552		)
Purchase price adjustments	(66		)
Balance at December 31, 2016	$	1,555,204

Summary of activity related to intangible assets

A summary of the activity related to intangible assets as of December 31, 2016 follows (in thousands):



	Physician Income Guarantees			Management Rights			Non-Compete Agreements			Certificates of Need		Customer Relationships			Other			Total Intangible Assets

Balance at December 31, 2014	$	973		$	24,757		$	16,590		$	3,711	$	6,274		$	2,583		$	54,888
Additions	1,052			—			7,532			—		—			—			8,584
Recruitment expense	(813		)	—			—			—		—			—			(813		)
Amortization	—			(1,731		)	(5,551		)	—		(1,338		)	(471		)	(9,091		)
Balance at December 31, 2015	$	1,212		$	23,026		$	18,571		$	3,711	$	4,936		$	2,112		$	53,568
Additions	210			—			4,025			69		—			450			4,754
Disposals	—			—			—			—		(22		)	(113		)	(135		)
Recruitment expense	(609		)	—			—			—		—			—			(609		)
Amortization	—			(1,736		)	(6,139		)	—		(1,210		)	(470		)	(9,555		)
Balance at December 31, 2016	$	813		$	21,290		$	16,457		$	3,780	$	3,704		$	1,979		$	48,023

Summary of scheduled amortization

A summary of the scheduled amortization related to the Company's finite-lived intangible assets as of December 31, 2016 follows (in thousands):



	Amortization of Finite-Lived Intangible Assets

2016	$	9,042
2017	6,923
2018	6,393
2019	4,023
2020	2,960
Thereafter	14,660
Total	$	44,001

Long-Term Debt (Tables)

12 Months Ended

Dec. 31, 2016

Debt Disclosure [Abstract]

Schedule of long-term debt

A summary of long-term debt follows (in thousands):



	December 31,
	2016			2015

2014 Revolver Loan	$	85,000		$	125,250
2014 First Lien Term Loans	932,000			861,300
2014 Second Lien Credit Agreement	—			246,500
Senior Unsecured Notes	400,000			—
Subordinated Notes	1,000			1,000
Notes payable and secured loans	42,521			40,615
Capital lease obligations	13,996			11,316
Less: Unamortized debt issuance costs and discounts	(32,274		)	(30,622		)
Total debt	1,442,243			1,255,359
Less: Current maturities	27,822			27,247
Total long-term debt	$	1,414,421		$	1,228,112

Debt redemption percentages

The Company may redeem the Senior Unsecured Notes, in whole or in part, at any time on or after April 15, 2018, plus accrued and unpaid interest, if any, to the date of redemption plus a redemption price equal to a percentage of the principal amount of the notes redeemed based on the following redemption schedule:



April 15, 2018 to April 14, 2019	106.656	%
April 15, 2019 to April 14, 2020	104.438	%
April 15, 2020 and thereafter	100.000	%

Summary of scheduled maturities of debt

A summary of the scheduled maturities of our debt obligations as of December 31, 2016 follows (in thousands):



	Capital Lease Obligations		Other Long-Term Debt		Total

2017	$	4,860	$	22,963	$	27,823
2018	3,952		22,076		26,028
2019	2,960		100,911		103,871
2020	1,535		908,458		909,993
2021	633		402,219		402,852
Thereafter	56		3,894		3,950
Total debt	$	13,996	$	1,460,521	$	1,474,517

Operating Leases (Tables)

12 Months Ended

Dec. 31, 2016

Leases [Abstract]

Future minimum operating lease payments

The future minimum lease payments under non-cancellable operating leases, net of sub-lease income, follows (in thousands):



2017	$	46,517
2018	42,917
2019	39,181
2020	34,415
2021	28,728
Thereafter	143,558
Total minimum operating lease payments	$	335,316

Future minimum lease payments to be received

The Company has various sub-lease arrangements and the future minimum lease payments to be received under these non-cancellable arrangements are as follows (in thousands):



2017	$	1,101
2018	1,137
2019	658
2020	468
2021	312
Thereafter	1,919
Total non-cancellable sub-lease income	$	5,595

- Definition

Tabular disclosure of a lessee's leasing arrangements including: (1) the basis on which contingent rental payments are determined, (2) the existence and terms of renewal or purchase options and escalation clauses, (3) restrictions imposed by lease arrangements, such as those concerning dividends, additional debt, and further leasing, (4) rent holidays, rent concessions, or leasehold improvement incentives and unusual provisions or conditions. Disclosure may also include the specific period used to amortize material leasehold improvements made at the inception of the lease or during the lease term. Additionally, for operating leases having initial or remaining noncancelable lease terms in excess of one year: (a) future minimum rental payments required as of the date of the latest balance sheet presented, in the aggregate and for each of the five succeeding fiscal years, (b) the total of minimum rentals to be received in the future under noncancelable subleases as of the date of the latest balance sheet presented, and (c) for all operating leases, rental expense for each period for which an income statement is presented, with separate amounts for minimum rentals, contingent rentals, and sublease rentals. Rental payments under leases with terms of a month or less that were not renewed need not be included.

+ References + Details

Earnings Per Share (Tables)

12 Months Ended

Dec. 31, 2016

Earnings Per Share [Abstract]

Reconciliation of numerator and denominator of basic and diluted EPS



	Year Ended December 31,
	2016		2015		2014

Numerator:
Net income (loss) attributable to Surgery Partners, Inc.	$	9,453	$	1,429	$	(65,897	)

Denominator:
Weighted average shares outstanding- basic ⁽¹⁾	48,018,944		36,066,233		32,295,364
Effect of dilutive securities ⁽²⁾	171,794		1,398,154		—
Weighted average shares outstanding- diluted	48,190,738		37,464,387		32,295,364

Earnings (loss) per share:
Basic earnings (loss) per share	$	0.20	$	0.04	$	(2.04	)
Diluted earnings (loss) per share ⁽²⁾	$	0.20	$	0.04	$	(2.04	)

Securities outstanding not included in the computation of diluted loss per share as their effect is antidilutive:
Stock options	—		—		—
Restricted shares	—		—		1,386,805

⁽¹⁾ Effect of the Reorganization has been retrospectively applied to all periods presented.

⁽²⁾The impact of potentially dilutive securities for the year ended December 31, 2014 was not considered because the effect would be anti-dilutive in each of those periods.

Income Taxes and Tax Receivable Agreement (Tables)

12 Months Ended

Dec. 31, 2016

Income Tax Disclosure [Abstract]

Schedule of Income Tax Expense (Benefit)

Income tax expense (benefit) is comprised of the following (in thousands):



	Year Ended December 31,
	2016			2015			2014

Current:
Federal	$	(31	)	$	—		$	—
State	244			909			1,669
Deferred:
Federal	7,326			(132,311		)	13,235
State	(444		)	(17,580		)	854
Total income tax expense (benefit)	$	7,095		$	(148,982	)	$	15,758

Schedule of Effective Income Tax Rate Reconciliation



	Year Ended December 31,
	2016			2015			2014

Tax expense (benefit) at U.S.federal statutory rate	$	32,263		$	(26,648	)	$	(3,840	)
State income tax, net of U.S. federal tax benefit	(86		)	1,059			1,402
Change in valuation allowance	354			(137,721		)	29,336
Expiration of carryforwards and stock option forfeitures	—			—			1,286
Net income attributable to non-controlling interests	(26,470		)	(24,996		)	(13,207		)
Changes in measurement of uncertain tax positions	(262		)	(10		)	589
Stock option compensation	(200		)	—			—
Nondeductible transaction costs	—			3,442			4,230
Tax return reconciling differences	1,635			(1,574		)	(4,419		)
Change in effective tax rate	—			(2,143		)	—
TRA liability	(327		)	39,428			—
Other	188			181			381
Total income tax expense (benefit)	$	7,095		$	(148,982	)	$	15,758

Schedule of Deferred Tax Assets and Liabilities

The components of temporary differences and the approximate tax effects that give rise to the Company’s net deferred tax asset are as follows (in thousands):



	December 31,
	2016			2015

Deferred tax assets:
Medical malpractice liability	$	4,194		$	869
Accrued vacation and incentive compensation	1,112			2,212
Net operating loss carryforwards	158,796			146,663
Allowance for bad debts	8,343			1,846
Capital loss carryforwards	2,785			2,052
Deferred rent	1,371			2,288
Depreciation on property and equipment	530			—
Deferred financing costs	—			3,083
TRA liability	4,542			2,750
Other deferred assets	4,879			3,286
Total gross deferred tax assets	186,552			165,049
Less: Valuation allowance	(7,358		)	(6,949		)
Total deferred tax assets	179,194			158,100
Deferred tax liabilities:
Deferred financing costs	(8,797		)	—
Depreciation on property and equipment	—			(806		)
Amortization of intangible assets	(15,241		)	(16,083		)
Basis differences of partnerships and joint ventures	(68,160		)	(46,494		)
Other deferred liabilities	(3,203		)	(612		)
Total deferred tax liabilities	(95,401		)	(63,995		)
Net deferred tax assets	$	83,793		$	94,105

Schedule of Unrecognized Tax Benefits Roll Forward

A reconciliation of the beginning and ending liability for gross unrecognized tax benefits for the years ended December 31, 2016 and 2015 is as follows (in thousands):



	Year Ended December 31,
	2016			2015

Unrecognized tax benefits at beginning of year	$	1,403		$	2,755
Additions for tax positions of prior years	60			136
Reductions for tax positions of prior year	(398		)	(996		)
Settlements	(4		)	(492		)
Unrecognized tax benefits at end of year	$	1,061		$	1,403

Equity-Based Compensation (Tables)

12 Months Ended

Dec. 31, 2016

Disclosure of Compensation Related Costs, Share-based Payments [Abstract]

Schedule of Stock Options, Valuation Assumptions

The following table sets forth the assumptions used by the Company to estimate the fair value of options granted under the 2015 Omnibus Incentive Plan:



Expected volatility		29% - 43%
Risk-free interest rate		0.54% - 1.36%
Expected dividends		—
Average expected term (years)		2.56
Fair value of stock options granted		$2.64 - $5.74

Schedule of Stock Options Activity

A summary of stock option activity during the year ended December 31, 2016 is as follows:



	Options	Weighted Average Exercise Price		Weighted Average Remaining Contractual Term (years)
Outstanding at December 31, 2014	—
Granted	8,448	$	20.03	3.0
Exercised	—
Forfeited	—
Outstanding at December 31, 2015	8,488	$	20.03	3.0
Granted	7,779	17.99		1.6
Exercised	—
Forfeited	—
Outstanding at December 31, 2016⁽¹⁾	16,267	$	19.05	1.8

⁽¹⁾ Of the outstanding options, 2,829 were exercisable as of December 31, 2016.

Schedule of Restricted Stock Activity

A summary of issued restricted stock activity for the years ended December 31, 2016, 2015, and 2014 follows:



	Total Shares		Vested Shares		Unvested Shares		Weighted-Average Grant Fair Value

Outstanding at January 1, 2014	3,234,664		1,788,780		1,445,884			$0.81
Granted	583,404		—		583,404		6.44
Forfeited/Terminated	(127,582	)	—		(127,582	)	1.27
Purchased	(803,336	)	(803,336	)	—		3.64
Vested	—		659,641		(659,641	)	1.43
Outstanding at December 31, 2014	2,887,150		1,645,085		1,242,065			$1.96
Granted	569,114		—		569,114		6.31
Forfeited/Terminated	—		—		—		—
Purchased	(11,742	)	(11,742	)	—		6.31
Vested	—		1,643,525		(1,643,525	)	3.79
Outstanding at December 31, 2015	3,444,522		3,276,868		167,654			$2.53
Granted	384,629		—		384,629		15.09
Forfeited/Terminated	(53,003	)	—		(53,003	)	11.85
Purchased	—		—		—		—
Vested	—		37,038		(37,038	)	6.31
Outstanding at December 31, 2016	3,776,148		3,313,906		462,242			$3.72

Segment Reporting (Tables)

12 Months Ended

Dec. 31, 2016

Segment Reporting [Abstract]

Schedule of Revenues by Reportable Segment

The following tables present financial information for each reportable segment (in thousands):



	Year Ended December 31,
	2016		2015		2014
Net Revenues:
Surgical facility services	$	1,042,097	$	884,144	$	339,309
Ancillary services	90,836		61,175		49,787
Optical services	12,505		14,572		14,193
Total revenues	$	1,145,438	$	959,891	$	403,289

Schedule of Segment Operating Income



	Year Ended December 31,
	2016			2015			2014
Segment Adjusted EBITDA:
Surgical facility services	$	214,218		$	180,113		$	83,149
Ancillary services	12,685			18,715			18,354
Optical services	3,308			3,905			3,880
Total segment adjusted EBITDA ⁽³⁾	$	230,211		$	202,733		$	105,383

General and administrative expenses	$	(60,246	)	$	(55,992	)	$	(31,452	)
Non-cash stock compensation expense	2,021			7,502			942
Contingent acquisition compensation expense	5,092			—			—
Management fee⁽⁴⁾	—			2,250			2,161
Acquisition related costs	2,185			1,560			—
Total adjusted EBITDA ⁽³⁾	179,263			158,053			77,034

Net income attributable to non-controlling interests	75,630			71,416			38,845
Depreciation and amortization	(39,551		)	(34,545		)	(15,061		)
Interest and other expense, net	(100,571		)	(100,980		)	(62,101		)
Income tax (expense) benefit	(7,095		)	148,982			(15,758		)
Non-cash stock compensation expense	(2,021		)	(7,502		)	(942		)
Contingent acquisition compensation expense	(5,092		)	—			—
Termination of management agreement and IPO costs	—			(5,834		)	—
Management fee ⁽⁴⁾	—			(2,250		)	(2,161		)
Merger transaction, integration and practice acquisition costs ⁽⁵⁾	(11,617		)	(20,579		)	(21,690		)
Gain on litigation settlement	14,101			—			—
(Loss) gain on disposal or impairment of long-lived assets, net	(2,355		)	2,097			(1,804		)
Tax receivable agreement expense	(3,733		)	(119,911		)	—
Loss on debt refinancing	(11,876		)	(16,102		)	(23,414		)
Total net income (loss)	$	85,083		$	72,845		$	(27,052	)

⁽³⁾The above table reconciles adjusted EBITDA by segment to net income as reflected in the unaudited condensed consolidated statements of operations.

⁽⁴⁾ Fee payable pursuant the Management and Investment Advisory Services Agreement between the Company and Bayside, which was terminated in connection with the Company's IPO.

Reconciliation of Assets from Segment to Consolidated



	December 31, 2016		December 31, 2015
Assets:
Surgical facility services	$	1,914,842	$	1,762,396
Ancillary services	184,002		118,198
Optical services	22,478		25,537
Total	$	2,121,322	$	1,906,131

General and administrative	$	183,636	$	198,312
Total assets	$	2,304,958	$	2,104,443

Schedule of Depreciation/Amortization and Cash Purchases of PPE



	Year Ended December 31,
	2016		2015		2014
Supplemental Information:
Cash purchases of property and equipment, net:
Surgical facility services	$	29,157	$	26,723	$	5,158
Ancillary services	5,388		1,051		1,034
Optical services	351		128		335
Total	$	34,896	$	27,902	$	6,527

General and administrative	$	4,213	$	5,537	$	1,209
Total cash purchases of property and equipment, net	$	39,109	$	33,439	$	7,736

Quarterly Financial Information (Unaudited) (Tables)

12 Months Ended

Dec. 31, 2016

Quarterly Financial Information Disclosure [Abstract]

Schedule of Quarterly Financial Information

The amounts are as follows (in thousands and unaudited):



	Fiscal Quarter
	1Q16		2Q16		3Q16		4Q16
Revenues	267,074		289,681		282,682		306,001
Cost of revenues	196,703		208,852		201,394		214,247
Net income	10,357		22,293		14,334		38,100
Net income attributable to non-controlling interests	(17,547	)	(20,173	)	(16,672	)	(21,238	)
Net (loss) income attributable to Surgery Partners, Inc.	(7,190	)	2,120		(2,338	)	16,862
Basic net (loss) income per share of common stock	(0.15	)	0.04		(0.05	)	0.35
Diluted net (loss) income per share common stock	(0.15	)	0.04		(0.05	)	0.35



	Fiscal Quarter
	1Q15		2Q15		3Q15		4Q15
Revenues	224,143		232,827		239,599		263,322
Cost of revenues	155,773		161,558		168,821		183,174
Net income	10,488		12,479		13,784		36,094
Net income attributable to non-controlling interests	(17,250	)	(17,905	)	(16,906	)	(19,355	)
Net (loss) income attributable to Surgery Partners, Inc.	(6,762	)	(5,426	)	(3,122	)	16,739
Basic net (loss) income per share of common stock	(0.21	)	(0.17	)	(0.10	)	0.35
Diluted net (loss) income per share common stock	(0.21	)	(0.17	)	(0.10	)	0.35

Organization (Details)					12 Months Ended
Organization (Details)	Oct. 06, 2015 USD ($)	Oct. 01, 2015 $ / shares shares	Nov. 03, 2014 USD ($) surgical_facility	Jun. 13, 2014 USD ($)	Dec. 31, 2016 USD ($) Entity surgical_facility state shares	Dec. 31, 2015 USD ($) shares	Dec. 31, 2014 USD ($)	Sep. 30, 2015 shares	Jan. 27, 2014 USD ($)
Product Information [Line Items]
Common stock, shares issued (in shares) \| shares					48,488,616	48,156,990
Proceeds from initial public offering, net of offering costs \| $					$ 0	$ 250,979,000	$ 0
Number of business entities acquired \| Entity					1
Number of States in which entity operates \| state					29
Number of surgical facilities owned					104
Number of surgical facilities owned, majority interest					74
Number of surgical facilities owned, consolidated					94
Facilities, Ambulatory Surgery Centers
Product Information [Line Items]
Number of surgical facilities owned					99
Facilities, Surgical Hospitals
Product Information [Line Items]
Number of surgical facilities owned					5
Facilities, Physician Clinics
Product Information [Line Items]
Number of surgical facilities owned					56
Line of Credit
Product Information [Line Items]
Debt maximum borrowing capacity \| $			$ 1,440,000,000.000						$ 90,000,000.0
Symbion Holdings Corporation
Product Information [Line Items]
Number of business entities acquired			55
Aggregate purchase price \| $			$ 711,288,000	$ 792,000,000
Symbion Holdings Corporation \| Facilities, Ambulatory Surgery Centers
Product Information [Line Items]
Number of business entities acquired			49
Symbion Holdings Corporation \| Facilities, Surgical Hospitals
Product Information [Line Items]
Number of business entities acquired			6
IPO
Product Information [Line Items]
Stock issued during period (in shares) \| shares		14,285,000
Fair value of stock options granted (in USD per share) \| $ / shares		$ 19.00
Proceeds from initial public offering, net of offering costs \| $	$ 255,800,000
IPO, Underwriting Fees
Product Information [Line Items]
Issuance Costs \| $	15,600,000
IPO, Directly Related Costs
Product Information [Line Items]
Issuance Costs \| $	$ 4,800,000
Surgery Center Holdings, LLC
Product Information [Line Items]
Common stock, shares issued (in shares) \| shares								33,871,990

Significant Accounting Policies - Schedule of Non-Controlling Interests - Redeemable (Details) - USD ($) $ in Thousands	12 Months Ended
	Dec. 31, 2016	Dec. 31, 2015
Non-Controlling Interests - Redeemable [Roll Forward]
Non-controlling interest, beginning balance	$ 183,439	$ 192,589
Net income attributable to non-controlling interests—redeemable	18,023	17,616
Acquisition and disposal of shares of non-controlling interests, net—redeemable	(3,781)	(6,830)
Distributions to non-controlling interest —redeemable holders	(17,160)	(19,936)
Non-controlling interest, ending balance	$ 180,521	$ 183,439

Significant Accounting Policies - Variable Interest Entities (Details) $ in Millions	12 Months Ended
	Dec. 31, 2016 USD ($) Entity	Dec. 31, 2016 USD ($) Anesthesia_Practice	Dec. 31, 2016 USD ($) surgical_facility	Dec. 31, 2016 USD ($) Practice	Dec. 31, 2015 USD ($) Anesthesia_Practice	Dec. 31, 2015 USD ($) surgical_facility	Dec. 31, 2015 USD ($) Practice
Variable Interest Entity [Line Items]
Number of business entities acquired \| Entity	1
Variable Interest Entity Primary Beneficiary
Variable Interest Entity [Line Items]
Number of facilities included in VIE		3	5	2	3	5	1
Total assets related to VIE	$ 99.5	$ 99.5	$ 99.5	$ 99.5	$ 104.2	$ 104.2	$ 104.2
Total liabilities related to VIE	$ 10.7	$ 10.7	$ 10.7	$ 10.7	$ 13.2	$ 13.2	$ 13.2

Significant Accounting Policies - Equity Method Investments (Details) - USD ($) $ in Thousands	Dec. 31, 2016	Dec. 31, 2015
Organization, Consolidation and Presentation of Financial Statements [Abstract]
Investments in and advances to affiliates	$ 34,980	$ 34,103

Significant Accounting Policies - Schedule of Carrying Amount and Fair Value of Financial Instruments (Details) - USD ($) $ in Thousands	Dec. 31, 2016	Dec. 31, 2015
Fair Value, Balance Sheet Grouping, Financial Statement Captions [Line Items]
Long-term debt	$ 1,474,517
Line of Credit \| 2014 First Lien Credit Agreement
Fair Value, Balance Sheet Grouping, Financial Statement Captions [Line Items]
Long-term debt	932,000	$ 861,300
Line of Credit \| 2014 First Lien Credit Agreement \| Carrying Amount
Fair Value, Balance Sheet Grouping, Financial Statement Captions [Line Items]
Long-term debt	911,784	839,701
Line of Credit \| 2014 First Lien Credit Agreement \| Fair Value \| Fair Value, Inputs, Level 2
Fair Value, Balance Sheet Grouping, Financial Statement Captions [Line Items]
Long-term debt	917,528	827,458
Line of Credit \| 2014 Second Lien Credit Agreement
Fair Value, Balance Sheet Grouping, Financial Statement Captions [Line Items]
Long-term debt	0	246,500
Line of Credit \| 2014 Second Lien Credit Agreement \| Carrying Amount
Fair Value, Balance Sheet Grouping, Financial Statement Captions [Line Items]
Long-term debt	0	237,532
Line of Credit \| 2014 Second Lien Credit Agreement \| Fair Value \| Fair Value, Inputs, Level 2
Fair Value, Balance Sheet Grouping, Financial Statement Captions [Line Items]
Long-term debt	0	224,617
Senior Unsecured Notes
Fair Value, Balance Sheet Grouping, Financial Statement Captions [Line Items]
Long-term debt	400,000	$ 0
Senior Unsecured Notes \| Carrying Amount
Fair Value, Balance Sheet Grouping, Financial Statement Captions [Line Items]
Long-term debt	387,942
Senior Unsecured Notes \| Fair Value \| Fair Value, Inputs, Level 2
Fair Value, Balance Sheet Grouping, Financial Statement Captions [Line Items]
Long-term debt	$ 412,189

Significant Accounting Policies - Fair Value of Financial Instruments (Details) - USD ($) $ in Thousands	Dec. 31, 2016	Dec. 31, 2015
Fair Value, Balance Sheet Grouping, Financial Statement Captions [Line Items]
Assets of SERP	$ 1,725	$ 1,606
Liability of SERP	1,725	1,608
Fair Value, Inputs, Level 1
Fair Value, Balance Sheet Grouping, Financial Statement Captions [Line Items]
Assets of SERP	1,700	$ 1,600
Liability of SERP	$ 1,700

Significant Accounting Policies - Schedule of Revenues by Service Type (Details) - Revenue Source - Revenue	12 Months Ended
	Dec. 31, 2016	Dec. 31, 2015	Dec. 31, 2014
Revenue from External Customer [Line Items]
Revenue by service type as a percentage of total revenues	100.00%	100.00%	100.00%
Healthcare Organization, Patient Service
Revenue from External Customer [Line Items]
Revenue by service type as a percentage of total revenues	98.20%	98.00%	96.20%
Surgical facility services
Revenue from External Customer [Line Items]
Revenue by service type as a percentage of total revenues	90.30%	91.60%	83.90%
Ancillary services
Revenue from External Customer [Line Items]
Revenue by service type as a percentage of total revenues	7.90%	6.40%	12.30%
Healthcare Organization, Other Service
Revenue from External Customer [Line Items]
Revenue by service type as a percentage of total revenues	1.80%	2.00%	3.80%
Optical services
Revenue from External Customer [Line Items]
Revenue by service type as a percentage of total revenues	1.10%	1.50%	3.50%
Other
Revenue from External Customer [Line Items]
Revenue by service type as a percentage of total revenues	0.70%	0.50%	0.30%

Significant Accounting Policies - Schedule of Revenues by Sources (Details) - USD ($) $ in Thousands	3 Months Ended								12 Months Ended
	Dec. 31, 2016	Sep. 30, 2016	Jun. 30, 2016	Mar. 31, 2016	Dec. 31, 2015	Sep. 30, 2015	Jun. 30, 2015	Mar. 31, 2015	Dec. 31, 2016	Dec. 31, 2015	Dec. 31, 2014
Organization, Consolidation and Presentation of Financial Statements [Abstract]
Increase of revenue as result of changes in estimates to third-party settlements									$ 6,800	$ 2,300
Health Care Organization, Receivable and Revenue Disclosures [Line Items]
Total net revenues	$ 306,001	$ 282,682	$ 289,681	$ 267,074	$ 263,322	$ 239,599	$ 232,827	$ 224,143	1,145,438	959,891	$ 403,289
Healthcare Organization, Patient Service
Health Care Organization, Receivable and Revenue Disclosures [Line Items]
Patient service revenues									$ 1,124,604	$ 940,711	$ 388,073
Healthcare Organization, Patient Service \| Customer \| Revenue
Health Care Organization, Receivable and Revenue Disclosures [Line Items]
Revenue by service type as a percentage of total revenues									100.00%	100.00%	100.00%
Optical services
Health Care Organization, Receivable and Revenue Disclosures [Line Items]
Other service revenues									$ 12,505	$ 14,572	$ 14,193
Other
Health Care Organization, Receivable and Revenue Disclosures [Line Items]
Other service revenues									8,329	4,608	1,023
Private insurance \| Healthcare Organization, Patient Service
Health Care Organization, Receivable and Revenue Disclosures [Line Items]
Patient service revenues									$ 579,662	$ 516,739	$ 202,172
Private insurance \| Healthcare Organization, Patient Service \| Customer \| Revenue
Health Care Organization, Receivable and Revenue Disclosures [Line Items]
Revenue by service type as a percentage of total revenues									51.50%	55.00%	52.10%
Government \| Healthcare Organization, Patient Service
Health Care Organization, Receivable and Revenue Disclosures [Line Items]
Patient service revenues									$ 448,953	$ 359,471	$ 134,041
Government \| Healthcare Organization, Patient Service \| Customer \| Revenue
Health Care Organization, Receivable and Revenue Disclosures [Line Items]
Revenue by service type as a percentage of total revenues									39.90%	38.20%	34.50%
Self-pay \| Healthcare Organization, Patient Service
Health Care Organization, Receivable and Revenue Disclosures [Line Items]
Patient service revenues									$ 19,817	$ 16,190	$ 13,645
Self-pay \| Healthcare Organization, Patient Service \| Customer \| Revenue
Health Care Organization, Receivable and Revenue Disclosures [Line Items]
Revenue by service type as a percentage of total revenues									1.80%	1.70%	3.50%
Other \| Healthcare Organization, Patient Service
Health Care Organization, Receivable and Revenue Disclosures [Line Items]
Patient service revenues									$ 76,172	$ 48,311	$ 38,215
Other \| Healthcare Organization, Patient Service \| Customer \| Revenue
Health Care Organization, Receivable and Revenue Disclosures [Line Items]
Revenue by service type as a percentage of total revenues									6.80%	5.10%	9.90%

Significant Accounting Policies - Accounts Receivable (Details) - USD ($) $ in Thousands	12 Months Ended
	Dec. 31, 2016	Dec. 31, 2015	Dec. 31, 2014
Organization, Consolidation and Presentation of Financial Statements [Abstract]
Third-Party Medicaid settlements receivable	$ 454
Third-Party Medicaid settlements liability	179	$ 5,222
Allowance for Doubtful Accounts Receivable [Roll Forward]
Allowance for doubtful accounts, beginning balance	18,322	5,329	$ 5,028
Provision for doubtful accounts	24,212	23,578	9,509
Accounts written off, net of recoveries	(12,662)	(10,585)	(9,208)
Allowance for doubtful accounts, ending balance	29,872	18,322	$ 5,329
Optical products receivable	$ 7,042	$ 8,434

Significant Accounting Policies - Schedule of Prepaid Expenses and Other Current Assets (Details) - USD ($) $ in Thousands	Dec. 31, 2016	Dec. 31, 2015
Organization, Consolidation and Presentation of Financial Statements [Abstract]
Prepaid expenses	$ 11,158	$ 7,409
Receivables - optical product purchasing organization	7,042	8,434
Acquisition escrow receivable	0	8,000
Insurance recoveries	2,476	2,363
Other current assets	11,338	8,414
Total	$ 32,014	$ 34,620

Significant Accounting Policies - Property and Equipment (Details)	12 Months Ended
	Dec. 31, 2016
Computer and software \| Minimum
Property, Plant and Equipment [Line Items]
Property, and equipment useful life	3 years
Computer and software \| Maximum
Property, Plant and Equipment [Line Items]
Property, and equipment useful life	5 years
Furniture and equipment \| Minimum
Property, Plant and Equipment [Line Items]
Property, and equipment useful life	5 years
Furniture and equipment \| Maximum
Property, Plant and Equipment [Line Items]
Property, and equipment useful life	7 years

Significant Accounting Policies - Goodwill and Intangible Assets (Details) - USD ($)		12 Months Ended
	Oct. 01, 2016	Dec. 31, 2016	Dec. 31, 2015	Dec. 31, 2014
Intangible Assets [Line Items]
Goodwill impairment	$ 0	$ 0	$ 0	$ 0
Physician Income Guarantees \| Minimum
Intangible Assets [Line Items]
Intangible asset useful life		3 years
Physician Income Guarantees \| Maximum
Intangible Assets [Line Items]
Intangible asset useful life		4 years
Non-Compete Agreements \| Minimum
Intangible Assets [Line Items]
Intangible asset useful life		2 years
Non-Compete Agreements \| Maximum
Intangible Assets [Line Items]
Intangible asset useful life		20 years
Management Rights
Intangible Assets [Line Items]
Intangible asset useful life		15 years
Customer Relationships \| Minimum
Intangible Assets [Line Items]
Intangible asset useful life		3 years
Customer Relationships \| Maximum
Intangible Assets [Line Items]
Intangible asset useful life		10 years

Significant Accounting Policies - Restricted Invested Assets (Details) - USD ($) $ in Thousands	Dec. 31, 2016	Dec. 31, 2015
Restricted Cash and Cash Equivalents Items [Line Items]
Restricted invested assets	$ 315	$ 316
Chesterfield, Missouri facility
Restricted Cash and Cash Equivalents Items [Line Items]
Restricted invested assets	$ 315	$ 316

Significant Accounting Policies - Schedule of Other Long-Term Assets (Details) - USD ($) $ in Thousands	Dec. 31, 2016	Dec. 31, 2015
Organization, Consolidation and Presentation of Financial Statements [Abstract]
Notes receivable	$ 716	$ 212
Deposits	4,196	2,475
Assets of SERP	1,725	1,606
Debt issuance costs	1,488	2,005
Insurance recoveries	6,835	3,976
Other	1,475	235
Total	$ 16,435	$ 10,509

Significant Accounting Policies - Schedule of Other Current Liabilities (Details) - USD ($) $ in Thousands	Dec. 31, 2016	Dec. 31, 2015
Other Liabilities, Current [Abstract]
Interest payable	$ 19,206	$ 5,410
Current taxes payable	2,622	1,977
Insurance liabilities	6,625	5,476
Third-party settlements	179	5,222
Acquisition consideration payable	0	16,768
Amounts due to patients and payors	12,221	11,424
Tax receivable agreement liability	999	0
Contingent acquisition compensation liability	4,589	0
Other accrued expenses	22,552	22,133
Total	$ 68,993	$ 68,410

Significant Accounting Policies - Schedule of Other Long-Term Liabilities (Details) - USD ($) $ in Thousands	Dec. 31, 2016	Dec. 31, 2015
Organization, Consolidation and Presentation of Financial Statements [Abstract]
Facility lease obligations	$ 52,653	$ 53,927
Medical malpractice liability	10,453	6,339
Liability of SERP	1,725	1,608
Contingent consideration obligation	0	14,049
Unfavorable lease liability	1,671	1,996
Other long-term liabilities	9,764	7,694
Total	76,266	85,613
Capital Leased Assets [Line Items]
Capital lease obligations	13,996	11,316
Idaho Falls, Idaho, Surgical Hospital
Capital Leased Assets [Line Items]
Current portion of lease obligation	1,100	797
Capital lease obligations	50,000	50,800
Ocala, Florida
Capital Leased Assets [Line Items]
Current portion of lease obligation	182	169
Capital lease obligations	$ 3,700	$ 3,900

Significant Accounting Policies - Professional, General and Workers' Compensation Insurance (Details) - USD ($) $ in Millions	Dec. 31, 2016	Dec. 31, 2015
Organization, Consolidation and Presentation of Financial Statements [Abstract]
Professional, general and workers' compensation insurance reserve	$ 13.8	$ 9.5
Estimated insurance recoveries	$ 9.3	$ 6.3

Significant Accounting Policies - Electronic Health Record Incentives (Details) - USD ($) $ in Thousands	12 Months Ended
	Dec. 31, 2016	Dec. 31, 2015	Dec. 31, 2014
Organization, Consolidation and Presentation of Financial Statements [Abstract]
Electronic health records incentive income	$ (408)	$ (1,761)	$ (3,356)

Significant Accounting Policies - Recent Accounting Pronouncements (Details) - Accounting Standards Update 2015-03 $ in Millions	Dec. 31, 2015 USD ($)
Other Noncurrent Assets
New Accounting Pronouncements or Change in Accounting Principle [Line Items]
Deferred loan costs	$ (2.2)
Long-term Debt
New Accounting Pronouncements or Change in Accounting Principle [Line Items]
Deferred loan costs	$ 2.2

Acquisitions and Developments - 2016 Transactions (Details) $ in Thousands	12 Months Ended
	Dec. 31, 2016 USD ($) Anesthesia_Practice surgical_facility Practice urgent_care_facility	Dec. 31, 2015 Anesthesia_Practice	Dec. 31, 2015 surgical_facility	Dec. 31, 2015 USD ($)	Dec. 31, 2014 USD ($)
Business Acquisition [Line Items]
General and administrative expenses	$ 60,246			$ 55,992	$ 31,452
Idaho Falls, Idaho, Surgical Hospital
Business Acquisition [Line Items]
Amount of additional interest purchased, percentage	7.04%
Amount of additional interest purchased, value	$ 20,300
Surgical Facility Acquisitions
Business Acquisition [Line Items]
Number of businesses acquired in new market \| surgical_facility	2		2
Number of businesses acquired in existing market	1	4	3
Aggregate purchase price	$ 36,500			84,200
Anesthesia Practice
Business Acquisition [Line Items]
Number of businesses acquired in new market \| Anesthesia_Practice	2
Number of businesses acquired in existing market \| Anesthesia_Practice	1
Urgent Care Facility
Business Acquisition [Line Items]
Number of businesses acquired in existing market \| urgent_care_facility	1
Physician Practice
Business Acquisition [Line Items]
Number of businesses acquired in existing market \| Practice	9
Aggregate purchase price					$ 1,600
Integrated Physician Practice
Business Acquisition [Line Items]
Number of businesses acquired in existing market \| Practice	2
Ancillary Services Acquisition
Business Acquisition [Line Items]
Aggregate purchase price	$ 114,700			$ 40,400
Fair value of contingent consideration liability	16,600
General and administrative expenses	$ 5,100

Acquisitions and Developments - Purchase Price Allocation (Details) - USD ($) $ in Thousands			12 Months Ended
	Nov. 03, 2014	Jun. 13, 2014	Dec. 31, 2016	Dec. 31, 2015	Dec. 31, 2014
Business Acquisition [Line Items]
Cash consideration			$ 146,405	$ 112,596	$ 263,280
Net assets acquired:
Excess of fair value over identifiable net assets acquired			1,555,204	$ 1,407,927	$ 1,298,753
Acquisitions
Business Acquisition [Line Items]
Cash consideration			135,061
Fair value of non-controlling interests			27,164
Aggregate purchase price			162,225
Net assets acquired:
Cash and cash equivalents			4,855
Accounts receivable, net			6,291
Prepaid expenses and other current assets			517
Property and equipment			3,921
Intangible assets			4,475
Other long-term assets			56
Accounts payable			(1,490)
Other current liabilities			(197)
Current maturities of long-term debt			(3,926)
Long-term deferred tax liabilities			(172)
Net assets acquired			14,330
Excess of fair value over identifiable net assets acquired			$ 147,895
Symbion Holdings Corporation
Business Acquisition [Line Items]
Cash consideration	$ 298,857
Acquisition consideration payable	16,768
Fair value of non-controlling interests	395,663
Aggregate purchase price	711,288	$ 792,000
Net assets acquired:
Cash and cash equivalents	40,374
Accounts receivable, net	79,830
Inventories	18,389
Prepaid expenses and other current assets	9,876
Property and equipment	153,179
Investments in and advances to affiliates	32,728
Intangible assets	31,534
Restricted invested assets	316
Other long-term assets	6,239
Accounts payable	(20,419)
Accrued payroll and benefits	(14,600)
Other current liabilities	(47,229)
Current maturities of long-term debt	(83,805)
Long-term debt, less current maturities	(376,395)
Long-term deferred tax liabilities	(19,853)
Other long-term liabilities	(60,500)
Net assets acquired	(250,336)
Excess of fair value over identifiable net assets acquired	$ 961,624

Acquisitions and Developments - Estimated Contingent Acquisition Compensation Expense (Details) - Acquisitions $ in Thousands	Dec. 31, 2016 USD ($)
Business Acquisition [Line Items]
2017	$ 7,476
2018	6,754
2019	1,311
Total	$ 15,541

Acquisitions and Developments - 2015 Transactions (Details) $ in Millions	12 Months Ended
	Dec. 31, 2016 USD ($) Entity surgical_facility	Dec. 31, 2015 Anesthesia_Practice	Dec. 31, 2015 surgical_facility	Dec. 31, 2015 Practice	Dec. 31, 2015 Physician	Dec. 31, 2015 USD ($)
Business Acquisition [Line Items]
Number of business entities acquired \| Entity	1
Number of physician practice transactions \| Physician					17
Surgical Facility Acquisitions
Business Acquisition [Line Items]
Number of businesses acquired in new market \| surgical_facility	2		2
Number of businesses acquired in existing market	1	4	3
Aggregate purchase price	$ 36.5					$ 84.2
Ancillary Services Acquisition
Business Acquisition [Line Items]
Aggregate purchase price	$ 114.7					$ 40.4
Number of business entities acquired \| Practice				13

Acquisitions and Developments - Acquisition of Symbion (Details) - USD ($)					12 Months Ended
	May 03, 2016	Mar. 31, 2016	Nov. 03, 2014	Jun. 13, 2014	Dec. 31, 2016	Dec. 31, 2015	Dec. 31, 2014	Dec. 31, 2013	Mar. 24, 2016	Oct. 07, 2015	Oct. 06, 2015	Jan. 27, 2014
Business Acquisition [Line Items]
Acquisition related costs					$ 2,185,000	$ 1,560,000	$ 0
Capitalized deferred financing costs					1,488,000	2,005,000
Debt instrument unamortized discount					32,274,000	30,622,000
Merger transaction costs					8,738,000	17,920,000	21,690,000
Loss on debt extinguishment					$ 11,876,000	$ 16,102,000	23,414,000
Line of Credit
Business Acquisition [Line Items]
Debt maximum borrowing capacity			$ 1,440,000,000.000									$ 90,000,000.0
Line of Credit \| 2014 First Lien Credit Agreement
Business Acquisition [Line Items]
Debt maximum borrowing capacity			870,000,000.0						$ 950,000,000.0
Line of Credit \| 2014 Second Lien Credit Agreement
Business Acquisition [Line Items]
Debt maximum borrowing capacity			490,000,000.0
Loss on debt extinguishment		$ 8,300,000
Line of Credit \| 2014 Revolver Loan
Business Acquisition [Line Items]
Debt maximum borrowing capacity			80,000,000.0							$ 150,000,000.0	$ 80,000,000.0
Symbion Holdings Corporation
Business Acquisition [Line Items]
Aggregate purchase price			711,288,000	$ 792,000,000
Cash consideration			300,100,000
Acquisition escrow deposit funded	$ 16,600,000		16,200,000
Debt assumed for acquiree			472,400,000
Acquisition related costs							93,300,000
Capitalized deferred financing costs							5,300,000
Business acquisition transaction costs							21,700,000
Debt instrument unamortized discount							42,900,000
Debt extinguishment costs							23,400,000
Goodwill, expected tax deductible amount			$ 142,500,000
Merger transaction costs							21,700,000
Loss on debt extinguishment							$ 23,400,000	$ 9,900,000
Symbion Holdings Corporation \| Payment in Kind (PIK) Note
Business Acquisition [Line Items]
Debt instrument, stated rate				8.00%

Acquisitions and Developments - Pro Forma Results (Details) - Symbion Holdings Corporation - USD ($) $ in Thousands	12 Months Ended
	Dec. 31, 2014	Dec. 31, 2013
Business Acquisition, Pro Forma Information [Abstract]
Net revenues	$ 873,683	$ 820,186
Net income	31,557	42,714
Noncontrolling Interest
Business Acquisition, Pro Forma Information [Abstract]
Net income	68,973	64,396
Parent
Business Acquisition, Pro Forma Information [Abstract]
Net income	$ (37,416)	$ (21,682)

Acquisitions and Developments - Other Acquisitions (Details) $ in Millions	12 Months Ended
	Dec. 31, 2016 Entity	Dec. 31, 2014 USD ($) Practice
Business Acquisition [Line Items]
Number of business entities acquired \| Entity	1
Physician Practice
Business Acquisition [Line Items]
Number of business entities acquired \| Practice		3
Aggregate purchase price \| $		$ 1.6

Divestitures (Details) - Disposed of by Sale $ in Thousands	12 Months Ended
Divestitures (Details) - Disposed of by Sale $ in Thousands	Dec. 31, 2016 USD ($) surgical_facility	Dec. 31, 2015 USD ($) surgical_facility
Income Statement, Balance Sheet and Additional Disclosures by Disposal Groups, Including Discontinued Operations [Line Items]
Number of surgical facilities sold \| surgical_facility	1	3
Transaction value of business disposition	$ 765	$ 10,900
Gain (loss) on disposition of business	$ 763	$ 2,900

Property and Equipment (Details) - USD ($) $ in Thousands	Dec. 31, 2016	Dec. 31, 2015
Property, Plant and Equipment [Line Items]
Property and equipment, at cost	$ 290,640	$ 254,788
Less: Accumulated depreciation	(86,387)	(70,238)
Property and equipment, net	204,253	184,550
Carrying value of assets under capital lease	15,400	12,300
Accumulated depreciation of assets under capital lease	11,600	10,500
Land
Property, Plant and Equipment [Line Items]
Property and equipment, at cost	8,082	6,790
Buildings and improvements
Property, Plant and Equipment [Line Items]
Property and equipment, at cost	118,172	104,971
Furniture and equipment
Property, Plant and Equipment [Line Items]
Property and equipment, at cost	14,670	14,520
Computer and software
Property, Plant and Equipment [Line Items]
Property and equipment, at cost	29,902	24,597
Medical equipment
Property, Plant and Equipment [Line Items]
Property and equipment, at cost	117,418	96,291
Construction in progress
Property, Plant and Equipment [Line Items]
Property and equipment, at cost	$ 2,396	$ 7,619

Goodwill and Intangible Assets - Goodwill (Details) - USD ($) $ in Thousands	12 Months Ended
	Dec. 31, 2016	Dec. 31, 2015
Goodwill [Roll Forward]
Goodwill, beginning of period	$ 1,407,927	$ 1,298,753
Acquisitions	147,895	113,812
Divestitures	(552)	(8,399)
Purchase price adjustments	(66)	3,761
Goodwill, end of period	$ 1,555,204	$ 1,407,927

Goodwill and Intangible Assets - Additional Information (Details)		12 Months Ended
	Oct. 01, 2016 USD ($)	Dec. 31, 2016 USD ($) reporting_unit	Dec. 31, 2015 USD ($)	Dec. 31, 2014 USD ($)
Goodwill and Intangible Assets Disclosure [Abstract]
Number of reporting units \| reporting_unit		5
Goodwill impairment	$ 0	$ 0	$ 0	$ 0
Amortization of intangible assets		$ 9,555,000	$ 9,091,000	$ 5,200,000

Goodwill and Intangible Assets - Summary of Intangible Assets (Details) - USD ($) $ in Thousands	12 Months Ended
	Dec. 31, 2016	Dec. 31, 2015	Dec. 31, 2014
Finite-lived assets:
Intangible assets, beginning balance	$ 53,568	$ 54,888
Additions	4,754	8,584
Disposals	(135)
Recruitment expense	(609)	(813)
Amortization	(9,555)	(9,091)	$ (5,200)
Intangible assets, ending balance	48,023	53,568	54,888
Physician Income Guarantees
Finite-lived assets:
Intangible assets, beginning balance	1,212	973
Additions	210	1,052
Disposals	0
Recruitment expense	(609)	(813)
Amortization	0	0
Intangible assets, ending balance	813	1,212	973
Management Rights
Finite-lived assets:
Intangible assets, beginning balance	23,026	24,757
Additions	0	0
Disposals	0
Recruitment expense	0	0
Amortization	(1,736)	(1,731)
Intangible assets, ending balance	21,290	23,026	24,757
Non-Compete Agreements
Finite-lived assets:
Intangible assets, beginning balance	18,571	16,590
Additions	4,025	7,532
Disposals	0
Recruitment expense	0	0
Amortization	(6,139)	(5,551)
Intangible assets, ending balance	16,457	18,571	16,590
Certificates of Need
Finite-lived assets:
Intangible assets, beginning balance	3,711	3,711
Additions	69	0
Disposals	0
Recruitment expense	0	0
Amortization	0	0
Intangible assets, ending balance	3,780	3,711	3,711
Customer Relationships
Finite-lived assets:
Intangible assets, beginning balance	4,936	6,274
Additions	0	0
Disposals	(22)
Recruitment expense	0	0
Amortization	(1,210)	(1,338)
Intangible assets, ending balance	3,704	4,936	6,274
Other
Finite-lived assets:
Intangible assets, beginning balance	2,112	2,583
Additions	450	0
Disposals	(113)
Recruitment expense	0	0
Amortization	(470)	(471)
Intangible assets, ending balance	$ 1,979	$ 2,112	$ 2,583

Goodwill and Intangible Assets - Future Amortization of Intangible Assets (Details) $ in Thousands	Dec. 31, 2016 USD ($)
Goodwill and Intangible Assets Disclosure [Abstract]
2017	$ 9,042
2018	6,923
2019	6,393
2020	4,023
2021	2,960
Thereafter	14,660
Total	$ 44,001

Long-Term Debt - Summary of Long-Term Debt (Details) - USD ($) $ in Thousands	Dec. 31, 2016	Dec. 31, 2015
Debt Instrument [Line Items]
Long-term debt	$ 1,474,517
Capital lease obligations	13,996	$ 11,316
Less: Unamortized debt issuance costs and discounts	(32,274)	(30,622)
Total debt	1,442,243	1,255,359
Less: Current maturities	27,822	27,247
Total long-term debt	1,414,421	1,228,112
Line of Credit \| 2014 Revolver Loan
Debt Instrument [Line Items]
Long-term debt	85,000	125,250
Line of Credit \| 2014 First Lien Term Loans
Debt Instrument [Line Items]
Long-term debt	932,000	861,300
Line of Credit \| 2014 Second Lien Credit Agreement
Debt Instrument [Line Items]
Long-term debt	0	246,500
Senior Unsecured Notes
Debt Instrument [Line Items]
Long-term debt	400,000	0
Subordinated Notes
Debt Instrument [Line Items]
Long-term debt	1,000	1,000
Notes payable and secured loans
Debt Instrument [Line Items]
Long-term debt	$ 42,521	$ 40,615

Long-Term Debt - 2014 Revolver Loan (Details) - USD ($)		12 Months Ended
Long-Term Debt - 2014 Revolver Loan (Details) - USD ($)	Jan. 27, 2014	Dec. 31, 2016	Dec. 31, 2015	Dec. 31, 2014	Oct. 07, 2015	Oct. 06, 2015	Nov. 03, 2014
Debt Instrument [Line Items]
Payments of debt issuance costs		$ 14,296,000	$ 0	$ 7,496,000
Line of Credit
Debt Instrument [Line Items]
Debt maximum borrowing capacity	$ 90,000,000.0						$ 1,440,000,000.000
Payments of debt issuance costs	$ 2,900,000
Line of Credit \| 2014 Revolver Loan
Debt Instrument [Line Items]
Debt maximum borrowing capacity					$ 150,000,000.0	$ 80,000,000.0	$ 80,000,000.0
Payments of debt issuance costs				$ 2,300,000
Accumulated amortization of deferred financing costs		$ 985,000	$ 530,000
Quarterly commitment fee percentage		0.50%
Debt remaining borrowing capacity		$ 61,900,000
Line of Credit \| 2014 Revolver Loan \| Alternate Base Rate Loan
Debt Instrument [Line Items]
Debt instrument, margin in addition to base rate		3.25%
Line of Credit \| 2014 Revolver Loan \| Alternate Base Rate Loan \| Federal Funds Effective Rate
Debt Instrument [Line Items]
Debt instrument, basis spread on variable rate		0.50%
Line of Credit \| 2014 Revolver Loan \| Alternate Base Rate Loan \| LIBOR
Debt Instrument [Line Items]
Debt instrument, basis spread on variable rate		1.00%
Line of Credit \| 2014 Revolver Loan \| Eurodollar Loan
Debt Instrument [Line Items]
Debt instrument, margin in addition to base rate		4.25%
Line of Credit \| Letter of Credit
Debt Instrument [Line Items]
Debt remaining borrowing capacity		$ 3,100,000

Long-Term Debt - 2014 First Lien Credit Agreement (Details) - Line of Credit - USD ($)		12 Months Ended
	Sep. 26, 2016	Dec. 31, 2016	Mar. 24, 2016	Nov. 03, 2014	Jan. 27, 2014
Debt Instrument [Line Items]
Debt maximum borrowing capacity				$ 1,440,000,000.000	$ 90,000,000.0
2014 First Lien Credit Agreement
Debt Instrument [Line Items]
Incremental increase to aggregate principle amount			$ 80,000,000.0
Debt maximum borrowing capacity			$ 950,000,000.0	$ 870,000,000.0
Debt instrument, threshold business days in certain condition to make mandatory interest payment		5 days
Debt Instrument, number of days after each fiscal year in certain condition to make mandatory interest payment		90 days
2014 First Lien Credit Agreement \| Alternate Base Rate Loan
Debt Instrument [Line Items]
Debt instrument, margin in addition to base rate	2.75%	2.75%
Debt instrument, maximum base rate condition		2.00%
2014 First Lien Credit Agreement \| Alternate Base Rate Loan \| Federal Funds Effective Rate
Debt Instrument [Line Items]
Debt instrument, basis spread on variable rate		0.50%
2014 First Lien Credit Agreement \| Alternate Base Rate Loan \| LIBOR
Debt Instrument [Line Items]
Debt instrument, basis spread on variable rate		1.00%
2014 First Lien Credit Agreement \| Eurodollar Loan
Debt Instrument [Line Items]
Debt instrument, margin in addition to base rate	3.75%	3.75%
Debt instrument, maximum base rate condition		1.00%

Long-Term Debt - 2014 Second Lien Credit Agreement (Details) - USD ($) $ in Thousands			12 Months Ended
	Mar. 31, 2016	Oct. 06, 2015	Dec. 31, 2016	Dec. 31, 2015	Dec. 31, 2014
Debt Instrument [Line Items]
Prepayment penalty, amount			$ 4,900	$ 0	$ 0
Loss on debt extinguishment			$ 11,876	$ 16,102	$ 23,414
2014 Second Lien Credit Agreement \| Line of Credit
Debt Instrument [Line Items]
Debt instrument, prepayment of principle	$ 252,800	$ 243,500
Discount write-off and issuance costs		8,300
Accrued interest paid		$ 65
Prepayment penalty percentage		3.00%
Prepayment penalty, amount		$ 7,300
Loss on debt extinguishment	8,300
Accrued interest	$ 1,300

Long-Term Debt - Additional Information (Details) - USD ($)		12 Months Ended
	Jan. 27, 2014	Dec. 31, 2016	Dec. 31, 2015	Dec. 31, 2014	Mar. 31, 2016	Nov. 03, 2014	Jan. 01, 2014	Apr. 11, 2013	Apr. 10, 2013
Debt Instrument [Line Items]
Debt issuance costs		$ 1,488,000	$ 2,005,000
Payments of debt issuance costs		14,296,000	0	$ 7,496,000
Long-term debt, carrying value		1,474,517,000
Capital leased assets		15,400,000	12,300,000
Senior Unsecured Notes
Debt Instrument [Line Items]
Original balance of debt					$ 400,000,000.0
Debt instrument, stated rate					8.875%
Long-term debt, carrying value		$ 400,000,000	0
Senior Unsecured Notes \| Redemption Period One
Debt Instrument [Line Items]
Amount of principal available to be redeemed, percentage		35.00%
Cash proceeds of principal amount, percentage		108.875%
Minimum principal remaining, percentage		50.00%
Period after equity offering		180 days
Redemption price, percentage		100.00%
Senior Unsecured Notes \| Redemption Period Five
Debt Instrument [Line Items]
Redemption price, percentage		101.00%
Debt issuance costs					$ 8,400,000
Line of Credit
Debt Instrument [Line Items]
Debt maximum borrowing capacity	$ 90,000,000.0					$ 1,440,000,000.000
Debt issuance and discount	1,400,000
Payments of debt issuance costs	$ 2,900,000
Debt interest expense				$ 380,000
Subordinated Notes
Debt Instrument [Line Items]
Debt instrument, stated rate							17.00%
Debt maximum borrowing capacity								$ 1,000,000.0	$ 53,800,000.0
Long-term debt, carrying value		$ 1,000,000	1,000,000
Notes payable and secured loans
Debt Instrument [Line Items]
Long-term debt, carrying value		$ 42,521,000	$ 40,615,000

Long-Term Debt - Debt Redemptions Percentages (Details) - Senior Unsecured Notes	12 Months Ended
	Dec. 31, 2016
Redemption Period Two
Debt Instrument [Line Items]
Redemption price, percentage	106.656%
Redemption Period Three
Debt Instrument [Line Items]
Redemption price, percentage	104.438%
Redemption Period Four
Debt Instrument [Line Items]
Redemption price, percentage	100.00%

Long-Term Debt - Summary of Scheduled Maturities of Debt Obligations (Details) $ in Thousands	Dec. 31, 2016 USD ($)
Condensed Balance Sheet Statements, Captions [Line Items]
2017	$ 27,823
2018	26,028
2019	103,871
2020	909,993
2021	402,852
Thereafter	3,950
Total debt	1,474,517
Capital Lease Obligations
Condensed Balance Sheet Statements, Captions [Line Items]
2017	4,860
2018	3,952
2019	2,960
2020	1,535
2021	633
Thereafter	56
Total debt	13,996
Other Long-Term Debt
Condensed Balance Sheet Statements, Captions [Line Items]
2017	22,963
2018	22,076
2019	100,911
2020	908,458
2021	402,219
Thereafter	3,894
Total debt	$ 1,460,521

Operating Leases (Details) $ in Thousands	12 Months Ended
Operating Leases (Details) $ in Thousands	Dec. 31, 2016 USD ($)	Dec. 31, 2015 USD ($) Lease	Dec. 31, 2014 USD ($)
Leases [Abstract]
Number of operating leases terminated \| Lease		4
Liability accrued from terminating lease contracts		$ 4,600
Operating Leases, Future Minimum Payments Due, Fiscal Year Maturity [Abstract]
2017	$ 46,517
2018	42,917
2019	39,181
2020	34,415
2021	28,728
Thereafter	143,558
Total minimum operating lease payments	335,316
Operating Leased Assets [Line Items]
Operating leases expense	47,300	40,100	$ 18,800
Operating Leases, Rent Expense, Net [Abstract]
2017	1,101
2018	1,137
2019	658
2020	468
2021	312
Thereafter	1,919
Total non-cancellable sub-lease income	5,595
Operating lease agreements, with physician investors
Operating Leased Assets [Line Items]
Operating leases expense	$ 14,400	$ 12,900	$ 6,900

Earnings Per Share (Details) - USD ($)
$ / shares in Units, $ in Thousands

3 Months Ended

12 Months Ended

Dec. 31, 2016

Sep. 30, 2016

Jun. 30, 2016

Mar. 31, 2016

Dec. 31, 2015

Sep. 30, 2015

Jun. 30, 2015

Mar. 31, 2015

Dec. 31, 2016

Dec. 31, 2015

Dec. 31, 2014

Numerator:

Net income (loss) attributable to Surgery Partners, Inc.

$ 16,862

$ (2,338)

$ 2,120

$ (7,190)

$ 16,739

$ (3,122)

$ (5,426)

$ (6,762)

$ 9,453

$ 1,429

$ (65,897)

Denominator:

Weighted average shares outstanding- basic (in shares)

48,018,944

36,066,233

32,295,364

Effect of dilutive securities (in shares)

171,794

1,398,154

Weighted average shares outstanding- diluted (in shares)

^[1],[2]

48,190,738

37,464,387

32,295,364

Earnings (loss) per share:

Basic (in USD per share)

$ 0.35

$ (0.05)

$ 0.04

$ (0.15)

$ 0.35

$ (0.10)

$ (0.17)

$ (0.21)

$ 0.20

$ 0.04

$ (2.04)

Diluted (in USD per share)

$ 0.35

$ (0.05)

$ 0.04

$ (0.15)

$ 0.35

$ (0.10)

$ (0.17)

$ (0.21)

$ 0.20

^[2]

$ 0.04

^[2]

$ (2.04)

^[2]

Stock options

Antidilutive Securities Excluded from Computation of Earnings Per Share [Line Items]

Antidilutive securities excluded from computation of earnings per share (in shares)

Restricted shares

Antidilutive Securities Excluded from Computation of Earnings Per Share [Line Items]

Antidilutive securities excluded from computation of earnings per share (in shares)

1,386,805

[1]	Effect of the Reorganization in 2015, as defined in Note 1, has been retrospectively applied to all periods presented.
[2]	The impact of potentially dilutive securities for the year ended December 31, 2014 was not considered because the effect would be anti-dilutive for the period.

Income Taxes and Tax Receivable Agreement - Additional Information (Details) - USD ($) $ in Thousands	12 Months Ended
	Dec. 31, 2016	Dec. 31, 2015	Dec. 31, 2014	Sep. 30, 2015
Income Tax Contingency [Line Items]
Percentage of tax attributes required to pay shareholders prior to IPO				85.00%
Total tax receivable agreement liability	$ 123,300
Current tax receivable agreement liability	999	$ 0
Cash paid for income taxes	$ 661	1,093	$ 676
U.S. federal statutory rate	35.00%
Valuation allowance	$ 7,358	6,949
Decrease in valuation allowance	500
Valuation allowance that if recognized, would credit directly to contributed capital	2,400
Accrued interest and penalties related to uncertain tax positions	163	$ 322
Uncertain tax positions that would impact effective tax rate	309
Additional Paid-in Capital
Income Tax Contingency [Line Items]
Additional-paid-in-capital increase, due to tax effect of disposals of shares of noncontrolling interests	336
Capital Loss Carryforward
Income Tax Contingency [Line Items]
Capital loss carryforwards	7,400
Credit Carryforward
Income Tax Contingency [Line Items]
Capital loss carryforwards	714
Federal Tax Authority
Income Tax Contingency [Line Items]
Net operating loss carryforwards	390,600
State Tax Authority
Income Tax Contingency [Line Items]
Net operating loss carryforwards	$ 542,700
LIBOR
Income Tax Contingency [Line Items]
Basis rate at which interest accrues	300.00%

Income Taxes and Tax Receivable Agreement - Income Tax Expense (Details) - USD ($) $ in Thousands	12 Months Ended
	Dec. 31, 2016	Dec. 31, 2015	Dec. 31, 2014
Current:
Federal	$ (31)	$ 0	$ 0
State	244	909	1,669
Deferred:
Federal	7,326	(132,311)	13,235
State	(444)	(17,580)	854
Total income tax expense (benefit)	$ 7,095	$ (148,982)	$ 15,758

Income Taxes and Tax Receivable Agreement - Income Tax Rate Reconciliation (Details) - USD ($) $ in Thousands	12 Months Ended
	Dec. 31, 2016	Dec. 31, 2015	Dec. 31, 2014
Effective Income Tax Rate Reconciliation, Amount [Abstract]
Tax expense (benefit) at U.S.federal statutory rate	$ 32,263	$ (26,648)	$ (3,840)
State income tax, net of U.S. federal tax benefit	(86)	1,059	1,402
Change in valuation allowance	354	(137,721)	29,336
Expiration of carryforwards and stock option forfeitures	0	0	1,286
Net income attributable to non-controlling interests	(26,470)	(24,996)	(13,207)
Changes in measurement of uncertain tax positions	(262)	(10)	589
Stock option compensation	(200)	0	0
Nondeductible transaction costs	0	3,442	4,230
Tax return reconciling differences	1,635	(1,574)	(4,419)
Change in effective tax rate	0	(2,143)	0
TRA liability	(327)	39,428	0
Other	188	181	381
Total income tax expense (benefit)	$ 7,095	$ (148,982)	$ 15,758

Income Taxes and Tax Receivable Agreement - Approx. Tax Effects of Temporary Differences, Deferred Tax Asset and Liability (Details) - USD ($) $ in Thousands	Dec. 31, 2016	Dec. 31, 2015
Deferred tax assets:
Medical malpractice liability	$ 4,194	$ 869
Accrued vacation and incentive compensation	1,112	2,212
Net operating loss carryforwards	158,796	146,663
Allowance for bad debts	8,343	1,846
Capital loss carryforwards	2,785	2,052
Deferred rent	1,371	2,288
Depreciation on property and equipment	530	0
Deferred financing costs	0	3,083
TRA liability	4,542	2,750
Other deferred assets	4,879	3,286
Total gross deferred tax assets	186,552	165,049
Less: Valuation allowance	(7,358)	(6,949)
Total deferred tax assets	179,194	158,100
Deferred tax liabilities:
Deferred financing costs	(8,797)	0
Depreciation on property and equipment	0	(806)
Amortization of intangible assets	(15,241)	(16,083)
Basis differences of partnerships and joint ventures	(68,160)	(46,494)
Other deferred liabilities	(3,203)	(612)
Total deferred tax liabilities	(95,401)	(63,995)
Net deferred tax assets	$ 83,793	$ 94,105

Income Taxes and Tax Receivable Agreement - Schedule of Gross Unrecognized Tax Benefits (Details) - USD ($) $ in Thousands	12 Months Ended
	Dec. 31, 2016	Dec. 31, 2015
Reconciliation of Unrecognized Tax Benefits, Excluding Amounts Pertaining to Examined Tax Returns [Roll Forward]
Unrecognized tax benefits at beginning of year	$ 1,403	$ 2,755
Additions for tax positions of prior years	60	136
Reductions for tax positions of prior year	(398)	(996)
Settlements	(4)	(492)
Unrecognized tax benefits at end of year	$ 1,061	$ 1,403

Equity-Based Compensation - Additional Information (Details) - USD ($) $ in Thousands	1 Months Ended	12 Months Ended
	Apr. 30, 2013	Dec. 31, 2016	Dec. 31, 2015	Dec. 31, 2014
Share-based Compensation Arrangement by Share-based Payment Award [Line Items]
Unrecognized compensation cost		$ 4,700
Equity-based compensation		$ 2,021	$ 7,502	$ 942
Restricted Share
Share-based Compensation Arrangement by Share-based Payment Award [Line Items]
Number of additional instruments issued (in shares)		384,629	569,114	583,404
Numbers of shares terminated (in shares)		53,003	0	127,582
Accelerated vesting (in shares)			1,632,626
Accelerated vesting, cost			$ 6,200
2015 Omnibus Incentive Plan
Share-based Compensation Arrangement by Share-based Payment Award [Line Items]
Shares authorized under plan (in shares)		4,815,700
Shares available for future grant (in shares)		4,311,816
Symbion, Inc \| B Units
Share-based Compensation Arrangement by Share-based Payment Award [Line Items]
Number of additional instruments issued (in shares)	1,300,000

Equity-Based Compensation - Fair Value Assumptions (Details) - Stock Option	12 Months Ended
	Dec. 31, 2016 $ / shares
Share-based Compensation Arrangement by Share-based Payment Award, Fair Value Assumptions and Methodology [Abstract]
Expected dividends	0.00%
Average expected term (years)	2 years 6 months 22 days
Minimum
Share-based Compensation Arrangement by Share-based Payment Award, Fair Value Assumptions and Methodology [Abstract]
Expected volatility	29.00%
Risk-free interest rate	0.54%
Fair value of stock options granted (in USD per share)	$ 2.64
Maximum
Share-based Compensation Arrangement by Share-based Payment Award, Fair Value Assumptions and Methodology [Abstract]
Expected volatility	43.00%
Risk-free interest rate	1.36%
Fair value of stock options granted (in USD per share)	$ 5.74

Equity-Based Compensation - Summary of Options Activity (Details) - $ / shares	12 Months Ended
	Dec. 31, 2016	Dec. 31, 2015
Options
Outstanding, beginning of period (in shares)	8,488	0
Granted (in shares)	7,779	8,448
Exercised (in shares)	0	0
Forfeited (in shares)	0	0
Outstanding, end of period (in shares)	16,267	8,488
Weighted Average Exercise Price
Granted (in USD per share)	$ 17.99	$ 20.03
Outstanding (in USD per share)	$ 19.05	$ 20.03
Weighted Average Remaining Contractual Term, Granted	1 year 7 months 6 days	3 years
Weighted Average Remaining Contractual Term, Outstanding	1 year 9 months 18 days	3 years
Outstanding options, exercisable (in shares)	2,829

Equity-Based Compensation - Summary of Restricted Share Activity (Details) - Restricted Share - $ / shares	12 Months Ended
	Dec. 31, 2016	Dec. 31, 2015	Dec. 31, 2014
Total Shares
Outstanding, beginning of the period (in shares)	3,444,522	2,887,150	3,234,664.000
Granted (in shares)	384,629	569,114	583,404
Forfeited/Terminated (in shares)	(53,003)	0	(127,582)
Purchased (in shares)	0	(11,742)	(803,336)
Outstanding, end of the period (in shares)	3,776,148	3,444,522	2,887,150
Vested Shares
Outstanding, beginning of the period (in shares)	3,313,906	3,276,868	1,645,085
Purchased (in shares)	0	(11,742)	(803,336)
Vested (in shares)	(37,038)	(1,643,525)	(659,641)
Outstanding, end of the period (in shares)	3,276,868	1,645,085	1,788,780.00
Unvested Shares
Outstanding, beginning of the period (in shares)	167,654	1,242,065	1,445,884.000
Granted (in shares)	384,629	569,114	583,404
Forfeited/Terminated (in shares)	(53,003)	0	(127,582)
Vested (in shares)	(37,038)	(1,643,525)	(659,641)
Outstanding, end of the period (in shares)	462,242	167,654	1,242,065
Weighted-Average Grant Fair Value
Outstanding, beginning of the period (in USD per share)	$ 2.53	$ 1.96	$ 0.81
Granted (in USD per share)	15.09	6.31	6.44
Forfeited/Terminated (in USD per share)	11.85	0.00	1.27
Purchased (in USD per share)	0.00	6.31	3.64
Vested (in USD per share)	6.31	3.79	1.43
Outstanding, end of the period (in USD per share)	$ 3.72	$ 2.53	$ 1.96

Employee Benefit Plans (Details) - USD ($) $ in Thousands	12 Months Ended
Employee Benefit Plans (Details) - USD ($) $ in Thousands	Dec. 31, 2016	Dec. 31, 2015	Dec. 31, 2014
Defined Contribution Plan Disclosure [Line Items]
Matching contribution expense	$ 5,100	$ 2,200	$ 754
Surgery Partners 401k Plan
Defined Contribution Plan Disclosure [Line Items]
Percent of base pay employee may contribute to receive employer match	6.00%
Employer contribution annual vesting percentage	20.00%
Supplemental Executive Retirement Savings Plan
Defined Contribution Plan Disclosure [Line Items]
Percent of base pay employee may contribute to receive employer match	2.00%
Percent of payroll employee may defer	25.00%
Percent of bonus employee may defer	50.00%
Employer matching contribution percentage of employee base salary	2.00%

Related Party Transactions (Details) - USD ($) $ in Thousands	12 Months Ended
	Dec. 31, 2016	Dec. 31, 2015	Dec. 31, 2014	Nov. 03, 2014	May 04, 2011
Related Party Transaction [Line Items]
Advisory fees	$ 81,185	$ 66,583	$ 18,028
Bayside Capital, Inc. \| Management and Investment Advisory Services Agreement \| Affiliated Entity
Related Party Transaction [Line Items]
Annual management fee per agreement with related party				$ 3,000	$ 2,000
Termination of management agreement and IPO costs		$ 5,400	2,000
Advisory fees			$ 17,600

Commitments and Contingencies (Details) $ in Thousands		1 Months Ended	12 Months Ended
Commitments and Contingencies (Details) $ in Thousands	Dec. 24, 2009 USD ($) Entity	Dec. 31, 2010 USD ($)	Dec. 31, 2016 USD ($) Entity	Dec. 31, 2015 USD ($)	Dec. 31, 2014 USD ($)	Dec. 31, 2010 USD ($)	Jan. 01, 2014	Jun. 10, 2013 USD ($)
Guarantor Obligations [Line Items]
Number of business entities acquired \| Entity			1
Interest expense			$ 100,571	$ 100,980	$ 62,101
Assets arising from contingencies, amount recognized								$ 14,000
Gain contingency, unrecorded amount, overstated accounts receivable								10,800
Gain on legal settlement			14,101	0	$ 0
Subordinated Notes
Guarantor Obligations [Line Items]
Promissory Note stated interest rate							17.00%
Operating Leases \| Financial Guarantee
Guarantor Obligations [Line Items]
Guaranteed operating lease payments			$ 12	$ 160
Operating lease term			10 years	10 years
2009 Acquisition
Guarantor Obligations [Line Items]
Number of business entities acquired \| Entity	36
Maximum potential contingent consideration	$ 10,000
Escrow account	$ 2,900
Amount awarded to settle acquisition price adjustment						$ 589
Amount of withdrawal notice to escrow deposit		$ 4,400
Gain contingency, unrecorded amount related to indemnification claims								454
Gain contingency, unrecorded amount offsetting contingent consideration								$ 8,300
Promissory Notes \| 2009 Acquisition \| Subordinated Notes
Guarantor Obligations [Line Items]
Promissory Note stated interest rate			8.00%
Interest expense			$ 1,000	$ 1,100

Segment Reporting - Revenues by Reportable Segment (Details) $ in Thousands	3 Months Ended								12 Months Ended
	Dec. 31, 2016 USD ($)	Sep. 30, 2016 USD ($)	Jun. 30, 2016 USD ($)	Mar. 31, 2016 USD ($)	Dec. 31, 2015 USD ($)	Sep. 30, 2015 USD ($)	Jun. 30, 2015 USD ($)	Mar. 31, 2015 USD ($)	Dec. 31, 2016 USD ($) segment	Dec. 31, 2015 USD ($)	Dec. 31, 2014 USD ($)
Segment Reporting [Abstract]
Number of operating segments \| segment									3
Segment Reporting Information [Line Items]
Revenues	$ 306,001	$ 282,682	$ 289,681	$ 267,074	$ 263,322	$ 239,599	$ 232,827	$ 224,143	$ 1,145,438	$ 959,891	$ 403,289
Surgical facility services
Segment Reporting Information [Line Items]
Revenues									1,042,097	884,144	339,309
Ancillary services
Segment Reporting Information [Line Items]
Revenues									90,836	61,175	49,787
Optical services
Segment Reporting Information [Line Items]
Revenues									$ 12,505	$ 14,572	$ 14,193

Segment Reporting - Segment Operating Income (Details) - USD ($) $ in Thousands	3 Months Ended								12 Months Ended
	Dec. 31, 2016	Sep. 30, 2016	Jun. 30, 2016	Mar. 31, 2016	Dec. 31, 2015	Sep. 30, 2015	Jun. 30, 2015	Mar. 31, 2015	Dec. 31, 2016	Dec. 31, 2015	Dec. 31, 2014
Segment Reporting Information [Line Items]
Total segment adjusted EBITDA									$ 179,263	$ 158,053	$ 77,034
General and administrative expenses									(60,246)	(55,992)	(31,452)
Non-cash stock compensation expense									2,021	7,502	942
Contingent acquisition compensation expense									5,092	0	0
Management fee									0	2,250	2,161
Acquisition related costs									2,185	1,560	0
Total adjusted EBITDA									179,263	158,053	77,034
Net income attributable to non-controlling interests	$ 21,238	$ 16,672	$ 20,173	$ 17,547	$ 19,355	$ 16,906	$ 17,905	$ 17,250	75,630	71,416	38,845
Depreciation and amortization									(39,551)	(34,545)	(15,061)
Interest and other expense, net									(100,571)	(100,980)	(62,101)
Income tax (expense) benefit									(7,095)	148,982	(15,758)
Non-cash stock compensation expense									(2,021)	(7,502)	(942)
Contingent acquisition compensation expense									(5,092)	0	0
Termination of management agreement and IPO costs									0	(5,834)	0
Management fee									0	(2,250)	(2,161)
Merger transaction, integration and practice acquisition costs									(11,617)	(20,579)	(21,690)
Gain on litigation settlement									14,101	0	0
(Loss) gain on disposal or impairment of long-lived assets, net									(2,355)	2,097	(1,804)
Tax receivable agreement expense									(3,733)	(119,911)	0
Loss on debt refinancing									(11,876)	(16,102)	(23,414)
Net income (loss)	$ 38,100	$ 14,334	$ 22,293	$ 10,357	$ 36,094	$ 13,784	$ 12,479	$ 10,488	85,083	72,845	(27,052)
Merger transaction and integration costs									8,738	17,920	21,690
Practice acquisition costs									2,879	2,659
Operating Segments
Segment Reporting Information [Line Items]
Total segment adjusted EBITDA									230,211	202,733	105,383
Total adjusted EBITDA									230,211	202,733	105,383
Operating Segments \| Surgical facility services
Segment Reporting Information [Line Items]
Total segment adjusted EBITDA									214,218	180,113	83,149
Total adjusted EBITDA									214,218	180,113	83,149
Operating Segments \| Ancillary services
Segment Reporting Information [Line Items]
Total segment adjusted EBITDA									12,685	18,715	18,354
Total adjusted EBITDA									12,685	18,715	18,354
Operating Segments \| Optical services
Segment Reporting Information [Line Items]
Total segment adjusted EBITDA									3,308	3,905	3,880
Total adjusted EBITDA									$ 3,308	$ 3,905	$ 3,880

Segment Reporting - Assets by Operating Segment (Details) - USD ($) $ in Thousands	Dec. 31, 2016	Dec. 31, 2015
Segment Reporting Information [Line Items]
Total assets	$ 2,304,958	$ 2,104,443
Operating Segments
Segment Reporting Information [Line Items]
Total assets	2,121,322	1,906,131
Operating Segments \| Surgical facility services
Segment Reporting Information [Line Items]
Total assets	1,914,842	1,762,396
Operating Segments \| Ancillary services
Segment Reporting Information [Line Items]
Total assets	184,002	118,198
Operating Segments \| Optical services
Segment Reporting Information [Line Items]
Total assets	22,478	25,537
General and administrative
Segment Reporting Information [Line Items]
Total assets	$ 183,636	$ 198,312

Segment Reporting - Cash Purchases of Property and Equipment (Details) - USD ($) $ in Thousands	12 Months Ended
	Dec. 31, 2016	Dec. 31, 2015	Dec. 31, 2014
Segment Reporting Information [Line Items]
Total cash purchases of property and equipment, net	$ 39,109	$ 33,439	$ 7,736
Operating Segments
Segment Reporting Information [Line Items]
Total cash purchases of property and equipment, net	34,896	27,902	6,527
Operating Segments \| Surgical facility services
Segment Reporting Information [Line Items]
Total cash purchases of property and equipment, net	29,157	26,723	5,158
Operating Segments \| Ancillary services
Segment Reporting Information [Line Items]
Total cash purchases of property and equipment, net	5,388	1,051	1,034
Operating Segments \| Optical services
Segment Reporting Information [Line Items]
Total cash purchases of property and equipment, net	351	128	335
General and administrative
Segment Reporting Information [Line Items]
Total cash purchases of property and equipment, net	$ 4,213	$ 5,537	$ 1,209

Quarterly Financial Information (Unaudited) (Details) - USD ($)
$ / shares in Units, $ in Thousands

3 Months Ended

12 Months Ended

Dec. 31, 2016

Sep. 30, 2016

Jun. 30, 2016

Mar. 31, 2016

Dec. 31, 2015

Sep. 30, 2015

Jun. 30, 2015

Mar. 31, 2015

Dec. 31, 2016

Dec. 31, 2015

Dec. 31, 2014

Quarterly Financial Information Disclosure [Abstract]

Revenues

$ 306,001

$ 282,682

$ 289,681

$ 267,074

$ 263,322

$ 239,599

$ 232,827

$ 224,143

$ 1,145,438

$ 959,891

$ 403,289

Cost of revenues

214,247

201,394

208,852

196,703

183,174

168,821

161,558

155,773

821,196

669,326

254,178

Net income

38,100

14,334

22,293

10,357

36,094

13,784

12,479

10,488

85,083

72,845

(27,052)

Net income attributable to non-controlling interests

(21,238)

(16,672)

(20,173)

(17,547)

(19,355)

(16,906)

(17,905)

(17,250)

(75,630)

(71,416)

(38,845)

Net income (loss) attributable to Surgery Partners, Inc.

$ 16,862

$ (2,338)

$ 2,120

$ (7,190)

$ 16,739

$ (3,122)

$ (5,426)

$ (6,762)

$ 9,453

$ 1,429

$ (65,897)

Basic net (loss) income per share (in USD per share)

$ 0.35

$ (0.05)

$ 0.04

$ (0.15)

$ 0.35

$ (0.10)

$ (0.17)

$ (0.21)

$ 0.20

$ 0.04

$ (2.04)

Diluted net (loss) income per share (in USD per share)

$ 0.35

$ (0.05)

$ 0.04

$ (0.15)

$ 0.35

$ (0.10)

$ (0.17)

$ (0.21)

$ 0.20

^[1]

$ 0.04

^[1]

$ (2.04)

^[1]

[1]	The impact of potentially dilutive securities for the year ended December 31, 2014 was not considered because the effect would be anti-dilutive for the period.

- Definition

The amount of net income (loss) for the period per each share of common stock or unit outstanding during the reporting period.

+ References + Details

- Definition

The portion of profit or loss for the period, net of income taxes, which is attributable to the parent.

+ References + Details