Where health systems are investing in spine, orthopedics in 2026

Reimbursement is tightening, and health systems are building anyway. CMS’ proposed 2027 physician fee schedule would cut orthopedic surgery pay by about 7% and neurosurgery by about 2%, yet systems spent 2026 breaking ground on orthopedic towers, recruiting spine surgeons in groups and folding independent practices into new institutes.

Here are 17 health systems, hospitals and large practices that expanded spine and orthopedic services in 2026, as reported by Becker’s. Projects are listed roughly by size of investment.

Editor’s note: This list is not exhaustive.

1. Sutter Health (Sacramento, Calif.) recruited four University of California San Francisco spine surgeons — Shane Burch, MD; Sigurd Berven, MD; Aaron Clark, MD; and Alekos Theologis, MD — to launch the Sutter Advanced Neuroscience & Spine Institute at California Pacific Medical Center in San Francisco. The institute’s permanent home, a 129,000-square-foot complex on CPMC’s Mission Bernal campus, is currently projected to cost nearly $500 million when it opens in 2028, up from $442 million when Sutter unveiled plans for it in April 2024.
2. UCLA Health (Los Angeles) won University of California Board of Regents approval for a $298.2 million project to convert a Los Angeles-area building into offices that will house a sports medicine facility and an ASC.
3. Hospital for Special Surgery (New York City) opened the 12-story, 94,000-square-foot Kellen Tower March 31, completing its Upper East Side campus expansion. The tower serves spine and joint replacement patients, including complex cases, and was funded in part by more than $195 million in early philanthropy.
4. CentraCare (St. Cloud, Minn.) opened a $194 million expansion at its Plaza campus June 29, adding clinical space for orthopedics and sports medicine.
5. Covenant HealthCare (Saginaw, Mich.) broke ground on a $25 million orthopedic facility to expand musculoskeletal care in the region.
6. Rochester (N.Y.) Regional Health began construction on a $17.5 million orthopedic and neurosciences center in Canandaigua, N.Y. The 39,000-square-foot center will consolidate three local practices under one roof and include four operating rooms, 16 pre- and post-procedure bays and 32 exam rooms.
7. NYC Health + Hospitals/Harlem (New York City) opened a $10 million orthopedic and podiatry clinic.
8. Northwell Health (New Hyde Park, N.Y.) opened the $6.3 million, 11,500-square-foot Northwell Spine Institute at Lenox Hill in April, combining orthopedics, sports medicine, neurosurgery and physical medicine and rehabilitation in one location. The system also opened a $2.36 million orthopedic location in West Harrison, N.Y.
9. Southwoods Health (Boardman, Ohio) bought an ExcelsiusGPS spine robot for $1.3 million.
10. Avera Health (Sioux Falls, S.D.) acquired The Center for Neurosciences, Orthopaedics & Spine in Dakota Dunes, S.D., in July. The physician-owned group brings more than 100 providers across nine specialties, more than 350 staff and eight clinic locations. Terms were not disclosed.
11. Bon Secours Mercy Health (Cincinnati) launched the Bon Secours Spine Institute across its Richmond, Va., region June 29. The program brings orthopedic and neurosurgical spine surgeons, physiatry, pain management and rehabilitation into one model, with nurse navigators routing patients to the right level of care.
12. TidalHealth (Salisbury, Md.) integrated Peninsula Orthopaedic Associates through a new entity, TidalHealth Peninsula Orthopaedic Institute, effective April 1. The system plans to expand orthopedic services in Seaford and Millsboro, Del., and the partners aim to launch an orthopedic surgery residency, pending accreditation.
13. CHI Health (Omaha, Neb.) broke ground June 24 on an orthopedic center at its Lakeside campus, designed as a regional hub for orthopedic surgery, sports medicine and joint replacement. It will also house Creighton University School of Medicine’s orthopedic surgery residency.
14. Banner Fort Collins (Colo.) Medical Center opened more than 10,000 square feet of clinical space for orthopedic and spine surgery in March. The project relocated the Joint Replacement Center of Northern Colorado, added a spine-focused neurosurgery clinic led by Eric Arias, MD, and added a fourth operating room.
15. Maury Regional Health (Columbia, Tenn.) opened its Orthopedic Surgical Institute in the Outpatient Pavilion at Maury Regional Medical Center. The institute has four operating rooms equipped with robotic and navigation systems.
16. Cape Fear Valley Health (Fayetteville, N.C.) opened an orthopedic spine surgery clinic in April to centralize spine services and ease capacity at existing sites. The clinic serves patients across the system’s eight hospitals.
17. Boston Bone & Joint Institute (Waltham, Mass.) and three partner organizations opened a 79,500-square-foot orthopedic ASC and medical office building in June. More than 30 providers affiliated with Beth Israel Lahey Health practice at the site, which has eight operating rooms and 28 recovery bays.

At the Becker’s 32nd Annual Meeting: The Business and Operations of ASCs, taking place October 29-31 in Chicago, ASC leaders, surgeons and healthcare executives will explore strategies to drive growth, enhance operational performance, navigate reimbursement challenges and prepare for the future of ambulatory surgery. Apply for complimentary registration now.