Valuing Cardiology Practices in 2026: A Comprehensive Guide for Cardiology, Owners, Investors, and M&A Professionals

Understanding the value of a practice is essential when planning for growth, partnership, or long-term succession. Cardiology practices range from independent general and interventional groups to fully integrated cardiovascular centers with advanced imaging and procedural services, each carrying distinct financial and operational considerations. This guide outlines the primary valuation methods used in 2026, including earnings-based and market-based approaches, while explaining how factors such as payer mix, physician productivity, ancillary revenue, and governance structure influence enterprise value. With a clear understanding of these drivers, physician owners can make informed strategic decisions that protect both their professional legacy and financial future.

Whether you're preparing to sell a practice, evaluating a partnership opportunity, or seeking to benchmark financial performance, this article explores the key valuation methodologies, drivers, and risk factors that appraise the value of a cardiology practice.

I. Industry Context: Why Cardiology Practices are in Demand

There is sustained and growing demand for cardiology services driven by demographic, clinical, and economic forces. The aging U.S. population continues to fuel higher rates of coronary artery disease, heart failure, arrhythmias, and structural heart conditions, all of which require ongoing specialist management. At the same time, rising prevalence of obesity, diabetes, and hypertension is expanding the pool of patients at risk for cardiovascular disease at younger ages. Advances in diagnostic imaging, interventional procedures, and remote cardiac monitoring have increased referral volumes and broadened the scope of outpatient-based cardiac care. Shifts toward value-based care and population health management have further elevated the role of cardiologists in preventing costly hospitalizations and managing chronic disease. Together, these trends support strong, long-term patient demand and reinforce cardiology’s position as a cornerstone specialty in the healthcare services market.

Key Growth Drivers

Key growth drivers for the industry include the following:

• Aging Population and Disease Prevalence The growing population of adults over 65 is driving sustained increases in cardiovascular disease, heart failure, and arrhythmias, leading to higher demand for both diagnostic and interventional cardiology services.

  
  

• Rising Rates of Chronic Conditions Widespread increases in obesity, diabetes, hypertension, and metabolic syndrome are expanding the long-term patient base for preventive, monitoring, and treatment-focused cardiac care.

  
  

• Expansion of Outpatient and Office-Based Procedures Technological advances and favorable reimbursement trends are shifting many cardiac procedures, such as imaging, catheterization, and device monitoring, into outpatient and physician-owned settings, improving access and practice economics.

  
  

• Growth of Advanced Diagnostics and Ancillary Services Increased utilization of echocardiography, nuclear cardiology, CT angiography, and remote monitoring devices is creating high-margin ancillary revenue streams that enhance practice scalability and valuation.

  
  

• Value-Based Care and Population Health Initiatives Payers and health systems are increasingly relying on cardiologists to manage high-risk populations, reduce hospital admissions, and improve quality metrics, strengthening referral relationships and long-term revenue stability.

Reimbursement Outlook

In 2026, cardiology reimbursement under the Medicare Physician Fee Schedule is expected to include modest overall increases in payment rates, with the baseline conversion factor rising by roughly 3.26% for non-APM participants and 3.77% for those in qualifying alternative payment models, reflecting statutory updates and broader policy adjustments. However, CMS has finalized a –2.5% efficiency adjustment on work relative value units for many non-time-based services, which, combined with changes to how practice expense RVUs are allocated, is projected to reduce reimbursement for many facility-based cardiology services even as office-based payments increase. Commercial payers typically mirror these Medicare trends, and evolving coding updates for procedures like complex PCI are influencing how cardiologists capture revenue in 2026. This mixed outlook highlights ongoing pressure on margins despite headline rate increases, underscoring the importance of strategic coding, site-of-service planning, and revenue cycle optimization for cardiology practices.

II. Top Reasons to Get a Valuation of Your Cardiology Practice

The following is a list of common reasons for commissioning a valuation analysis or appraisal of a cardiology practice:

1. Preparing for a Sale or Strategic Partnership

• To establish a defensible asking price when marketing the business

• To evaluate offers from private equity, strategic buyers, or joint venture partners

• To understand how your practice compares to market benchmarks

  
  

2. Internal Ownership Transition

• For buy-in or buy-out of partners or associates

• To support fair and compliant equity allocation among clinicians

• To plan for generational succession or family transfers

3. Compliance with Healthcare Regulations

• To support Fair Market Value (FMV) and Commercial Reasonableness (CR) assessments required by Stark Law and Anti-Kickback Statute in deals involving ownership by other healthcare providers

• To document compliance in joint ventures, especially when there is a referral relationships (hospitals, ancillary service providers, or physicians)

  
  

4. Estate & Tax Planning

• For gift or estate tax reporting to the IRS (especially for closely held businesses)

• To support asset protection strategies

• To plan for long-term wealth transfer or charitable contributions

  
  

5. Litigation or Dispute Resolution

• For divorce proceedings involving business asset division

• In shareholder or partnership disputes

• For economic damages assessments in legal proceedings

  
  

6. Business Planning & Strategic Growth

• To establish a valuation baseline for performance benchmarking

• To support capital raise, refinancing, or line-of-credit applications

• To identify value drivers and areas for operational improvement

III. Valuation Approaches for Cardiology

Valuation professionals typically apply three core methodologies to estimate the value of a cardiology practice:

Income Approach (Discounted Cash Flow or Capitalization of Earnings)

This approach values a business based on the present value of its expected future earnings or cash flows. It’s most appropriate when a practice has a stable operating history and predictable future performance.

Key assumptions include:

• Normalized EBITDA or owner’s discretionary earnings

• Growth rate assumptions (organic and acquisitive)

• Risk-adjusted discount rate (typically 10–25% for cardiology)

• Capital expenditure needs

Pros: Based on the business’ future earning power

Cons: Sensitive to forecasting errors and discount rate subjectivity

Market Approach (Comparable Transaction Method, e.g. Market Multiples)

This method uses observed EBITDA multiples or revenue multiples from recent M&A transactions or public companies in the cardiology space. Typical multiples for small to medium -sized cardiology practices are within the range of 4x to 8x EBITDA, depending on a wide variety of factors.

Pros: Easy to benchmark; useful in active M&A environments

Cons: Requires access to quality private market data and careful adjustment for size, margin, geography, and a variety of other factors

Asset-Based Approach

Used only when the business is underperforming or being liquidated. The value is derived from the net assets (e.g., equipment, leasehold improvements) minus liabilities.

Pros: Useful in distressed scenarios

Cons: Intangible value of the practice can be difficult to quantify under this method

IV. Key Value Drivers in Cardiology Valuation

Several specific factors can materially influence a Cardiology practice’s valuation multiple:

Earnings Quality

Buyers and valuation professionals place significant emphasis on normalized EBITDA and / or cash flow. Adjustments often include:

• Owner compensation (if above/below market)

• Non-recurring revenue or expenses

• Related-party lease arrangements

• Post-transaction adjustments

• Out-of-period adjustments

Growth Potential

Discount rates and valuation multiples are a function of perceived risk and growth. Key considerations within the cardiology specialty related to growth include the following:

1. Aging Population & Disease Prevalence → Predictable Cash Flow Premiums Practices with strong exposure to Medicare and established senior patient panels tend to receive higher valuation multiples because their demand profile is stable and highly recurring. Buyers place a premium on practices with consistent follow-up volumes, chronic disease management programs, and low patient churn, which reduces revenue volatility.

   
   

2. Chronic Disease Growth → Platform and Scale Valuations Groups that demonstrate long-term management of hypertension, diabetes-related heart disease, and heart failure are often positioned as “platform” practices in roll-up strategies. These practices may command higher initial multiples and earn-out opportunities because acquirers view them as anchors for regional expansion.

   
   

3. Outpatient Shift → Facility and Ancillary Value Uplift Practices operating office-based labs (OBLs), imaging centers, or ambulatory cath labs frequently receive valuation premiums due to enhanced margins and vertical integration. Transactions often include separate valuations for these assets, with buyers structuring deals to preserve physician control while monetizing facility income.

   
   

4. Advanced Diagnostics & Monitoring → EBITDA Multiple Expansion Strong ancillary utilization and remote monitoring programs increase EBITDA margins, which directly supports higher multiples. Buyers may structure performance-based incentives tied to imaging growth, device management volumes, or technology adoption to protect upside.

   
   

5. Value-Based Care → Long-Term Partnership Structures Practices with bundled payment experience, shared savings arrangements, or population health contracts are attractive to strategic and private equity buyers seeking downside protection. These groups are more likely to see minority recapitalizations, phased buy-ins, and long-term governance arrangements rather than full exits.

   
   

Cardiology practices that combine clinical depth with scalable ancillaries, stable referral networks, and population health capabilities tend to receive premium valuations and more flexible deal terms. Proactively aligning operations with these growth drivers can materially improve both headline pricing and post-transaction control.

Risk Factors

Key considerations within the cardiology specialty related to risk include the following:

• Reimbursement Pressure and Policy Uncertainty Ongoing adjustments to Medicare and commercial payer fee schedules, budget neutrality rules, and value-based payment models continue to place downward pressure on professional and procedural reimbursement.

  
  

• Physician Workforce Shortages and Burnout Growing demand for cardiology services, combined with an aging physician workforce and high burnout rates, creates recruitment and retention challenges that can limit growth and strain operating margins.

  
  

• Regulatory and Compliance Complexity Cardiology practices face heightened scrutiny related to Stark Law, Anti-Kickback Statute, billing accuracy, and quality reporting, increasing compliance costs and audit risk.

  
  

• Rising Operating and Capital Costs Investments in imaging equipment, cath labs, IT systems, staffing, and cybersecurity are increasingly expensive, compressing margins—especially for independent and smaller practices.

  
  

• Market Consolidation and Competitive Pressure Continued hospital, health system, and private equity consolidation can weaken independent practices’ negotiating leverage, intensify referral competition, and limit access to favorable payer contracts.

V. Current Market Trends in Cardiology M&A

Cardiology remains an attractive specialty from an M&A perspective, although public M&A deal announcements fluctuate significantly from year to year, and represent only a small portion of actual deal volume. The number of announced cardiology acquisition declined significantly in 2025 after a large spike in activity in 2023.

Cardiology EBITDA Multiple Trends

Larger cardiology platforms typically command higher EBITDA multiples than smaller independent clinics due to their scale, diversified revenue base, and reduced operational risk. These platforms benefit from centralized management, robust referral networks, and greater negotiating leverage with payers and vendors, factors that enhance profitability and stability. Additionally, buyers place a premium on the platform’s ability to support future growth through acquisitions or de novo expansion, while smaller clinics may be more dependent on a single provider or location. This combination of scalability, infrastructure, and lower risk profile makes larger platforms more attractive and valuable in the eyes of strategic and financial buyers.

According to our database, multiples for larger cardiology platforms with EBITDA of over $10 million annually can range from 10x to 15x EBITDA.

Cash Flow Multiples for Small Cardiology

There are a number of small cardiology practices listed for sale at any given time, but it's difficult to glean much useful information from data on smaller businesses where context around the level of owner involvement is unavailable. A cardiology practice making $400k per year in cash flow for an absentee owner is much different from a cardiology practice making $400k per year in take-home for a full-time physician-owner. Our study of current and recently removed businesses for sale shows a range of multiples from 1.57x cash flow to 2.18x cash flow at the 25th and 75th percentiles, with a median of 2.11x. Revenue multiples range from 0.58x to 0.91x at the 25th and 75th percentiles, with a median of 0.65x.

VI. Final Thoughts: Keys to Maximizing Value

If you're a cardiology practice owner or executive planning to explore a sale or equity partnership, consider the following strategies to enhance your valuation:

• Build and Optimize High-Margin Ancillary Services Expanding imaging, remote monitoring, office-based labs, and diagnostic testing increases EBITDA and reduces reliance on professional fees. Buyers place a premium on diversified, scalable revenue streams with strong utilization and documentation.

  
  

• Strengthen Physician Retention and Succession Planning Establish clear pathways for junior partners, competitive compensation models, and long-term employment agreements. Practices with stable provider rosters and visible leadership continuity are viewed as lower risk and command higher multiples.

  
  

• Improve Operational and Financial Transparency Clean up financial reporting, normalize physician compensation, and separate personal expenses well in advance of a transaction. Well-organized, audit-ready financials accelerate diligence and prevent valuation discounts.

  
  

• Optimize Payer Mix and Revenue Cycle Performance Renegotiate underperforming contracts, improve collections, and reduce denial and days-in-A/R metrics. Strong net collections and predictable cash flow directly support premium valuations.

  
  

• Position the Practice as a Scalable Growth Platform Expand referral networks, standardize clinical protocols, and pursue selective mergers or satellite locations. Buyers pay more for practices that can serve as regional “platforms” rather than standalone assets.

About HealthFMV

HealthFMV specializes in appraising healthcare businesses and services arrangements, including cardiology practices.

• Business Valuation: We perform independent, third-party valuations of healthcare businesses to document regulatory, tax, and financial reporting compliance, resolve ownership disputes, and help ensure both parties to the transaction are comfortable with the financial terms.

  
  

• Transaction Advisory: We work with healthcare business owners, organization executives, providers, and their health lawyers to develop transaction structures and deal terms that further their business objectives while maintaining compliance with the complex healthcare regulatory environment.

  
  

• Services Arrangements: We prepare fair market value and commercial reasonableness opinions for a variety of healthcare services arrangements including management services, hospital-based specialty stipends, case rates and PC/TC splits, block leasing, and shared savings distributions, among others.

Contact Will Hamilton at whamilton@healthfmv.com with questions about our healthcare valuation services or to discuss your specific situation. Visit scoperesearch.co for more information about our healthcare M&A research services.