Acquires 13 Centers During the Quarter

Christopher A. Holden, President and Chief Executive Officer of AmSurg Corp. (NASDAQ: AMSG), today announced record financial results for the fourth quarter and 12 months ended December 31, 2008. Revenues for the quarter were $153,146,000, an increase of 8% from $141,482,000 for the fourth quarter of 2007. Net earnings from continuing operations rose 13% to $12,862,000 from $11,367,000. Net earnings from continuing operations per diluted share increased 11% to $0.40 for the fourth quarter of 2008 from $0.36 for the same quarter in 2007. As expected, net earnings from continuing operations for the fourth quarter of 2008 included a negative impact of $0.01 per diluted share from the effect of the Medicare rule revising the payment system for ASCs, which was effective January 1, 2008.

For the year, revenue grew 16% to $600,655,000 from $518,311,000 for 2007. Net earnings from continuing operations increased 19% to $49,512,000 from $41,766,000. Net earnings from continuing operations per diluted share rose 16% to $1.55 for 2008 from $1.34 for 2007. Net earnings from continuing operations for 2008 included a negative impact of $0.05 per diluted share from the revised Medicare payment system.

“We are pleased to have achieved double-digit earnings growth in the fourth quarter during a tough economic environment,” said Mr. Holden, “while meeting our financial guidance for the quarter and the full year. Reflecting this environment, same-facility revenue was essentially flat for each month of the quarter. In addition, our revenue performance was affected, as expected, by the negative impact of the Medicare rule revising the payment system for ASCs, which totaled $0.01 per diluted share for the quarter and $0.05 per diluted share for 2008. Although this impact for the fourth quarter was offset by positive same-facility procedure growth, it contributed to a flat same-center revenue performance on a comparable-quarter basis.

“Our center development activity for the fourth quarter was robust, with 13 center acquisitions completed during the quarter. We exceeded expectations by adding 20 centers for all 2008, which expanded our continuing centers in operation to 189 at year end. Most of the fourth-quarter center acquisitions were completed late in the year, limiting their impact on revenue for the quarter. We completed 2008 with five centers under letter of intent and three centers under development, one of which is expected to open in 2009. Since the end of 2008, we have completed the acquisitions of three of the centers that were under letter of intent at year end.

“We continued to produce significant growth in cash flow from operations for the fourth quarter of 2008 and the full year. Cash flow from operations for the quarter increased 13% from the fourth quarter of 2007 to $25.7 million and for the year grew 15% to $90.9 million. We funded a substantial majority of our annual capital expenditures with cash flow from operations, although the percentage was somewhat lower than anticipated for 2008 due to our adding more centers than planned for the year. The Company’s leverage metrics at the end of 2008 remain at moderate, manageable levels. Our long-term debt to total capitalization was 37% at the end of 2008 compared with 35% at the end of 2007, and year-end long-term debt to trailing 12 months EBITDA increased to 2.4 from 2.3 at the end of 2007.

“For 2009, we again expect to fund our planned capital expenditures primarily with internally generated funds, with cash flow from operations for 2009 expected in a range of $95 million to $100 million. We also have additional capacity under our revolving credit facility, which matures in July 2011, of approximately $50 million. With our strong financial position and sources of liquidity, we are confident of having the financial resources to fund our anticipated growth for 2009, despite the challenging credit and economic environment.

“Our guidance for 2009 is based on, among other things, the operating environment since the end of the third quarter and the limited visibility we have about the impact of the economic downturn on our results of operations for the year. As a result, we have today established AmSurg’s guidance for 2009 and the first quarter of 2009 as follows:

• Revenues in a range of $650 million to $680 million for 2009.
• Same-center revenue growth is expected to be flat for the full year, which includes a negative impact of one percentage point from the effect of the Medicare rule revising the payment system for ASCs, which was effective January 1, 2008.
• The addition of 13 to 16 new centers for the year.
• An estimated effective income tax rate for the year of 39.5%.
• Net earnings from continuing operations per diluted share for 2009 in a range of $1.64 to $1.67, including a negative $0.07 impact from the effect of the revised Medicare payment system.
• Net earnings from continuing operations per diluted share for the first quarter of 2009 in a range of $0.38 to $0.40 per diluted share.”

The information contained in the preceding paragraphs is forward-looking information, and the attainment of these targets is dependent not only on AmSurg’s achievement of its assumptions discussed above, but also on the risks and uncertainties listed below that could cause actual results, performance or developments to differ materially from those expressed or implied by this forward-looking information.

Mr. Holden concluded, “While we do not discount the potential impact on our business of a long and/or deep economic downturn, we believe AmSurg is well-positioned in both an absolute sense and relative to our industry peers to weather current economic conditions. We remain differentiated among our peers for the strength of our financial position and cash flow, the consistency of our primary surgical specialties and the scale of our operations. In addition, both the increasing national urgency to reduce the costs of healthcare and the demographics of the baby boom generation favor our high quality, high volume and low cost ASC facilities. As a result, we expect to continue investing in the expansion of AmSurg and in the value proposition we provide our physician partners and patients, despite the economic environment. We remain confident that our efforts will enhance our ability to achieve our objectives for long term growth in earnings and shareholder value.”

AmSurg Corp. will hold a conference call to discuss this release today at 5:00 p.m. Eastern time. Investors will have the opportunity to listen to the conference call over the Internet by going to www.amsurg.com and clicking “Investor Relations” or by going to www.earnings.com at least 15 minutes early to register, download, and install any necessary audio software. For those who cannot listen to the live broadcast, a replay will be available at these sites shortly after the call and continue for 30 days.

This press release contains forward-looking statements. These statements, which have been included in reliance on the “safe harbor” provisions of the Private Securities Litigation Reform Act of 1995, involve risks and uncertainties. Investors are hereby cautioned that these statements may be affected by potential adverse consequences to our business as a result of current and future economic conditions, which could lead to reductions in reimbursement or other changes to the Medicare program, lack of access to capital, or reductions in the number of procedures performed at our surgery centers, and the other important factors, among others, set forth in AmSurg’s Annual Report on Form 10-K for the fiscal year ended December 31, 2007, and other filings with the Securities and Exchange Commission, including the following risks: the risk that payments from third-party payors, including government healthcare programs, may decrease or not increase as the Company’s costs increase; the Company’s ability to maintain favorable relations with its physician partners; the Company’s ability to acquire and develop additional surgery centers on favorable terms; the Company’s ability to grow revenues by increasing procedure volume while maintaining its operating margins and profitability at its existing centers; the Company’s ability to manage the growth in its business; the Company’s ability to obtain sufficient capital resources to complete acquisitions and develop new surgery centers; the Company’s ability to compete for physician partners, managed care contracts, patients and strategic relationships; risks associated with weather and other factors that may affect the Company’s surgery centers; uncertainties associated with judicial, regulatory and legislative developments in New Jersey; the Company’s failure to comply with applicable laws and regulations; the risk of changes in legislation, regulations or regulatory interpretations that may negatively affect the Company; the risk of becoming subject to federal and state investigation; the risk of regulatory changes that may obligate the Company to buy out interests of physicians who are minority owners of its surgery centers; risks associated with the Company’s status as a general partner of limited partnerships; the Company’s legal responsibility to minority owners of its surgery centers, which may conflict with its interests and prevent it from acting solely in its best interests; risks associated with the write-off of the impaired portion of intangible assets; and risks associated with the tax deductibility of goodwill. Consequently, actual results, performance or developments may differ materially from the forward-looking statements included above. AmSurg disclaims any intent or obligation to update these forward-looking statements.

AmSurg Corp. acquires, develops and operates ambulatory surgery centers in partnership with physician practice groups throughout the United States. At December 31, 2008, AmSurg owned a majority interest in 189 continuing centers in operation and had three centers under development.

AmSurg Corp.
Claire M. Gulmi, Executive Vice President and Chief Financial Officer
615-665-1283