##### Table of Contents



UNITED STATES SECURITIES AND EXCHANGE COMMISSION
 Washington, D.C. 20549
 FORM 10-K
 Annual Report Pursuant to Section 13 or 15(d) of the
Securities Exchange Act of 1934
For the Fiscal Year Ended December 31, 2009
 Commission File Number 000-22217
 AMSURG CORP.
 (Exact Name of Registrant as Specified in Its Charter)
 Tennessee(State or Other Jurisdiction of Incorporation or Organization)
    
    62-1493316(I.R.S. Employer Identification No.)20 Burton Hills Boulevard, Nashville, TN
    
    37215(Address of Principal Executive Offices)
    
    (Zip Code)
 (615) 665-1283  (Registrants Telephone Number, Including Area Code)
 Securities registered pursuant to Section 12(b) of the Act:
    
    Common Stock, no par value(Title of class)Nasdaq Global Select Market(Name of each exchange on which registered)
 Securities registered pursuant to Section 12(g) of the Act:
    
    None
  þ o
  o þ
  þ o
  o o
 þ
  Large accelerated filer þ
Accelerated filer o
Non-accelerated filer o(Do not check if a smaller reporting company)
Smaller reporting Company o  o þ
  Documents Incorporated by Reference




---



##### 



Table of Contents to Annual Report on Form 10-K for the Fiscal Year Ended December 31, 2009
 Part IItem 1.
    
    Business
    
    
    1Executive Officers of the Registrant
    
    
    14Item 1A.
    
    Risk Factors
    
    
    15Item 1B.
    
    Unresolved Staff Comments
    
    
    19Item 2.
    
    Properties
    
    
    19Item 3.
    
    Legal Proceedings
    
    
    19Item 4.
    
    Submission of Matters to a Vote of Security Holders
    
    
    19Part IIItem 5.
    
    Market for Registrants Common Equity, Related Stockholder Matters and Issuer
Purchases of Equity Securities
    
    
    20Item 6.
    
    Selected Financial Data
    
    
    21Item 7.
    
    Managements Discussion and Analysis of Financial Condition and Results of Operations
    
    
    22Item 7A.
    
    Quantitative and Qualitative Disclosures About Market Risk
    
    
    31Item 8.
    
    Financial Statements and Supplementary Data
    
    
    32Item 9.
    
    Changes in and Disagreements with Accountants on Accounting and Financial Disclosure
    
    
    56Item 9A.
    
    Controls and Procedures
    
    
    56Item 9B.
    
    Other Information
    
    
    58Part IIIItem 10.
    
    Directors, Executive Officers and Corporate Governance
    
    
    58Item 11.
    
    Executive Compensation
    
    
    58Item 12.
    
    Security Ownership of Certain Beneficial Owners and Management and Related
Stockholder Matters
    
    
    58Item 13.
    
    Certain Relationships and Related Transactions, and Director Independence
    
    
    58Item 14.
    
    Principal Accounting Fees and Services
    
    
    59Part IVItem 15.
    
    Exhibits and Financial Statement Schedules
    
    
    59Signatures
    
    
    62EX-10.17EX-10.28EX-21.1EX-23.1EX-31.1EX-31.2EX-32.1
  
 i




---



##### Table of Contents



Part I
 
 Item 1.
    
    Business
  1-800-SEC-0330.
 Industry Overview
   Cost-Effective Alternative.
 Physician and Patient Preference.
 New Technology.
 Strategy
  
    
    selectively acquire both single-specialty ASCs and muti-specialty ASCs with substantial
minority physician ownership;
    
    develop new ASCs in partnership with physicians; and
    
    grow revenues and profitability at our existing surgery centers.
 
 1




---



##### Table of Contents



Item 1.
    
    Business  (continued)
   Acquisition and Development of Surgery Centers
   
    
    quality of the physicians affiliated with the center;
    
    market position of the center and the physicians affiliated with the center;
    
    payor and case mix;
    
    competition and growth opportunities in the market;
    
    staffing and supply review;
    
    equipment assessment; and
    
    opportunities for operational efficiencies.
      
 2




---



##### Table of Contents



Item 1.
    
    Business  (continued)
   Growth in Revenues at Existing Facilities
  
    
    growth in the number of physicians performing procedures at our centers;
    
    obtaining new or more favorable managed care contracts for our centers;
    
    marketing our centers to referring physicians, payors and patients; and
    
    achieving efficiencies in center operations.
 Growth in the number of physicians performing procedures.
 
    
    encouraging the physicians affiliated with the ASCs to recruit new physicians to their
practices;
    
    identifying additional physicians or physician practices to join the partnerships that
own the ASCs; and
    
    recruiting non-partner physicians in the same or other specialties to use excess
capacity at the ASCs.
  Obtaining new or more favorable managed care contracts.
 Marketing our centers to referring physicians, payors and patients.
 Achieving efficiencies in center operations.
 
    
    physician scheduling enhancements;
    
    specially trained clinical staff focused on improved patient flow; and
    
    improved operating room turnover.
  Surgery Center Operations
  
 3




---



##### Table of Contents



Item 1.
    
    Business  (continued)
   
    
    gastroenterology - colonoscopy and other endoscopy procedures;
    
    ophthalmology - cataracts and retinal laser surgery; and
    
    orthopaedic -  knee and shoulder arthroscopy and carpal tunnel repair.
  Accreditation
  Surgery Center Locations
  Operating orAcquisition/
    
    ProcedureLocation
    
    Specialty
    
    Opening Date
    
    RoomsAcquired Centers:Knoxville, Tennessee
    
    Gastroenterology
    
    November 1992
    
    
    8Topeka, Kansas
    
    Gastroenterology
    
    November 1992
    
    
    3Nashville, Tennessee
    
    Gastroenterology
    
    November 1992
    
    
    3Washington, D.C.
    
    Gastroenterology
    
    November 1993
    
    
    3Torrance, California
    
    Gastroenterology
    
    February 1994
    
    
    2Maryville, Tennessee
    
    Gastroenterology
    
    January 1995
    
    
    3Miami, Florida
    
    Gastroenterology
    
    April 1995
    
    
    5Panama City, Florida
    
    Gastroenterology
    
    July 1996
    
    
    3Ocala, Florida
    
    Gastroenterology
    
    August 1996
    
    
    3Columbia, South Carolina
    
    Gastroenterology
    
    October 1996
    
    
    4Wichita, Kansas
    
    Orthopaedic
    
    November 1996
    
    
    3Crystal River, Florida
    
    Gastroenterology
    
    January 1997
    
    
    3Abilene, Texas
    
    Ophthalmology
    
    March 1997
    
    
    2Fayetteville, Arkansas
    
    Gastroenterology
    
    May 1997
    
    
    3Independence, Missouri
    
    Gastroenterology
    
    September 1997
    
    
    1Kansas City, Missouri
    
    Gastroenterology
    
    September 1997
    
    
    1Phoenix, Arizona
    
    Ophthalmology
    
    February 1998
    
    
    2Denver, Colorado
    
    Gastroenterology
    
    April 1998
    
    
    4Sun City, Arizona
    
    Ophthalmology
    
    May 1998
    
    
    5Baltimore, Maryland
    
    Gastroenterology
    
    November 1998
    
    
    3Boca Raton, Florida
    
    Ophthalmology
    
    December 1998
    
    
    2Indianapolis, Indiana
    
    Gastroenterology
    
    June 1999
    
    
    4Chattanooga, Tennessee
    
    Gastroenterology
    
    July 1999
    
    
    3Mount Dora, Florida
    
    Ophthalmology
    
    September 1999
    
    
    2Oakhurst, New Jersey
    
    Gastroenterology
    
    September 1999
    
    
    2Cape Coral, Florida
    
    Gastroenterology
    
    November 1999
    
    
    2La Jolla, California
    
    Gastroenterology
    
    December 1999
    
    
    2Burbank, California
    
    Ophthalmology
    
    December 1999
    
    
    1Waldorf, Maryland
    
    Gastroenterology
    
    December 1999
    
    
    2Las Vegas, Nevada
    
    Ophthalmology
    
    December 1999
    
    
    2Glendale, California
    
    Ophthalmology
    
    January 2000
    
    
    1Las Vegas, Nevada
    
    Ophthalmology
    
    May 2000
    
    
    2Hutchinson, Kansas
    
    Ophthalmology
    
    June 2000
    
    
    2
 
 4




---



##### Table of Contents



Item 1.
    
    Business  (continued)
  Operating orAcquisition/
    
    ProcedureLocation
    
    Specialty
    
    Opening Date
    
    RoomsNew Orleans, Louisiana
    
    Ophthalmology
    
    July 2000
    
    
    2Kingston, Pennsylvania
    
    Ophthalmology, Pain Management
    
    December 2000
    
    
    3Inverness, Florida
    
    Gastroenterology
    
    December 2000
    
    
    3Columbia, Tennessee
    
    Multispecialty
    
    February 2001
    
    
    2Bel Air, Maryland
    
    Gastroenterology
    
    February 2001
    
    
    2Dover, Delaware
    
    Multispecialty
    
    February 2001
    
    
    3Sarasota, Florida
    
    Ophthalmology
    
    February 2001
    
    
    2Greensboro, North Carolina
    
    Ophthalmology
    
    March 2001
    
    
    4Ft. Lauderdale, Florida
    
    Ophthalmology
    
    March 2001
    
    
    3Bloomfield, Connecticut
    
    Ophthalmology
    
    July 2001
    
    
    1Lawrenceville, New Jersey
    
    Multispecialty
    
    October 2001
    
    
    3Newark, Delaware
    
    Gastroenterology
    
    October 2001
    
    
    5Alexandria, Louisiana
    
    Ophthalmology
    
    December 2001
    
    
    2Paducah, Kentucky
    
    Ophthalmology
    
    May 2002
    
    
    2Columbia, Tennessee
    
    Gastroenterology
    
    June 2002
    
    
    2Ft. Myers, Florida
    
    Ophthalmology
    
    July 2002
    
    
    2Tulsa, Oklahoma
    
    Ophthalmology
    
    July 2002
    
    
    3Peoria, Arizona
    
    Multispecialty
    
    October 2002
    
    
    3Lewes, Delaware
    
    Gastroenterology
    
    December 2002
    
    
    2Rogers, Arkansas
    
    Ophthalmology
    
    December 2002
    
    
    2Winter Haven, Florida
    
    Ophthalmology
    
    December 2002
    
    
    2Mesa, Arizona
    
    Gastroenterology
    
    December 2002
    
    
    4Voorhees, New Jersey
    
    Gastroenterology
    
    March 2003
    
    
    4St. George, Utah
    
    Gastroenterology
    
    July 2003
    
    
    2San Antonio, Texas
    
    Gastroenterology
    
    July 2003
    
    
    4Pueblo, Colorado
    
    Ophthalmology
    
    September 2003
    
    
    2Reno, Nevada
    
    Gastroenterology
    
    December 2003
    
    
    4Edina, Minnesota
    
    Ophthalmology
    
    December 2003
    
    
    1Gainesville, Florida
    
    Orthopaedic
    
    February 2004
    
    
    5West Palm, Florida
    
    Gastroenterology
    
    March 2004
    
    
    2Raleigh, North Carolina
    
    Gastroenterology
    
    April 2004
    
    
    4Sun City, Arizona
    
    Gastroenterology
    
    September 2004
    
    
    2Casper, Wyoming
    
    Gastroenterology
    
    October 2004
    
    
    2Rockville, Maryland
    
    Gastroenterology
    
    October 2004
    
    
    5Overland Park, Kansas
    
    Gastroenterology
    
    October 2004
    
    
    3Lake Bluff, Illinois
    
    Gastroenterology
    
    November 2004
    
    
    3San Luis Obispo, California
    
    Gastroenterology
    
    December 2004
    
    
    2Templeton, California
    
    Gastroenterology
    
    December 2004
    
    
    2Lutherville, Maryland
    
    Gastroenterology
    
    January 2005
    
    
    2Tacoma, Washington
    
    Gastroenterology
    
    March 2005
    
    
    5Tacoma, Washington
    
    Gastroenterology
    
    March 2005
    
    
    2Tacoma, Washington
    
    Gastroenterology
    
    March 2005
    
    
    2Tacoma, Washington
    
    Gastroenterology
    
    March 2005
    
    
    2Orlando, Florida
    
    Gastroenterology
    
    June 2005
    
    
    1Orlando, Florida
    
    Gastroenterology
    
    June 2005
    
    
    4Ocala, Florida
    
    Multispecialty
    
    June 2005
    
    
    3Scranton, Pennsylvania
    
    Gastroenterology
    
    August 2005
    
    
    3Towson, Maryland
    
    Gastroenterology
    
    August 2005
    
    
    4Yuma, Arizona
    
    Gastroenterology
    
    October 2005
    
    
    3St. Louis, Missouri
    
    Orthopaedic
    
    November 2005
    
    
    2Salem, Oregon
    
    Ophthalmology
    
    December 2005
    
    
    2West Orange, New Jersey
    
    Gastroenterology
    
    December 2005
    
    
    3St. Cloud, Minnesota
    
    Ophthalmology
    
    December 2005
    
    
    2Tulsa, Oklahoma
    
    Gastroenterology
    
    December 2005
    
    
    3Laurel, Maryland
    
    Gastroenterology
    
    December 2005
    
    
    3Torrance, California
    
    Multispecialty
    
    February 2006
    
    
    4Nashville, Tennessee
    
    Ophthalmology
    
    February 2006
    
    
    2Arcadia, California
    
    Gastroenterology
    
    March 2006
    
    
    2Towson, Maryland
    
    Gastroenterology
    
    August 2006
    
    
    2
 
 5




---



##### Table of Contents



Item 1.
    
    Business  (continued)
  Operating orAcquisition/
    
    ProcedureLocation
    
    Specialty
    
    Opening Date
    
    RoomsThe Woodlands, Texas
    
    Gastroenterology
    
    September 2006
    
    
    2Bala Cynwyd, Pennsylvania
    
    Gastroenterology
    
    September 2006
    
    
    2Malvern, Pennsylvania
    
    Gastroenterology
    
    September 2006
    
    
    3Oakland, California
    
    Gastroenterology
    
    October 2006
    
    
    3South Bend, Indiana
    
    Gastroenterology
    
    January 2007
    
    
    4Lancaster, Pennsylvania
    
    Gastroenterology
    
    January 2007
    
    
    2Silver Spring, Maryland
    
    Gastroenterology
    
    January 2007
    
    
    2Rockville, Maryland
    
    Gastroenterology
    
    January 2007
    
    
    3New Orleans, Louisiana
    
    Gastroenterology
    
    January 2007
    
    
    2Marrero, Louisiana
    
    Gastroenterology
    
    January 2007
    
    
    2Metairie, Louisiana
    
    Gastroenterology
    
    January 2007
    
    
    3Toms River, New Jersey
    
    Gastroenterology
    
    May 2007
    
    
    2Pottsville, Pennsylvania
    
    Gastroenterology
    
    June 2007
    
    
    3Memphis, Tennessee
    
    Gastroenterology
    
    July 2007
    
    
    4Kissimmee, Florida
    
    Gastroenterology
    
    July 2007
    
    
    1Glendora, California
    
    Gastroenterology
    
    August 2007
    
    
    4Mesquite, Texas
    
    Gastroenterology
    
    August 2007
    
    
    2Conroe, Texas
    
    Gastroenterology
    
    August 2007
    
    
    4Altamonte Springs, Florida
    
    Gastroenterology
    
    September 2007
    
    
    3New Port Richey, Florida
    
    Multispecialty
    
    October 2007
    
    
    3Glendale, Arizona
    
    Gastroenterology
    
    October 2007
    
    
    3Orlando, Florida
    
    Gastroenterology
    
    October 2007
    
    
    1San Diego, California
    
    Multispecialty
    
    November 2007
    
    
    4Poway, California
    
    Multispecialty
    
    November 2007
    
    
    2Baton Rouge, Louisiana
    
    Gastroenterology
    
    December 2007
    
    
    10Baltimore, Maryland
    
    Gastroenterology
    
    January 2008
    
    
    4Glen Burnie, Maryland
    
    Gastroenterology
    
    January 2008
    
    
    2St. Clair Shores, Michigan
    
    Ophthalmology
    
    May 2008
    
    
    2Orlando, Florida
    
    Gastroenterology
    
    May 2008
    
    
    4Greenbrae, California
    
    Gastroenterology
    
    August 2008
    
    
    3Pomona, California
    
    Multispecialty
    
    September 2008
    
    
    5Akron, Ohio
    
    Gastroenterology
    
    November 2008
    
    
    3Redding, California
    
    Gastroenterology
    
    December 2008
    
    
    2Phoenix, Arizona
    
    Gastroenterology
    
    December 2008
    
    
    2Silver Spring, Maryland
    
    Ophthalmology
    
    December 2008
    
    
    3Phoenix, Arizona
    
    Orthopaedic
    
    December 2008
    
    
    8Bryan, Texas
    
    Gastroenterology
    
    December 2008
    
    
    3Westminster, Maryland
    
    Gastroenterology
    
    December 2008
    
    
    2McKinney, Texas
    
    Multispecialty
    
    December 2008
    
    
    2Durham, North Carolina
    
    Gastroenterology
    
    December 2008
    
    
    4Dayton, Ohio
    
    Gastroenterology
    
    December 2008
    
    
    1Kettering, Ohio
    
    Gastroenterology
    
    December 2008
    
    
    5Huber Heights, Ohio
    
    Gastroenterology
    
    December 2008
    
    
    1Springboro, Ohio
    
    Gastroenterology
    
    December 2008
    
    
    3North Charleston, South Carolina
    
    Gastroenterology
    
    January 2009
    
    
    3North Knoxville, Tennessee
    
    Gastroenterology
    
    January 2009
    
    
    2West Bridgewater, Massachusetts
    
    Gastroenterology
    
    February 2009
    
    
    2Canon City, Colorado
    
    Multispecialty
    
    June 2009
    
    
    2Media, Pennsylvania
    
    Gastroenterology
    
    July 2009
    
    
    3Hermitage, Tennessee
    
    Gastroenterology
    
    October 2009
    
    
    3Phoenix, Arizona
    
    Orthopaedic
    
    December 2009
    
    
    5Dallas, Texas
    
    Gastroenterology
    
    December 2009
    
    
    4Dallas, Texas
    
    Gastroenterology
    
    December 2009
    
    
    3Bedford, Texas
    
    Gastroenterology
    
    December 2009
    
    
    3Plano, Texas
    
    Gastroenterology
    
    December 2009
    
    
    4North Richland Hills, Texas
    
    Gastroenterology
    
    December 2009
    
    
    4
 
 6




---



##### Table of Contents



Item 1.
    
    Business  (continued)
  Operating orAcquisition/
    
    ProcedureLocation
    
    Specialty
    
    Opening Date
    
    RoomsDeveloped Centers:Santa Fe, New Mexico
    
    Gastroenterology
    
    May 1994
    
    
    3Beaumont, Texas
    
    Gastroenterology
    
    October 1994
    
    
    5Abilene, Texas
    
    Gastroenterology
    
    December 1994
    
    
    3Knoxville, Tennessee
    
    Ophthalmology
    
    June 1996
    
    
    2Sidney, Ohio
    
    Multispecialty
    
    December 1996
    
    
    4Montgomery, Alabama
    
    Ophthalmology
    
    May 1997
    
    
    2Willoughby, Ohio
    
    Gastroenterology
    
    July 1997
    
    
    2Milwaukee, Wisconsin
    
    Gastroenterology
    
    July 1997
    
    
    3Chevy Chase, Maryland
    
    Gastroenterology
    
    July 1997
    
    
    4Melbourne, Florida
    
    Gastroenterology
    
    August 1997
    
    
    2Lorain, Ohio
    
    Gastroenterology
    
    August 1997
    
    
    2Hillmont, Pennsylvania
    
    Gastroenterology
    
    October 1997
    
    
    2Hialeah, Florida
    
    Gastroenterology
    
    December 1997
    
    
    3Cincinnati, Ohio
    
    Gastroenterology
    
    January 1998
    
    
    3Evansville, Indiana
    
    Ophthalmology
    
    February 1998
    
    
    2Shawnee, Kansas
    
    Gastroenterology
    
    April 1998
    
    
    3Salt Lake City, Utah
    
    Gastroenterology
    
    April 1998
    
    
    2Oklahoma City, Oklahoma
    
    Gastroenterology
    
    May 1998
    
    
    4El Paso, Texas
    
    Gastroenterology
    
    December 1998
    
    
    4Toledo, Ohio
    
    Gastroenterology
    
    December 1998
    
    
    3Florham Park, New Jersey
    
    Gastroenterology
    
    December 1999
    
    
    3Minneapolis, Minnesota
    
    Ophthalmology
    
    June 2000
    
    
    2Crestview Hills, Kentucky
    
    Gastroenterology
    
    September 2000
    
    
    3Louisville, Kentucky
    
    Gastroenterology
    
    September 2000
    
    
    3Louisville, Kentucky
    
    Ophthalmology
    
    September 2000
    
    
    2Ft. Myers, Florida
    
    Gastroenterology
    
    October 2000
    
    
    3Seneca, Pennsylvania
    
    Multispecialty
    
    October 2000
    
    
    4Sarasota, Florida
    
    Gastroenterology
    
    December 2000
    
    
    2Tamarac, Florida
    
    Gastroenterology
    
    December 2000
    
    
    2Inglewood, California
    
    Gastroenterology
    
    May 2001
    
    
    3Clemson, South Carolina
    
    Orthopaedic
    
    September 2002
    
    
    3Middletown, Ohio
    
    Gastroenterology
    
    October 2002
    
    
    3Troy, Michigan
    
    Gastroenterology
    
    August 2003
    
    
    3Kingsport, Tennessee
    
    Ophthalmology
    
    October 2003
    
    
    2Columbia, South Carolina
    
    Gastroenterology
    
    November 2003
    
    
    2Greenville, South Carolina
    
    Gastroenterology
    
    August 2004
    
    
    4Sebring, Florida
    
    Ophthalmology
    
    November 2004
    
    
    2Temecula, California
    
    Gastroenterology
    
    November 2004
    
    
    2Escondido, California
    
    Gastroenterology
    
    December 2004
    
    
    2Tampa, Florida
    
    Gastroenterology
    
    January 2005
    
    
    8Rockledge, Florida
    
    Gastroenterology
    
    May 2005
    
    
    3Lakeland, Florida
    
    Gastroenterology
    
    May 2005
    
    
    4Liberty, Missouri
    
    Gastroenterology
    
    June 2005
    
    
    1Knoxville, Tennessee
    
    Gastroenterology
    
    September 2005
    
    
    2Sun City, Arizona
    
    Multispecialty
    
    November 2005
    
    
    3Port Huron, Michigan
    
    Orthopaedic
    
    March 2006
    
    
    2Hanover, New Jersey
    
    Gastroenterology
    
    October 2006
    
    
    3Raleigh, North Carolina
    
    Gastroenterology
    
    December 2006
    
    
    3San Antonio, Texas
    
    Gastroenterology
    
    May 2007
    
    
    3Cary, North Carolina
    
    Gastroenterology
    
    November 2007
    
    
    4El Dorado, Arkansas
    
    Multispecialty
    
    December 2007
    
    
    2Greensboro, North Carolina
    
    Gastroenterology
    
    August 2008
    
    
    2Puyallup, Washington
    
    Gastroenterology
    
    May 2009
    
    
    3Blaine, Minnesota
    
    Multispecialty
    
    November 2009
    
    
    3576
 
 7




---



##### Table of Contents



Item 1.
    
    Business  (continued)
 
  Revenues
    
    
    ASCs are paid based upon a percentage of the payments to hospital outpatient departments
pursuant to the hospital outpatient prospective payment system;
    
    a scheduled phase-in of the revised rates over four years from 2008 through 2011; and
    
    planned annual increases in the ASC rates beginning in 2010 based on the consumer price
index, or CPI.
     
 8




---



##### Table of Contents



Item 1.
    
    Business  (continued)
 
  Competition
  Competition for Center Acquisitions.
 Competition for Physicians to Utilize Our Centers, Patients and Managed Care Contracts.
 Competition for Joint Venture Development of Centers.
 Government Regulation
  Certification
 Medicare-Medicaid Fraud and Abuse Provisions
 
 9




---



##### Table of Contents



Item 1.
    
    Business  (continued)
 
     
    
    the limited partnerships and limited liability companies exist to effect legitimate
business purposes, including the ownership, operation and continued improvement of high
quality, cost-effective and efficient services to the patients served;
    
    the limited partnerships and limited liability companies function as an extension of the
group practices of physicians who are affiliated with the surgery centers and the surgical
procedures are performed personally by these physicians without referring the patients
outside of their practice;
    
    our physician partners have a substantial investment at risk in the limited partnerships
and limited liability companies;
    
    terms of the investment do not take into account volume of the physician partners past
or anticipated future services provided to patients of the centers;
    
    the physician partners are not required or encouraged as a condition of the investment
to treat Medicare or Medicaid patients at the centers or to influence others to refer such
patients to the centers for treatment;
    
    the limited partnerships, the limited liability companies, our subsidiaries and our
affiliates will not loan any funds to or guarantee any debt on behalf of the physician
partners with respect to their investment; and
    
    distributions by the limited partnerships and limited liability companies are allocated
uniformly in proportion to ownership interests.
    
 10




---



##### Table of Contents



Item 1.
    
    Business  (continued)
 
    Prohibition on Physician Ownership of Healthcare Facilities and Certain Self-Referrals
   The Federal False Claims Act and Similar Federal and State Laws.
 
 11




---



##### Table of Contents



Item 1.
    
    Business  (continued)
 
    Healthcare Industry Investigations
  Privacy and Security Requirements.
    
 12




---



##### Table of Contents



Item 1.
    
    Business  (continued)
 
 HIPAA Administrative Simplification Requirements.
 Obligations to Buy Out Physician Partners
 CONs and State Licensing
  Corporate Practice of Medicine.
 Employees
  Legal Proceedings and Insurance
  
 13




---



##### Table of Contents



Item 1.
    
    Business  (continued)
 
 
 EXECUTIVE OFFICERS OF THE REGISTRANT
  Name
    
    Age
    
    ExperienceChristopher A. Holden
    
    
    45
    
    
    Chief Executive Officer and Director since
October 2007; Senior Vice President and a
Division President of Triad Hospitals Inc.
from May 1999 to July 2007; President 
West Division of the Central Group of
Columbia/HCA Healthcare Corporation from
January 1998 to May 1999.Claire M. Gulmi
    
    
    56
    
    
    Executive Vice President since February
2006; Chief Financial Officer since
September 1994; Director since May 2004;
Senior Vice President from March 1997 to
February 2006; Secretary since December
1997; Vice President from September 1994
through March 1997.David L. Manning
    
    
    60
    
    
    Executive Vice President and Chief
Development Officer since February 2006;
Senior Vice President of Development from
April 1992 to February 2006.Phillip A. Clendenin
    
    
    45
    
    
    Senior Vice President of Corporate Services since March 2009; Chief Executive Officer
of River Region Health System from July
2001 to July 2008; Chief Executive Officer
of Greenview Regional Hospital from
November 1997 to June 2001.Kevin D. Eastridge
    
    
    44
    
    
    Senior Vice President of Finance since July
2008; Vice President of Finance from April
1998 to July 2008; Chief Accounting Officer
since July 2004; Controller from March 1997
to June 2004.Billie A. Payne
    
    
    58
    
    
    Senior Vice President of Operations since
December 2007; Vice President of Operations
from March 1998 to December 2007.
 
 14




---



##### Table of Contents



Item 1A.
    
    Risk Factors
 
  Our business may be adversely affected by current and future economic conditions.
 We may be unable to renew or replace our revolving credit agreement when it terminates in July
2011, and the terms of any renewed or replacement agreement could be materially different than the
terms in place today.
 We depend on payments from third-party payors, including government healthcare programs. If these
payments decrease or do not increase as our costs increase, our operating margins and profitability
would be adversely affected.
  Our business may be adversely affected by changes to the medical practices of our physician
partners or if we fail to maintain good relationships with the physician partners who use our
surgery centers.
 If we fail to acquire and develop additional surgery centers on favorable terms, our future growth
and operating results could be adversely affected.
 
 15




---



##### Table of Contents



Item 1A.
    
    Risk Factors  (continued)
 
  If we are unable to increase procedure volume at our existing centers, our operating margins and
profitability could be adversely affected.
 If we are unable to manage the growth in our business, our operating results could be adversely
affected.
 If we do not have sufficient capital resources to complete acquisitions and develop new surgery
centers, our growth and results of operations could be adversely affected.
 If we are unable to effectively compete for physician partners, managed care contracts, patients
and strategic relationships, our business would be adversely affected.
  Our surgery centers may be negatively impacted by weather and other factors beyond our control.
 If we fail to comply with applicable laws and regulations, we could suffer penalties or be required
to make significant changes to our operations.
 
    
    physician ownership of our surgery centers;
    
    our relationships with physicians and other referral sources;
    
    CON approvals and other regulations affecting the construction or acquisition of
centers, capital expenditures or the addition of services;
 
 16




---



##### Table of Contents



Item 1A.
    
    Risk Factors  (continued)
 
 
    
    the adequacy of medical care, equipment, personnel, and operating policies and
procedures;
    
    qualifications of medical and support personnel;
    
    maintenance and protection of records;
    
    billing for services by healthcare providers, including appropriate treatment of
overpayments and credit balances;
    
    privacy and security of individually identifiable health information; and
    
    environmental protection.
  If a federal or state agency asserts a different position or enacts new laws or regulations
regarding illegal remuneration or other forms of fraud and abuse, we could suffer penalties or be
required to make significant changes to our operations.
   Providers in the healthcare industry have been the subject of federal and state investigations, and
we may become subject to investigations in the future.
  
 17




---



##### Table of Contents



Item 1A.
    
    Risk Factors  (continued)
 
 If regulations or regulatory interpretations change, we may be obligated to buy out interests of
physicians who are minority owners of the surgery centers.
 
    
    make the referral of Medicare and other patients to our surgery centers by physicians
affiliated with us illegal;
    
    create the substantial likelihood that cash distributions from the limited partnerships
or limited liability companies to the affiliated physicians will be illegal; or
    
    cause the ownership by the physicians of interests in the limited partnerships or
limited liability companies to be illegal.
  We are liable for the debts and other obligations of the limited partnerships that own and operate
certain of our surgery centers.
 We may be subject to liabilities for claims brought against our facilities.
 We have a legal responsibility to the minority owners of the entities through which we own our
surgery centers, which may conflict with our interests and prevent us from acting solely in our own
best interests.
 We may write-off intangible assets, such as goodwill.
 The IRS may challenge tax deductions for certain acquired goodwill.
 
 18




---



##### Table of Contents



Item 1A.
    
    Risk Factors  (continued)
 
  
 Item 1B.
    
    Unresolved Staff Comments
  
 Item 2.
    
    Properties
  
 Item 3.
    
    Legal Proceedings
  
 Item 4.
    
    Submission of Matters to a Vote of Security Holders
  
 19




---



##### Table of Contents



PART II
 
 Item 5.
    
    Market for Registrants Common Equity, Related Stockholder Matters and Issuer Purchases of
Equity Securities
  1st
    
    2nd
    
    3rd
    
    4thQuarter
    
    Quarter
    
    Quarter
    
    Quarter2008:High
    
    $
    29.76
    
    
    $
    27.79
    
    
    $
    28.93
    
    
    $
    26.05Low
    
    $
    22.72
    
    
    $
    21.96
    
    
    $
    23.96
    
    
    $
    17.912009:High
    
    $
    24.03
    
    
    $
    21.71
    
    
    $
    22.65
    
    
    $
    23.61Low
    
    $
    12.23
    
    
    $
    15.18
    
    
    $
    18.95
    
    
    $
    20.25
  
 20




---



##### Table of Contents



Item 6.
    
    Selected Financial Data
 
 Year Ended December 31,2009
    
    
    2008
    
    
    2007
    
    
    2006
    
    
    2005(Dollars in thousands, except per share data)Consolidated Statement of Earnings Data:Revenues
    
    $
    668,752
    
    
    $
    600,107
    
    
    $
    517,707
    
    
    $
    439,435
    
    
    $
    361,455Operating expenses
    
    
    443,387
    
    
    
    389,549
    
    
    
    336,573
    
    
    
    285,390
    
    
    
    229,438Operating income
    
    
    225,365
    
    
    
    210,558
    
    
    
    181,134
    
    
    
    154,045
    
    
    
    132,017Interest expense
    
    
    7,789
    
    
    
    9,938
    
    
    
    9,569
    
    
    
    7,387
    
    
    
    3,897Earnings from continuing operations before income
taxes
    
    
    217,576
    
    
    
    200,620
    
    
    
    171,565
    
    
    
    146,658
    
    
    
    128,120Income tax expense
    
    
    35,687
    
    
    
    33,101
    
    
    
    27,065
    
    
    
    22,941
    
    
    
    21,853Net earnings from continuing operations
    
    
    181,889
    
    
    
    167,519
    
    
    
    144,500
    
    
    
    123,717
    
    
    
    106,267Discontinued operations:Earnings from operations of discontinued interests
in surgery centers, net of income tax expense
    
    
    163
    
    
    
    180
    
    
    
    4,091
    
    
    
    6,671
    
    
    
    6,780(Loss) gain on disposal of discontinued interests in
surgery centers, net of income tax (benefit) expense
    
    
    (702
    )
    
    
    (1,773
    )
    
    
    1,712
    
    
    
    (463
    )
    
    
    (1,158
    )Net (loss) gain earnings from discontinued operations
    
    
    (539
    )
    
    
    (1,593
    )
    
    
    5,803
    
    
    
    6,208
    
    
    
    5,622Net earnings
    
    
    181,350
    
    
    
    165,926
    
    
    
    150,303
    
    
    
    129,925
    
    
    
    111,889Less net earnings attributable to noncontrolling interests
    
    
    129,202
    
    
    
    118,880
    
    
    
    106,128
    
    
    
    92,186
    
    
    
    76,738Net earnings attributable to AmSurg Corp.
common shareholders
    
    $
    52,148
    
    
    $
    47,046
    
    
    $
    44,175
    
    
    $
    37,739
    
    
    $
    35,151Amounts attributable to AmSurg Corp. common shareholders:Earnings from continuing operations, net of tax
    
    $
    52,788
    
    
    $
    49,541
    
    
    $
    41,785
    
    
    $
    35,207
    
    
    $
    33,071Discontinued operations, net of tax
    
    
    (640
    )
    
    
    (2,495
    )
    
    
    2,390
    
    
    
    2,532
    
    
    
    2,080Net earnings attributable to AmSurg Corp.
common shareholders
    
    $
    52,148
    
    
    $
    47,046
    
    
    $
    44,175
    
    
    $
    37,739
    
    
    $
    35,151Basic earnings per common share:Net earnings from continuing operations attributable to
AmSurg Corp. common shareholders
    
    $
    1.73
    
    
    $
    1.57
    
    
    $
    1.36
    
    
    $
    1.18
    
    
    $
    1.12Net earnings attributable to AmSurg Corp. common
shareholders
    
    $
    1.71
    
    
    $
    1.49
    
    
    $
    1.44
    
    
    $
    1.27
    
    
    $
    1.19Diluted earnings per common share:Net earnings from continuing operations attributable to
AmSurg Corp. common shareholders
    
    $
    1.71
    
    
    $
    1.55
    
    
    $
    1.34
    
    
    $
    1.16
    
    
    $
    1.10Net earnings attributable to AmSurg Corp. common
shareholders
    
    $
    1.69
    
    
    $
    1.47
    
    
    $
    1.42
    
    
    $
    1.24
    
    
    $
    1.17Weighted average number of shares and share equivalents
outstanding (in thousands):Basic
    
    
    30,576
    
    
    
    31,503
    
    
    
    30,619
    
    
    
    29,822
    
    
    
    29,573Diluted
    
    
    30,862
    
    
    
    31,963
    
    
    
    31,102
    
    
    
    30,398
    
    
    
    30,147Operating and Other Financial Data:Continuing centers at end of year
    
    
    202
    
    
    
    188
    
    
    
    168
    
    
    
    144
    
    
    
    133Procedures performed during year
    
    
    1,238,339
    
    
    
    1,108,585
    
    
    
    952,370
    
    
    
    803,603
    
    
    
    683,712Same-center revenue increase
    
    
    0
    %
    
    
    3
    %
    
    
    4
    %
    
    
    5
    %
    
    
    3
    %Cash flows provided by operating activities
    
    $
    232,584
    
    
    $
    209,696
    
    
    $
    182,916
    
    
    $
    162,689
    
    
    $
    139,060Cash flows used in investing activities
    
    
    (112,792
    )
    
    
    (131,780
    )
    
    
    (179,368
    )
    
    
    (71,794
    )
    
    
    (83,308
    )Cash flows used in financing activities
    
    
    (121,963
    )
    
    
    (76,321
    )
    
    
    (6,322
    )
    
    
    (91,308
    )
    
    
    (50,248
    )At December 31,2009
    
    
    2008
    
    
    2007
    
    
    2006
    
    
    2005(In thousands)Consolidated Balance Sheet Data:Cash and cash equivalents
    
    $
    29,377
    
    
    $
    31,548
    
    
    $
    29,953
    
    
    $
    20,083
    
    
    $
    20,496Working capital
    
    
    80,493
    
    
    
    85,497
    
    
    
    83,792
    
    
    
    66,591
    
    
    
    61,072Total assets
    
    
    1,058,757
    
    
    
    905,879
    
    
    
    781,634
    
    
    
    590,032
    
    
    
    527,816Long-term debt and other long-term liabilities
    
    
    311,077
    
    
    
    288,251
    
    
    
    232,223
    
    
    
    127,821
    
    
    
    125,712Non-redeemable and redeemable noncontrolling interests
    
    
    128,618
    
    (1)

    
    66,079
    
    
    
    62,006
    
    
    
    52,341
    
    
    
    47,271AmSurg Corp. shareholders equity
    
    
    505,116
    
    
    
    460,429
    
    
    
    411,225
    
    
    
    343,108
    
    
    
    294,618
 (1)
    
    See Managements Discussion and Analysis of Financial Condition and Results of Operations  Critical Accounting Policies.
 
 21




---



##### Table of Contents



Item 7.
    
    Managements Discussion and Analysis of Financial Condition and Results of Operations
 
 Forward-Looking Statements
 This report contains certain forward-looking statements (all statements other than statements with
respect to historical fact) within the meaning of the federal securities laws, which are intended
to be covered by the safe harbors created thereby. Investors are cautioned that all
forward-looking statements involve known and unknown risks and uncertainties including, without
limitation, those described in Item 1A. Risk Factors, some of which are beyond our control.
Although we believe that the assumptions underlying the forward-looking statements contained herein
are reasonable, any of the assumptions could be inaccurate. Therefore, there can be no assurance
that the forward-looking statements included in this report will prove to be accurate. Actual
results could differ materially and adversely from those contemplated by any forward-looking
statement. In light of the significant risks and uncertainties inherent in the forward-looking
statements included herein, the inclusion of such information should not be regarded as a
representation by us or any other person that our objectives and plans will be achieved. We
undertake no obligation to publicly release any revisions to any forward-looking statements in this
discussion to reflect events and circumstances occurring after the date hereof or to reflect
unanticipated events. Forward-looking statements and our liquidity, financial condition and
results of operations may be affected by the risks set forth in Item 1A. Risk Factors or by other
unknown risks and uncertainties.
 Overview
  2009
    
    
    2008
    
    
    2007Procedures
    
    
    1,238,339
    
    
    
    1,108,585
    
    
    
    952,370Continuing centers in operation, end of year
    
    
    202
    
    
    
    188
    
    
    
    168Average number of continuing centers in operation, during year
    
    
    193
    
    
    
    172
    
    
    
    155New centers added during year
    
    
    14
    
    
    
    20
    
    
    
    24Centers disposed during year
    
    
    (1
    )
    
    
    (6
    )
    
    
    (4
    )Centers under development, end of year
    
    
    1
    
    
    
    3
    
    
    
    2Centers held for sale, end of year
    
    
    (1
    )
    
    
    (1
    )
    
    
    Centers under letter of intent, end of year
    
    
    1
    
    
    
    5
    
    
    
    4
    Sources of Revenues
   
 22




---



##### Table of Contents



Item 7.
    
    Managements Discussion and Analysis of Financial Condition and Results of Operations  (continued)
 
   
    
    ASCs are paid based upon a percentage of the payments to hospital outpatient departments
pursuant to the hospital outpatient prospective payment system;
    
    a scheduled phase-in of the revised rates over four years from 2008 through 2011; and
    
    planned annual increases in the ASC rates beginning in 2010 based on the consumer price
index, or CPI.
     Critical Accounting Policies
  Principles of Consolidation.
 
 23




---



##### Table of Contents



Item 7.
    
    Managements Discussion and Analysis of Financial Condition and Results of Operations  (continued)
 
     Revenue Recognition.
 Allowance for Contractual Adjustments and Bad Debt Expense.
 Purchase Price Allocation.
 Goodwill.
 
 24




---



##### Table of Contents



Item 7.
    
    Managements Discussion and Analysis of Financial Condition and Results of Operations  (continued)
 
  Results of Operations
   Consolidations
    
 25




---



##### Table of Contents



Item 7.
    
    Managements Discussion and Analysis of Financial Condition and Results of Operations  (continued)
 
  2009
    
    
    2008
    
    
    2007Revenues
    
    
    100.0
    %
    
    
    100.0
    %
    
    
    100.0
    %Operating expenses:Salaries and benefits
    
    
    29.9
    
    
    
    28.9
    
    
    
    29.4Supply cost
    
    
    12.4
    
    
    
    11.8
    
    
    
    11.5Other operating expenses
    
    
    20.6
    
    
    
    20.8
    
    
    
    20.5Depreciation and amortization
    
    
    3.4
    
    
    
    3.4
    
    
    
    3.6Total operating expenses
    
    
    66.3
    
    
    
    64.9
    
    
    
    65.0Operating income
    
    
    33.7
    
    
    
    35.1
    
    
    
    35.0Interest expense
    
    
    1.2
    
    
    
    1.7
    
    
    
    1.9Earnings from continuing operations before income taxes
    
    
    32.5
    
    
    
    33.4
    
    
    
    33.1Income tax expense
    
    
    5.3
    
    
    
    5.5
    
    
    
    5.2Net earnings from continuing operations, net of income tax expense
    
    
    27.2
    
    
    
    27.9
    
    
    
    27.9Discontinued operations:Earnings from operations of discontinued interests in surgery centers,
net of income tax expense
    
    
    
    
    
    
    
    
    
    
    0.8(Loss) gain on disposal of discontinued interests in surgery centers,
net of income tax expense (benefit)
    
    
    (0.1
    )
    
    
    (0.3
    )
    
    
    0.3Net (loss) gain from discontinued operations
    
    
    (0.1
    )
    
    
    (0.3
    )
    
    
    1.1Net earnings
    
    
    27.1
    
    
    
    27.6
    
    
    
    29.0Less net earnings attributable to noncontrolling interests:Net earnings from continuing operations
    
    
    19.3
    
    
    
    19.6
    
    
    
    19.8Net earnings from discontinued operations
    
    
    
    
    
    
    0.2
    
    
    
    0.7Total net earnings attributable to noncontrolling interests
    
    
    19.3
    
    
    
    19.8
    
    
    
    20.5Net earnings attributable to AmSurg Corp. common shareholders
    
    
    7.8
    
    
    
    7.8
    
    
    
    8.5Amounts attributable to AmSurg Corp. common shareholders:Earnings from continuing operations, net of tax
    
    
    7.9
    
    
    
    8.2
    
    
    
    8.1Discontinued operations, net of tax
    
    
    (0.1
    )
    
    
    (0.4
    )
    
    
    0.4Net earnings attributable to AmSurg Corp. common shareholders
    
    
    7.8
    
    
    
    7.8
    
    
    
    8.5
 Year Ended December 31, 2009 Compared to Year Ended December 31, 2008
  
    
    centers acquired or opened in 2008, which contributed $59.7 million of additional
revenues due to having a full period of operations in 2009; and
    
    centers acquired and opened in 2009, which generated $8.6 million in revenues.
  
 26




---



##### Table of Contents



Item 7.
    
    Managements Discussion and Analysis of Financial Condition and Results of Operations  (continued)
 
    
    
    centers acquired or opened during 2008, which resulted in an increase of $10.4 million
in other operating expenses;
    
    centers acquired or opened during 2009, which resulted in an increase of $2.2 million in
other operating expenses; and
    
    an increase of $2.1 million in other operating expenses at our 2009 same-center group
resulting primarily from general inflationary cost increases and additional procedure
volume.
        
 27




---



##### Table of Contents



Item 7.
    
    Managements Discussion and Analysis of Financial Condition and Results of Operations  (continued)
 
 Year Ended December 31, 2008 Compared to Year Ended December 31, 2007
  
    
    centers acquired or opened in 2007, which contributed $53.6 million of additional
revenues due to having a full period of operations in 2008;
    
    centers acquired or opened in 2008, which generated $15.0 million in revenues; and
    
    $13.9 million of revenue growth recognized by our 2008 same-center group primarily as a
result of procedure growth.
    
    
    centers acquired or opened during 2007, which resulted in an increase of $9.2 million in
other operating expenses;
    
    an increase of $4.1 million in other operating expenses at our 2008 same-center group
resulting primarily from additional procedure volume and general inflationary cost
increases; and
    
    centers acquired or opened during 2008, which resulted in an increase of $2.8 million in
other operating expenses.
      
 28




---



##### Table of Contents



Item 7.
    
    Managements Discussion and Analysis of Financial Condition and Results of Operations  (continued)
 
 Liquidity and Capital Resources
    
    
    $95.8 million for acquisitions of interests in ASCs and related transactions;
    
    $16.4 million for new or replacement property at existing centers, including $148,000 in
new capital leases; and
    
    $3.7 million for centers under development.
       
 29




---



##### Table of Contents



Item 7.
    
    Managements Discussion and Analysis of Financial Condition and Results of Operations  (continued)
 
  Payments Due by PeriodLess than
    
    
    
    
    
    
    
    
    
    More than 5Total
    
    1 Year
    
    1-3 Years
    
    3-5 Years
    
    YearsLong-term debt, including
interest (1)
    
    $
    292,468
    
    
    $
    4,351
    
    
    $
    283,192
    
    
    $
    3,787
    
    
    $
    1,138Capital lease obligations,
including interest
    
    
    4,493
    
    
    
    2,234
    
    
    
    2,142
    
    
    
    117
    
    
    
    Operating leases, including
renewal option periods (2)
    
    
    419,538
    
    
    
    35,504
    
    
    
    68,718
    
    
    
    64,607
    
    
    
    250,709Construction in progress
commitments
    
    
    1,891
    
    
    
    1,891
    
    
    
    
    
    
    
    
    
    
    
    Liability for unrecognized tax
benefits
    
    
    8,383
    
    
    
    
    
    
    
    8,383
    
    
    
    
    
    
    
    Purchase committment
    
    
    28,070
    
    
    
    28,070
    
    
    
    
    
    
    
    
    
    
    
    Total contractual cash
obligations
    
    $
    754,843
    
    
    $
    72,050
    
    
    $
    362,435
    
    
    $
    68,511
    
    
    $
    251,847
 
 (1)
    
    Our long-term debt may increase based on future acquisition activity. We will use our
operating cash flow to repay existing long-term debt under our revolving credit agreement
prior to its maturity date.(2)
    
    Operating lease obligations do not include common area maintenance, or CAM, insurance or tax
payments for which the
Company is also obligated. Total expense related to CAM, insurance and taxes for the 2009
fiscal year was approximately $4.2 million.   Recent Accounting Pronouncements
   
 30




---



##### Table of Contents



Item 7A.
    
    Quantitative and Qualitative Disclosures About Market Risk
 
   FairValue atYears Ended December 31,
    
    
    
    
    
    
    
    
    
    December 31,2010
    
    2011
    
    2012
    
    2013
    
    2014
    
    Thereafter
    
    Total
    
    2009Fixed rate
    
    $
    4,651
    
    
    $
    53,643
    
    
    $
    2,534
    
    
    $
    1,699
    
    
    $
    821
    
    
    $
    
    
    
    $
    63,348
    
    
    $
    59,548Average interest
rate
    
    
    6.6
    %
    
    
    6.3
    %
    
    
    5.9
    %
    
    
    5.9
    %
    
    
    6.1
    %
    
    
    Variable rate
    
    $
    1,006
    
    
    $
    227,309
    
    
    $
    890
    
    
    $
    674
    
    
    $
    429
    
    
    $
    1,042
    
    
    $
    231,350
    
    
    $
    223,495Average interest
rate
    
    
    4.8
    %
    
    
    1.8
    %
    
    
    5.3
    %
    
    
    6.1
    %
    
    
    5.3
    %
    
    
    4.9
    %
  
 31




---



##### Table of Contents



Item 8.
    
    Financial Statements and Supplementary Data
 
 REPORT OF INDEPENDENT REGISTERED PUBLIC ACCOUNTING FIRM
 
    Business Combinations Consolidation Income Taxes
 Internal ControlIntegrated Framework
  
 
 32




---



##### Table of Contents



Item 8.
    
    Financial Statements and Supplementary Data  (continued)
 
 AmSurg Corp.
Consolidated Balance Sheets
December 31, 2009 and 2008
(Dollars in thousands)
 2009
    
    
    2008AssetsCurrent assets:Cash and cash equivalents
    
    $
    29,377
    
    
    $
    31,548Accounts receivable, net of allowance of $12,375 and $11,757, respectively
    
    
    66,886
    
    
    
    63,602Supplies inventory
    
    
    8,745
    
    
    
    8,083Deferred income taxes
    
    
    2,324
    
    
    
    1,378Prepaid and other current assets
    
    
    15,408
    
    
    
    17,223Current assets held for sale
    
    
    34
    
    
    
    25Total current assets
    
    
    122,774
    
    
    
    121,859Long-term receivables and other assets
    
    
    56
    
    
    
    46Property and equipment, net
    
    
    112,084
    
    
    
    111,884Goodwill
    
    
    813,876
    
    
    
    661,693Intangible assets, net
    
    
    9,797
    
    
    
    10,221Long-term assets held for sale
    
    
    170
    
    
    
    176Total assets
    
    $
    1,058,757
    
    
    $
    905,879Liabilities and EquityCurrent liabilities:Current portion of long-term debt
    
    $
    5,657
    
    
    $
    6,801Accounts payable
    
    
    14,821
    
    
    
    14,240Accrued salaries and benefits
    
    
    18,156
    
    
    
    12,040Other accrued liabilities
    
    
    3,208
    
    
    
    3,246Current income taxes payable
    
    
    402
    
    
    
    Current liabilities held for sale
    
    
    37
    
    
    
    35Total current liabilities
    
    
    42,281
    
    
    
    36,362Long-term debt
    
    
    289,041
    
    
    
    265,835Deferred income taxes
    
    
    71,665
    
    
    
    54,758Other long-term liabilities
    
    
    22,036
    
    
    
    22,416Commitments and contingenciesNoncontrolling interests  redeemable
    
    
    123,363
    
    
    
    63,202Preferred stock, no par value, 5,000,000 shares authorized, no shares issued or outstanding
    
    
    
    
    
    
    Equity:Common
stock, no par value 70,000,000 shares authorized, 30,674,525 and
31,342,241 shares outstanding, respectively
    
    
    163,729
    
    
    
    172,192Retained earnings
    
    
    343,236
    
    
    
    291,088Accumulated other comprehensive loss, net of income taxes
    
    
    (1,849
    )
    
    
    (2,851
    )Total AmSurg Corp. equity
    
    
    505,116
    
    
    
    460,429Noncontrolling interests  non-redeemable
    
    
    5,255
    
    
    
    2,877Total equity
    
    
    510,371
    
    
    
    463,306Total liabilities and equity
    
    $
    1,058,757
    
    
    $
    905,879
  
 33




---



##### Table of Contents



Item 8.
    
    Financial Statements and Supplementary Data  (continued)
 
 AmSurg Corp.
Consolidated Statements of Earnings
Years Ended December 31, 2009, 2008 and 2007
(In thousands, except earnings per share
 2009
    
    
    2008
    
    
    2007Revenues
    
    $
    668,752
    
    
    $
    600,107
    
    
    $
    517,707Operating expenses:Salaries and benefits
    
    
    200,281
    
    
    
    173,369
    
    
    
    152,104Supply cost
    
    
    82,565
    
    
    
    70,601
    
    
    
    59,864Other operating expenses
    
    
    137,614
    
    
    
    124,764
    
    
    
    105,957Depreciation and amortization
    
    
    22,927
    
    
    
    20,815
    
    
    
    18,648Total operating expenses
    
    
    443,387
    
    
    
    389,549
    
    
    
    336,573Operating income
    
    
    225,365
    
    
    
    210,558
    
    
    
    181,134Interest expense
    
    
    7,789
    
    
    
    9,938
    
    
    
    9,569Earnings from continuing operations before income taxes
    
    
    217,576
    
    
    
    200,620
    
    
    
    171,565Income tax expense
    
    
    35,687
    
    
    
    33,101
    
    
    
    27,065Net earnings from continuing operations
    
    
    181,889
    
    
    
    167,519
    
    
    
    144,500Discontinued operations:Earnings from operations of discontinued interests in surgery centers,
net of income tax expense
    
    
    163
    
    
    
    180
    
    
    
    4,091(Loss) gain on disposal of discontinued interests in surgery centers,
net of income tax (benefit) expense
    
    
    (702
    )
    
    
    (1,773
    )
    
    
    1,712Net (loss) gain from discontinued operations
    
    
    (539
    )
    
    
    (1,593
    )
    
    
    5,803Net earnings
    
    
    181,350
    
    
    
    165,926
    
    
    
    150,303Less net earnings attributable to noncontrolling interests:Net earnings from continuing operations
    
    
    129,101
    
    
    
    117,978
    
    
    
    102,715Net earnings from discontinued operations
    
    
    101
    
    
    
    902
    
    
    
    3,413Total net earnings attributable to noncontrolling interests
    
    
    129,202
    
    
    
    118,880
    
    
    
    106,128Net earnings attributable to AmSurg Corp. common shareholders
    
    $
    52,148
    
    
    $
    47,046
    
    
    $
    44,175Amounts attributable to AmSurg Corp. common shareholders:Earnings from continuing operations, net of tax
    
    $
    52,788
    
    
    $
    49,541
    
    
    $
    41,785Discontinued operations, net of tax
    
    
    (640
    )
    
    
    (2,495
    )
    
    
    2,390Net earnings attributable to AmSurg Corp. common shareholders
    
    $
    52,148
    
    
    $
    47,046
    
    
    $
    44,175Earnings per share-basic:Net earnings from continuing operations attributable to AmSurg Corp.
common shareholders
    
    $
    1.73
    
    
    $
    1.57
    
    
    $
    1.36Net (loss) gain from discontinued operations attributable to AmSurg
Corp. common shareholders
    
    
    (0.02
    )
    
    
    (0.08
    )
    
    
    0.08Net earnings attributable to AmSurg Corp. common shareholders
    
    $
    1.71
    
    
    $
    1.49
    
    
    $
    1.44Earnings per share-diluted:Net earnings from continuing operations attributable to AmSurg Corp.
common shareholders
    
    $
    1.71
    
    
    $
    1.55
    
    
    $
    1.34Net (loss) gain from discontinued operations attributable to AmSurg
Corp. common shareholders
    
    
    (0.02
    )
    
    
    (0.08
    )
    
    
    0.08Net earnings attributable to AmSurg Corp. common shareholders
    
    $
    1.69
    
    
    $
    1.47
    
    
    $
    1.42Weighted average number of shares and share equivalents outstanding:Basic
    
    
    30,576
    
    
    
    31,503
    
    
    
    30,619Diluted
    
    
    30,862
    
    
    
    31,963
    
    
    
    31,102
  
 34




---



##### Table of Contents



Item 8.
    
    Financial Statements and Supplementary Data  (continued)
 
 AmSurg Corp.
Consolidated Statements of Comprehensive Income
Years Ended December 31, 2009, 2008 and 2007
(In thousands
 2009
    
    
    2008
    
    
    2007Net earnings
    
    $
    181,350
    
    
    $
    165,926
    
    
    $
    150,303Other comprehensive income, net of tax:Unrealized gain (loss) on interest rate swap, net of tax
    
    
    1,002
    
    
    
    (1,414
    )
    
    
    (967
    )Comprehensive income, net of tax
    
    
    182,352
    
    
    
    164,512
    
    
    
    149,336Less comprehensive income attributable to noncontrolling interests
    
    
    129,202
    
    
    
    118,880
    
    
    
    106,128Comprehensive income attributable to AmSurg Corp. common shareholders
    
    $
    53,150
    
    
    $
    45,632
    
    
    $
    43,208
  
 35




---



##### Table of Contents



Item 8.
    
    Financial Statements and Supplementary Data  (continued)
 
 AmSurg Corp.
Consolidated Statements of Changes in Equity
Years Ended December 31, 2009, 2008 and 2007
(In thousands
 AmSurg Corp. ShareholdersNon-Non-
    
    
    
    
    
    ControllingAccumulated
    
    Controlling
    
    
    
    
    
    InterestsOther
    
    Interests
    
    Total
    
    RedeemableCommon Stock
    
    Retained
    
    Comprehensive
    
    Non-
    
    Equity
    
    (Temporary
    
    NetShares
    
    Amount
    
    Earnings
    
    Loss
    
    Redeemable
    
    (Permanent)
    
    Equity)
    
    EarningsBalance at January 1, 2007
    
    
    29,934
    
    
    $
    143,077
    
    
    $
    200,501
    
    
    $
    (470
    )
    
    $
    
    
    
    $
    343,108
    
    
    $
    52,341Cumulative adjustment to
beginning retained earnings on

January 1, 2007
    
    
    
    
    
    
    
    
    
    
    (634
    )
    
    
    
    
    
    
    
    
    
    
    (634
    )
    
    
    Issuance of restricted common
stock
    
    
    200
    
    
    
    
    
    
    
    
    
    
    
    
    
    
    
    
    
    
    
    
    
    
    
    Cancellation of restricted
common stock
    
    
    (5
    )
    
    
    
    
    
    
    
    
    
    
    
    
    
    
    
    
    
    
    
    
    
    
    Stock options exercised
    
    
    1,074
    
    
    
    17,661
    
    
    
    
    
    
    
    
    
    
    
    
    
    
    
    17,661
    
    
    
    Share-based compensation
    
    
    
    
    
    
    4,560
    
    
    
    
    
    
    
    
    
    
    
    
    
    
    
    4,560
    
    
    
    Tax benefit related to
exercise of stock options
    
    
    
    
    
    
    3,322
    
    
    
    
    
    
    
    
    
    
    
    
    
    
    
    3,322
    
    
    
    Net earnings
    
    
    
    
    
    
    
    
    
    
    44,175
    
    
    
    
    
    
    
    465
    
    
    
    44,640
    
    
    
    105,663
    
    
    $
    150,303Distributions to
noncontrolling interests, net
of capital
contributions
    
    
    
    
    
    
    
    
    
    
    
    
    
    
    
    
    
    
    (280
    )
    
    
    (280
    )
    
    
    (102,785
    )Acquisitions and other
transactions impacting
noncontrolling
interests
    
    
    
    
    
    
    
    
    
    
    
    
    
    
    
    
    
    
    2,352
    
    
    
    2,352
    
    
    
    4,250Loss on interest rate swap,
net of income tax expense of
$624
    
    
    
    
    
    
    
    
    
    
    
    
    
    
    (967
    )
    
    
    
    
    
    
    (967
    )
    
    
    Balance at December 31, 2007
    
    
    31,203
    
    
    
    168,620
    
    
    
    244,042
    
    
    
    (1,437
    )
    
    
    2,537
    
    
    
    413,762
    
    
    
    59,469Issuance of restricted common
stock
    
    
    147
    
    
    
    
    
    
    
    
    
    
    
    
    
    
    
    
    
    
    
    
    
    
    
    Cancellation of restricted
common stock
    
    
    (10
    )
    
    
    
    
    
    
    
    
    
    
    
    
    
    
    
    
    
    
    
    
    
    
    Stock options exercised
    
    
    519
    
    
    
    9,970
    
    
    
    
    
    
    
    
    
    
    
    
    
    
    
    9,970
    
    
    
    Stock repurchased
    
    
    (517
    )
    
    
    (12,413
    )
    
    
    
    
    
    
    
    
    
    
    
    
    
    
    (12,413
    )
    
    
    Share-based compensation
    
    
    
    
    
    
    4,710
    
    
    
    
    
    
    
    
    
    
    
    
    
    
    
    4,710
    
    
    
    Tax benefit related to
exercise of stock options
    
    
    
    
    
    
    1,305
    
    
    
    
    
    
    
    
    
    
    
    
    
    
    
    1,305
    
    
    
    Net earnings
    
    
    
    
    
    
    
    
    
    
    47,046
    
    
    
    
    
    
    
    3,308
    
    
    
    50,354
    
    
    
    115,572
    
    
    $
    165,926Distributions to
noncontrolling interests, net
of capital contributions
    
    
    
    
    
    
    
    
    
    
    
    
    
    
    
    
    
    
    (3,087
    )
    
    
    (3,087
    )
    
    
    (115,100
    )Acquisitions and other
transactions impacting
noncontrolling
interests
    
    
    
    
    
    
    
    
    
    
    
    
    
    
    
    
    
    
    119
    
    
    
    119
    
    
    
    3,261Loss on interest rate swap, net
of income tax benefit of $911
    
    
    
    
    
    
    
    
    
    
    
    
    
    
    (1,414
    )
    
    
    
    
    
    
    (1,414
    )
    
    
    Balance at December 31, 2008
    
    
    31,342
    
    
    $
    172,192
    
    
    $
    291,088
    
    
    $
    (2,851
    )
    
    $
    2,877
    
    
    $
    463,306
    
    
    $
    63,202
  
 36




---



##### Table of Contents



Item 8.
    
    Financial Statements and Supplementary Data  (continued)
 
 AmSurg Corp.
Consolidated Statements of Changes in Equity  (continued)

Years Ended December 31, 2009, 2008 and 2007
(In thousands
 AmSurg Corp. ShareholdersNon-Non-
    
    
    
    
    
    ControllingAccumulated
    
    Controlling
    
    
    
    
    
    Interests Other
    
    Interests
    
    Total
    
    RedeemableCommon Stock
    
    Retained
    
    Comprehensive
    
    Non-
    
    Equity
    
    (Temporary
    
    NetShares
    
    Amount
    
    Earnings
    
    Loss
    
    Redeemable
    
    (Permanent)
    
    Equity)
    
    EarningsBalance at December 31, 2008
    
    
    31,342
    
    
    $
    172,192
    
    
    $
    291,088
    
    
    $
    (2,851
    )
    
    $
    2,877
    
    
    $
    463,306
    
    
    $
    63,202Issuance of restricted
common stock
    
    
    162
    
    
    
    
    
    
    
    
    
    
    
    
    
    
    
    
    
    
    
    
    
    
    
    Cancellation of restricted
common stock
    
    
    (14
    )
    
    
    (26
    )
    
    
    
    
    
    
    
    
    
    
    
    
    
    
    (26
    )
    
    
    Stock options exercised
    
    
    15
    
    
    
    201
    
    
    
    
    
    
    
    
    
    
    
    
    
    
    
    201
    
    
    
    Stock repurchased
    
    
    (831
    )
    
    
    (12,587
    )
    
    
    
    
    
    
    
    
    
    
    
    
    
    
    (12,587
    )
    
    
    Share-based compensation
    
    
    
    
    
    
    4,068
    
    
    
    
    
    
    
    
    
    
    
    
    
    
    
    4,068
    
    
    
    Tax benefit related to
exercise of stock options
    
    
    
    
    
    
    2
    
    
    
    
    
    
    
    
    
    
    
    
    
    
    
    2
    
    
    
    Net earnings
    
    
    
    
    
    
    
    
    
    
    52,148
    
    
    
    
    
    
    
    4,065
    
    
    
    56,213
    
    
    
    125,137
    
    
    $
    181,350Distributions to
noncontrolling interests, net
of capital contributions
    
    
    
    
    
    
    
    
    
    
    
    
    
    
    
    
    
    
    (3,848
    )
    
    
    (3,848
    )
    
    
    (126,797
    )Sale of noncontrolling interests
    
    
    
    
    
    
    (121
    )
    
    
    
    
    
    
    
    
    
    
    
    
    
    
    (121
    )
    
    
    947Acquisitions and other
transactions impacting
noncontrolling interests
    
    
    
    
    
    
    
    
    
    
    
    
    
    
    
    
    
    
    2,161
    
    
    
    2,161
    
    
    
    60,874Gain on interest rate swap, net
of income tax expense of $646
    
    
    
    
    
    
    
    
    
    
    
    
    
    
    1,002
    
    
    
    
    
    
    
    1,002
    
    
    
    Balance at December 31, 2009
    
    
    30,674
    
    
    $
    163,729
    
    
    $
    343,236
    
    
    $
    (1,849
    )
    
    $
    5,255
    
    
    $
    510,371
    
    
    $
    123,363
  
 37




---



##### Table of Contents



Item 8.
    
    Financial Statements and Supplementary Data  (continued)
 
 AmSurg Corp.
Consolidated Statements of Cash Flows
Years Ended December 31, 2009, 2008 and 2007
(In thousands
 2009
    
    
    2008
    
    
    2007Cash flows from operating activities:Net earnings
    
    $
    181,350
    
    
    $
    165,926
    
    
    $
    150,303Adjustments to reconcile net earnings to net cash provided by
operating activities:Depreciation and amortization
    
    
    22,927
    
    
    
    20,815
    
    
    
    18,648Net loss on sale and impairment of long-lived assets
    
    
    455
    
    
    
    922
    
    
    
    724Share-based compensation
    
    
    4,068
    
    
    
    4,710
    
    
    
    4,560Excess tax benefit from share-based compensation
    
    
    (32
    )
    
    
    (1,351
    )
    
    
    (3,322
    )Deferred income taxes
    
    
    14,703
    
    
    
    14,729
    
    
    
    8,063Increase (decrease) in cash and cash equivalents, net of effects of
acquisitions and dispositions, due to changes in:Accounts receivable, net
    
    
    1,494
    
    
    
    3,792
    
    
    
    (2,300
    )Supplies inventory
    
    
    (60
    )
    
    
    (83
    )
    
    
    47Prepaid and other current assets
    
    
    (733
    )
    
    
    2,344
    
    
    
    (2,958
    )Accounts payable
    
    
    1,289
    
    
    
    (1,904
    )
    
    
    962Accrued expenses and other liabilities
    
    
    6,666
    
    
    
    (487
    )
    
    
    8,128Other, net
    
    
    457
    
    
    
    283
    
    
    
    61Net cash flows provided by operating activities
    
    
    232,584
    
    
    
    209,696
    
    
    
    182,916Cash flows from investing activities:Acquisition of interests in surgery centers and related transactions
    
    
    (95,826
    )
    
    
    (118,671
    )
    
    
    (162,777
    )Acquisition of property and equipment
    
    
    (19,930
    )
    
    
    (18,379
    )
    
    
    (24,640
    )Proceeds from sale of interests in surgery centers
    
    
    1,298
    
    
    
    3,812
    
    
    
    5,433Repayment of notes receivable
    
    
    1,666
    
    
    
    1,458
    
    
    
    2,616Net cash flows used in investing activities
    
    
    (112,792
    )
    
    
    (131,780
    )
    
    
    (179,368
    )Cash flows from financing activities:Proceeds from long-term borrowings
    
    
    137,178
    
    
    
    157,787
    
    
    
    178,316Repayment on long-term borrowings
    
    
    (116,951
    )
    
    
    (114,788
    )
    
    
    (89,712
    )Distributions to noncontrolling interests
    
    
    (130,855
    )
    
    
    (118,769
    )
    
    
    (103,545
    )Proceeds from issuance of common stock upon exercise of stock options
    
    
    201
    
    
    
    9,970
    
    
    
    17,661Repurchase of common stock
    
    
    (12,587
    )
    
    
    (12,413
    )
    
    
    Capital contributions and ownership transactions by noncontrolling interests
    
    
    1,036
    
    
    
    582
    
    
    
    480Excess tax benefit from share-based compensation
    
    
    32
    
    
    
    1,351
    
    
    
    3,322Financing cost incurred
    
    
    (17
    )
    
    
    (41
    )
    
    
    (200
    )Net cash flows (used in) provided by financing activities
    
    
    (121,963
    )
    
    
    (76,321
    )
    
    
    6,322Net (decrease) increase in cash and cash equivalents
    
    
    (2,171
    )
    
    
    1,595
    
    
    
    9,870Cash and cash equivalents, beginning of year
    
    
    31,548
    
    
    
    29,953
    
    
    
    20,083Cash and cash equivalents, end of year
    
    $
    29,377
    
    
    $
    31,548
    
    
    $
    29,953
  
 38




---



##### Table of Contents



Item 8.
    
    Financial Statements and Supplementary Data  (continued)
 AmSurg Corp.
Notes to the Consolidated Financial Statements
 1.
    
    Summary of Significant Accounting Policiesa.
    
    Principles of Consolidation
  Consolidations
    b.
    
    Cash and Cash Equivalents




---



##### Table of Contents



Item 8.
    
    Financial Statements and Supplementary Data  (continued)
 AmSurg Corp.
Notes to the Consolidated Financial Statements  (continued)
 c.
    
    Supplies Inventory
  d.
    
    Prepaid and Other Current Assets
  e.
    
    Property and Equipment, net
  f.
    
    Goodwill
  g.
    
    Intangible Assets
  h.
    
    Other Long-Term Liabilities
  i.
    
    Revenue Recognition
   j.
    
    Operating Expenses




---



##### Table of Contents



Item 8.
    
    Financial Statements and Supplementary Data  (continued)
 AmSurg Corp.
Notes to the Consolidated Financial Statements  (continued)
  k.
    
    Income Taxes
  Income Taxes
   l.
    
    Earnings Per Share
  m.
    
    Fair Value of Financial Instruments
  n.
    
    Share-Based Compensation




---



##### Table of Contents



Item 8.
    
    Financial Statements and Supplementary Data  (continued)
 AmSurg Corp.
Notes to the Consolidated Financial Statements  (continued)
  o.
    
    Use of Estimates
   p.
    
    Recent Accounting Pronouncements
   q.
    
    Reclassifications and Restatements
   2.
    
    Acquisitions and Dispositionsa.
    
    Acquisitions
 Business Combinations




---



##### Table of Contents



Item 8.
    
    Financial Statements and Supplementary Data  (continued)
 AmSurg Corp.
Notes to the Consolidated Financial Statements  (continued)
    2009Accounts receivable
    
    $
    4,603Prepaid and other current assets
    
    
    616Property and equipment
    
    
    5,263Accounts payable
    
    
    (898
    )Other accrued liabilities
    
    
    (955
    )Long-term debt
    
    
    (1,802
    )Goodwill (approximately $92,283 deductible for tax purposes)
    
    
    152,227Total fair value
    
    
    159,054Less: Fair value attributable to noncontrolling interests
    
    
    63,228Acquisition date fair value of total consideration transferred
    
    $
    95,826
    2009Revenues
    
    $
    10,327Net earnings
    
    
    3,721Less: Net earnings attributable to noncontrolling interests
    
    
    2,264Net earnings attributable to AmSurg Corp. common shareholders
    
    $
    1,457




---



##### Table of Contents



Item 8.
    
    Financial Statements and Supplementary Data  (continued)
 AmSurg Corp.
Notes to the Consolidated Financial Statements  (continued)
 b.
    
    Pro Forma Information
  2009
    
    
    2008Revenues
    
    $
    710,007
    
    
    $
    711,338Net earnings
    
    
    194,006
    
    
    
    197,423Amounts attributable to AmSurg Corp. common shareholders:Net earnings from continuing operations
    
    
    57,446
    
    
    
    58,768Net earnings
    
    
    56,806
    
    
    
    56,273Net earnings from continuing operations per common share:Basic
    
    $
    1.88
    
    
    $
    1.87Diluted
    
    $
    1.86
    
    
    $
    1.84Net earnings:Basic
    
    $
    1.86
    
    
    $
    1.79Diluted
    
    $
    1.84
    
    
    $
    1.76Weighted average number of shares and share equivalents:Basic
    
    
    30,576
    
    
    
    31,503Diluted
    
    
    30,862
    
    
    
    31,963
 c.
    
    Dispositions
   2009
    
    
    2008
    
    
    2007Revenues
    
    $
    1,714
    
    
    $
    6,110
    
    
    $
    19,738Earnings before income taxes
    
    
    204
    
    
    
    156
    
    
    
    5,782Net earnings
    
    
    163
    
    
    
    180
    
    
    
    4,091
 3.
    
    Property and Equipment
  2009
    
    
    2008Land and improvements
    
    $
    164
    
    
    $
    164Building and improvements
    
    
    98,565
    
    
    
    88,875Movable equipment, software and software development costs
    
    
    143,990
    
    
    
    131,085Construction in progress
    
    
    2,521
    
    
    
    4,913245,240
    
    
    
    225,037Less accumulated depreciation
    
    
    (133,156
    )
    
    
    (113,153
    )Property and equipment, net
    
    $
    112,084
    
    
    $
    111,884




---



##### Table of Contents



Item 8.
    
    Financial Statements and Supplementary Data  (continued)
 AmSurg Corp.
Notes to the Consolidated Financial Statements  (continued)
  4.
    
    Goodwill and Intangible Assets
  2009
    
    
    2008Balance, beginning of year
    
    $
    661,693
    
    
    $
    546,915Purchase price allocations
    
    
    152,594
    
    
    
    117,003Disposals
    
    
    (411
    )
    
    
    (2,225
    )Balance, end of year
    
    $
    813,876
    
    
    $
    661,693
  2009
    
    2008Gross
    
    
    
    
    
    
    
    
    
    GrossCarrying
    
    Accumulated
    
    
    
    
    
    Carrying
    
    AccumulatedAmount
    
    Amortization
    
    Net
    
    Amount
    
    Amortization
    
    NetDeferred financing cost
    
    $
    2,780
    
    
    $
    (2,310
    )
    
    $
    470
    
    
    $
    2,744
    
    
    $
    (2,018
    )
    
    $
    726Customer and non-compete
agreements
    
    
    3,180
    
    
    
    (1,618
    )
    
    
    1,562
    
    
    
    3,180
    
    
    
    (1,418
    )
    
    
    1,762Total amortizable
intangible assets
    
    $
    5,960
    
    
    $
    (3,928
    )
    
    $
    2,032
    
    
    $
    5,924
    
    
    $
    (3,436
    )
    
    $
    2,488
   5.
    
    Long-term Debt
  2009
    
    
    2008$300,000,000 credit agreement at prime, or LIBOR plus 0.50% to 1.50%, or a
combination thereof (revolving average rate of 1.8% at December 31, 2009),
due July 2011
    
    $
    276,300
    
    
    $
    249,000Other debt at an average rate of 5.6%, due through 2022
    
    
    14,250
    
    
    
    17,445Capitalized lease arrangements at an average rate of 7.1%, due through 2014
    
    
    4,148
    
    
    
    6,191294,698
    
    
    
    272,636Less current portion
    
    
    5,657
    
    
    
    6,801Long-term debt
    
    $
    289,041
    
    
    $
    265,835




---



##### Table of Contents



Item 8.
    
    Financial Statements and Supplementary Data  (continued)
 AmSurg Corp.
Notes to the Consolidated Financial Statements  (continued)
    6.
    
    Derivative Instruments
 Derivatives and Hedging
   Asset Derivatives December 31,
    
    Liability Derivatives December 31,2009
    
    2008
    
    2009
    
    2008Balance
    
    
    
    Balance
    
    
    
    Balance
    
    
    
    
    
    BalanceSheet
    
    Fair
    
    Sheet
    
    Fair
    
    Sheet
    
    Fair
    
    Sheet
    
    FairLocation
    
    Value
    
    Location
    
    Value
    
    Location
    
    Value
    
    Location
    
    ValueDerivatives designated 
as hedging 
instruments under 
ASC 815
    
    Other
assets,
net
    
    $    
    
    Other
assets,
net
    
    $    
    
    Other
long-term
liabilities
    
    $
    3,095
    
    
    Other
long-term
liabilities
    
    $
    4,689
 7.
    
    Fair Value Measurements




---



##### Table of Contents



Item 8.
    
    Financial Statements and Supplementary Data  (continued)
 
 AmSurg Corp.
Notes to the Consolidated Financial Statements  (continued)
   Fair Value Measurements atReporting Date Using:Quoted Pricesin Active
    
    SignificantMarkets for
    
    Other
    
    SignificantDecember 31,
    
    Identical
    
    Observable
    
    Unobservable2009
    
    Assets
    
    Inputs
    
    InputsAssets:Supplemental executive
retirement savings plan
investments
    
    $
    4,544
    
    
    $
    
    

    
    $
    4,544
    
    
    $
    
    Liabilities:Supplemental executive
retirement savings plan
obligations
    
    $
    4,734
    
    
    $
    
    

    
    $
    4,734
    
    
    $
    
    Interest rate swap agreements
    
    
    3,095
    
    
    
    
    

    
    
    3,095
    
    
    
    
    Total liabilities
    
    $
    7,829
    
    
    $
    
    

    
    $
    7,829
    
    
    $
    
    
  8.
    
    Leases
  CapitalizedYear Ended
    
    Equipment
    
    
    OperatingDecember 31,
    
    Leases
    
    
    Leases2010
    
    $
    2,234
    
    
    $
    35,5042011
    
    
    1,546
    
    
    
    34,8552012
    
    
    596
    
    
    
    33,8632013
    
    
    105
    
    
    
    32,8552014
    
    
    12
    
    
    
    31,752Thereafter
    
    
    
    
    
    
    250,709Total minimum rentals
    
    
    4,493
    
    
    $
    419,538Less amounts representing interest at rates ranging from 3.8% to 9.7%
    
    
    345Capital lease obligations
    
    $
    4,148
  9.
    
    Shareholders Equitya.
    
    Common Stock




---



##### Table of Contents



Item 8.
    
    Financial Statements and Supplementary Data  (continued)
 
 AmSurg Corp.
Notes to the Consolidated Financial Statements  (continued)
  b.
    
    Shareholder Rights Plan
  c.
    
    Stock Incentive Plans
    2009
    
    2008
    
    2007Share-based compensation expense
    
    $
    4,068
    
    
    $
    4,710
    
    
    $
    4,560Fair value of shares vested
    
    
    5,382
    
    
    
    6,523
    
    
    
    5,729Cash received from option exercises
    
    
    201
    
    
    
    9,970
    
    
    
    17,661Tax benefit from option exercises
    
    
    34
    
    
    
    1,549
    
    
    
    3,558




---



##### Table of Contents



Item 8.
    
    Financial Statements and Supplementary Data  (continued)
 
 AmSurg Corp.
Notes to the Consolidated Financial Statements  (continued)
  WeightedNumber
    
    Averageof
    
    ExerciseShares
    
    PriceNon-vested shares at January 1, 2007
    
    
    3,262
    
    
    $
    26.19Shares granted
    
    
    199,795
    
    
    
    23.11Shares vested
    
    
    (3,626
    )
    
    
    25.27Shares forfeited
    
    
    (5,432
    )
    
    
    22.84Non-vested shares at December 31, 2007
    
    
    193,999
    
    
    
    23.13Shares granted
    
    
    147,724
    
    
    
    24.79Shares vested
    
    
    (4,210
    )
    
    
    24.94Shares forfeited
    
    
    (9,762
    )
    
    
    24.01Non-vested shares at December 31, 2008
    
    
    327,751
    
    
    
    23.83Shares granted
    
    
    162,507
    
    
    
    19.34Shares vested
    
    
    (9,666
    )
    
    
    22.55Shares forfeited
    
    
    (14,205
    )
    
    
    23.59Non-vested shares at December 31, 2009
    
    
    466,387
    
    
    $
    22.29
  WeightedWeighted
    
    AverageNumber
    
    Average
    
    Remainingof
    
    Exercise
    
    ContractualShares
    
    Price
    
    Term (in years)Outstanding at January 1, 2007
    
    
    4,589,532
    
    
    $
    20.46
    
    
    
    7.4Options granted
    
    
    385,293
    
    
    
    22.84Options exercised with total intrinsic value of $7,639,000
    
    
    (1,074,334
    )
    
    
    16.44Options terminated
    
    
    (226,017
    )
    
    
    23.22Outstanding at December 31, 2007
    
    
    3,674,474
    
    
    
    21.72
    
    
    
    7.1Options granted
    
    
    203,911
    
    
    
    24.75Options exercised with total intrinsic value of $3,947,000
    
    
    (518,702
    )
    
    
    19.25Options terminated
    
    
    (83,880
    )
    
    
    24.26Outstanding at December 31, 2008
    
    
    3,275,803
    
    
    
    22.23
    
    
    
    6.7Options granted
    
    
    
    
    
    
    Options exercised with total intrinsic value of $112,000
    
    
    (14,699
    )
    
    
    13.67Options terminated
    
    
    (110,052
    )
    
    
    23.73Outstanding at December 31, 2009 with aggregate intrinsic value
of $4,332,000
    
    
    3,151,052
    
    
    $
    22.22
    
    
    
    5.0Vested or expected to vest at December 31, 2009 with total
intrinsic value of $4,313,013
    
    
    3,056,520
    
    
    $
    22.19
    
    
    
    4.9Exercisable at December 31, 2009 with total intrinsic value
of $4,200,000
    
    
    2,493,851
    
    
    $
    22.00
    
    
    
    4.5




---



##### Table of Contents



Item 8.
    
    Financial Statements and Supplementary Data  (continued)
 
 AmSurg Corp.
Notes to the Consolidated Financial Statements  (continued)
  2008
    
    
    2007Applied assumptions:Expected term/life of options in years
    
    
    5.1
    
    
    
    4.9Forfeiture rate
    
    
    3.0
    %
    
    
    3.0
    %Average risk-free interest rate
    
    
    2.7
    %
    
    
    4.7
    %Volatility rate
    
    
    31.9
    %
    
    
    34.2
    %Dividends
    
    
    
    
    
    
    
 d.
    
    Earnings per Share
  Earnings
    
    
    Shares
    
    
    Per Share(Numerator)
    
    
    (Denominator)
    
    
    AmountFor the year ended December 31, 2009:Net earnings
from continuing operations attributable to AmSurg Corp.
per common share (basic)
    
    $
    52,788
    
    
    
    30,576
    
    
    $
    1.73Effect of dilutive securities options and non-vested shares
    
    
    
    
    
    
    286Net earnings from continuing operations attributable to AmSurg Corp.
per common share (diluted)
    
    $
    52,788
    
    
    
    30,862
    
    
    $
    1.71Net earnings attributable to AmSurg Corp. per common share (basic)
    
    $
    52,148
    
    
    
    30,576
    
    
    $
    1.71Effect of dilutive securities options and non-vested shares
    
    
    
    
    
    
    286Net earnings attributable to AmSurg Corp. per common share (diluted)
    
    $
    52,148
    
    
    
    30,862
    
    
    $
    1.69For the year ended December 31, 2008:Net earnings from continuing operations attributable to AmSurg Corp. 
per common share (basic)
    
    $
    49,541
    
    
    
    31,503
    
    
    $
    1.57Effect of dilutive securities options and non-vested shares
    
    
    
    
    
    
    460Net earnings from continuing operations attributable to AmSurg Corp.
per common share (diluted)
    
    $
    49,541
    
    
    
    31,963
    
    
    $
    1.55Net earnings attributable to AmSurg Corp. per common share (basic)
    
    $
    47,046
    
    
    
    31,503
    
    
    $
    1.49Effect of dilutive securities options and non-vested shares
    
    
    
    
    
    
    460Net earnings attributable to AmSurg Corp. per common share (diluted)
    
    $
    47,046
    
    
    
    31,963
    
    
    $
    1.47For the year ended December 31, 2007:Net earnings from continuing operations attributable to AmSurg Corp.
per common share (basic)
    
    $
    41,785
    
    
    
    30,619
    
    
    $
    1.36Effect of dilutive securities options and non-vested shares
    
    
    
    
    
    
    483Net earnings from continuing operations attributable to AmSurg Corp.
per common share (diluted)
    
    $
    41,785
    
    
    
    31,102
    
    
    $
    1.34Net earnings attributable to AmSurg Corp. per common share (basic)
    
    $
    44,175
    
    
    
    30,619
    
    
    $
    1.44Effect of dilutive securities options and non-vested shares
    
    
    
    
    
    
    483Net earnings attributable to AmSurg Corp. per common share (diluted)
    
    $
    44,175
    
    
    
    31,102
    
    
    $
    1.42




---



##### Table of Contents



Item 8.
    
    Financial Statements and Supplementary Data  (continued)
 
 AmSurg Corp.
Notes to the Consolidated Financial Statements  (continued)
 10.
    
    Income Taxes
  2009
    
    2008
    
    2007Income from continuing operations
    
    $
    35,687
    
    
    $
    33,101
    
    
    $
    27,065Discontinued operations
    
    
    287
    
    
    
    1,512
    
    
    
    1,663Shareholders equity
    
    
    (2
    )
    
    
    (1,305
    )
    
    
    (3,945
    )Other comprehensive income (loss)
    
    
    646
    
    
    
    (911
    )
    
    
    (624
    )Total
    
    $
    36,618
    
    
    $
    32,397
    
    
    $
    24,159
  2009
    
    2008
    
    2007Current:Federal
    
    $
    17,113
    
    
    $
    20,204
    
    
    $
    14,798State
    
    
    4,454
    
    
    
    4,074
    
    
    
    2,927Deferred:Federal
    
    
    11,950
    
    
    
    7,401
    
    
    
    7,783State
    
    
    2,170
    
    
    
    1,422
    
    
    
    1,557Income tax expense
    
    $
    35,687
    
    
    $
    33,101
    
    
    $
    27,065
  2009
    
    2008
    
    2007Statutory federal income tax
    
    $
    76,152
    
    
    $
    70,217
    
    
    $
    60,048Less federal income tax assumed directly by noncontrolling interests
    
    
    (45,185
    )
    
    
    (41,292
    )
    
    
    (35,950
    )State income taxes, net of federal income tax benefit
    
    
    4,281
    
    
    
    3,433
    
    
    
    2,545Increase in valuation allowances
    
    
    327
    
    
    
    564
    
    
    
    108Interest related to unrecognized tax benefits
    
    
    2
    
    
    
    57
    
    
    
    224Other
    
    
    110
    
    
    
    122
    
    
    
    90Income tax expense
    
    $
    35,687
    
    
    $
    33,101
    
    
    $
    27,065
   2009
    
    2008
    
    2007Balance at beginning of year
    
    $
    6,190
    
    
    $
    5,569
    
    
    $
    4,868Additions for tax positions of current year
    
    
    576
    
    
    
    621
    
    
    
    701Balance at end of year
    
    $
    6,766
    
    
    $
    6,190
    
    
    $
    5,569




---



##### Table of Contents



Item 8.
    
    Financial Statements and Supplementary Data  (continued)
 
 AmSurg Corp.
Notes to the Consolidated Financial Statements  (continued)
   2009
    
    2008Deferred tax assets:Allowance for uncollectible accounts
    
    $
    1,137
    
    
    $
    1,348Accrued assets and other
    
    
    2,943
    
    
    
    1,280Valuation allowances
    
    
    (1,066
    )
    
    
    (676
    )Total current deferred tax assets
    
    
    3,014
    
    
    
    1,952Share-based compensation
    
    
    7,269
    
    
    
    5,490Interest on unrecognized tax benefits
    
    
    667
    
    
    
    655Accrued liabilities and other
    
    
    3,264
    
    
    
    4,505Operating and capital loss carryforwards
    
    
    3,875
    
    
    
    3,553Valuation allowances
    
    
    (3,272
    )
    
    
    (2,547
    )Total non-current deferred tax assets
    
    
    11,803
    
    
    
    11,656Total deferred tax assets
    
    
    14,817
    
    
    
    13,608Deferred tax liabilities:Prepaid expenses
    
    
    690
    
    
    
    574Accrued liabilities and other
    
    
    203
    
    
    
    405Property and equipment, principally due to differences in depreciation
    
    
    1,594
    
    
    
    724Goodwill, principally due to differences in amortization
    
    
    81,671
    
    
    
    65,285Total deferred tax liabilities
    
    
    84,158
    
    
    
    66,988Net deferred tax liabilities
    
    $
    69,341
    
    
    $
    53,380
  2009
    
    2008Current deferred income tax assets
    
    $
    2,324
    
    
    $
    1,378Non-current deferred income tax liabilities
    
    
    71,665
    
    
    
    54,758Net deferred tax liabilities
    
    $
    69,341
    
    
    $
    53,380
  11.
    
    Related Party Transactions
   2009
    
    2008
    
    2007Operating leases
    
    $
    18,176
    
    
    $
    14,235
    
    
    $
    12,378Salaries and benefits
    
    
    60,298
    
    
    
    64,132
    
    
    
    53,374Billing fees
    
    
    9,589
    
    
    
    9,007
    
    
    
    7,951Medical advisory services
    
    
    1,989
    
    
    
    1,836
    
    
    
    1,499




---



##### Table of Contents



Item 8.
    
    Financial Statements and Supplementary Data  (continued)
 
 AmSurg Corp.
Notes to the Consolidated Financial Statements  (continued)
   12.
    
    Employee Benefit Programs
   13.
    
    Commitments and Contingencies
     
 53




---



##### Table of Contents



Item 8.
    
    Financial Statements and Supplementary Data  (continued)
 
 AmSurg Corp.
Notes to the Consolidated Financial Statements  (continued)
 14.
    
    Supplemental Cash Flow Information
  2009
    
    2008
    
    2007Cash paid during the year for:Interest
    
    $
    7,854
    
    
    $
    10,188
    
    
    $
    9,961Income taxes, net of refunds
    
    
    19,336
    
    
    
    19,297
    
    
    
    14,906Non-cash investing and financing activities:(Decrease) increase in accounts payable associated with acquisition of property
and equipment
    
    
    (1,892
    )
    
    
    2,098
    
    
    
    607Capital lease obligations incurred to acquire equipment
    
    
    148
    
    
    
    970
    
    
    
    746Notes received for sale of a partnership interest
    
    
    
    
    
    
    885
    
    
    
    Effect of acquisitions and related transactions:Assets acquired, net of cash and adjustments
    
    
    162,709
    
    
    
    134,512
    
    
    
    178,882Liabilities assumed and noncontrolling interests
    
    
    (66,883
    )
    
    
    (14,861
    )
    
    
    (16,105
    )Notes payable and other obligations
    
    
    
    
    
    
    (980
    )
    
    
    Payment for interests in surgery centers and related transactions
    
    $
    95,826
    
    
    $
    118,671
    
    
    $
    162,777
 15.
    
    Subsequent Events
  
 54




---



##### Table of Contents



Item 8.
    
    Financial Statements and Supplementary Data  (continued)
 
 AmSurg Corp.
Notes to the Consolidated Financial Statements  (continued)
 Quarterly Statement of Earnings Data (Unaudited)
  2008
    
    2009Q1
    
    Q2
    
    Q3
    
    Q4
    
    Q1
    
    Q2
    
    Q3
    
    Q4(In thousands, except per share data)Revenues
    
    $
    145,579
    
    
    $
    150,722
    
    
    $
    150,749
    
    
    $
    153,057
    
    
    $
    163,424
    
    
    $
    168,844
    
    
    $
    167,873
    
    
    $
    168,611Earnings from
continuing
operations before
income taxes
    
    
    48,311
    
    
    
    51,411
    
    
    
    50,257
    
    
    
    50,641
    
    
    
    52,853
    
    
    
    56,366
    
    
    
    54,856
    
    
    
    53,501Net earnings from
continuing
operations
    
    
    40,395
    
    
    
    43,017
    
    
    
    42,240
    
    
    
    41,867
    
    
    
    44,307
    
    
    
    47,001
    
    
    
    45,912
    
    
    
    44,669Net earnings (loss)
from discontinued
operations
    
    
    312
    
    
    
    (1,163
    )
    
    
    467
    
    
    
    (1,209
    )
    
    
    8
    
    
    
    (148
    )
    
    
    410
    
    
    
    (809
    )Net earnings
    
    
    40,707
    
    
    
    41,854
    
    
    
    42,707
    
    
    
    40,658
    
    
    
    44,315
    
    
    
    46,853
    
    
    
    46,322
    
    
    
    43,860Net earnings
attributable to
AmSurg Corp. common
shareholders:Continuing
    
    
    11,622
    
    
    
    12,444
    
    
    
    12,595
    
    
    
    12,880
    
    
    
    12,613
    
    
    
    13,798
    
    
    
    13,393
    
    
    
    12,984Discontinuing
    
    
    84
    
    
    
    (1,200
    )
    
    
    (211
    )
    
    
    (1,168
    )
    
    
    3
    
    
    
    (218
    )
    
    
    410
    
    
    
    (835
    )Net earnings
    
    $
    11,706
    
    
    $
    11,244
    
    
    $
    12,384
    
    
    $
    11,712
    
    
    $
    12,616
    
    
    $
    13,580
    
    
    $
    13,803
    
    
    $
    12,149Diluted net
earnings from
continuing
operations per
common share
    
    $
    0.37
    
    
    $
    0.39
    
    
    $
    0.39
    
    
    $
    0.41
    
    
    $
    0.40
    
    
    $
    0.45
    
    
    $
    0.44
    
    
    $
    0.42Diluted net
earnings per common
share
    
    $
    0.37
    
    
    $
    0.35
    
    
    $
    0.38
    
    
    $
    0.37
    
    
    $
    0.40
    
    
    $
    0.44
    
    
    $
    0.45
    
    
    $
    0.40
 
 55




---



##### Table of Contents



Item 9.
    
    Changes in and Disagreements with Accountants on Accounting and Financial Disclosure
  
 Item 9A.
    
    Controls and Procedures
 Managements Report on Internal Control Over Financial Reporting
    Internal Control  Integrated Framework
  /s/ Christopher A. HoldenChristopher A. HoldenPresident and Chief Executive Officer/s/ Claire M. GulmiClaire M. GulmiExecutive Vice President and Chief Financial Officer 
 56




---



##### Table of Contents



Item 9A.
    
    Controls and Procedures  (continued)
 
 Report of Independent Registered Public Accounting Firm
 
 Internal Control  Integrated Framework
    Internal Control
 Integrated Framework
 Business
Combinations, Consolidation, Income Taxes
  
 
 57




---



##### Table of Contents



Item 9A.
    
    Controls and Procedures  (continued)
 
 Evaluation of Disclosure Controls and Procedures
  Changes in Internal Control Over Financial Reporting
  
 Item 9B.
    
    Other Information
  
 Part III
 
 Item 10.
    
    Directors, Executive Officers and Corporate Governance
     
 Item 11.
    
    Executive Compensation
  
 Item 12.
    
    Security Ownership of Certain Beneficial Owners and Management and Related Stockholder Matters
  
 Item 13.
    
    Certain Relationships and Related Transactions, and Director Independence
   
 58




---



##### Table of Contents



Item 14.
    
    Principal Accounting Fees and Services
  
 Part IV
 
 Item 15.
    
    Exhibits and Financial Statement Schedules
  (1)
    
    Financial Statements:See Item 8 herein.(2)
    
    Financial Statement Schedules:
 Report of Independent Registered Public Accounting Firm
    
    
    S-1Schedule II  Valuation and Qualifying Accounts
    
    
    S-2(All other schedules are omitted because they are not applicable or
not required, or because the required information is included in the
consolidated financial statements or notes thereto.)
 (3)
    
    Exhibits:See the exhibit listing set forth below.
 
 59




---



##### Table of Contents



(3) Exhibits
 
 Exhibit
    
    
    
    Description3.1
    
    
    
    Second Amended and Restated Charter of AmSurg, as amended
(incorporated by reference to Exhibit 4.2 to the Quarterly
Report on Form 10-Q for the quarter ended June 30, 2004)3.2
    
    
    
    Second Amended and Restated Bylaws of AmSurg, as amended
(incorporated by reference to Exhibit 4.3 to the Quarterly
Report on Form 10-Q for the quarter ended June 30, 2004)4.1
    
    
    
    Specimen common stock certificate (incorporated by
reference to Exhibit 4.1 to the Registration Statement on
Form 10/A-4 (filed with the Commission on July 13, 2001))4.2
    
    
    
    Second Amended and Restated Rights Agreement, dated as of
July 12, 2001, between AmSurg and SunTrust Bank, Atlanta,
including the Form of Rights Certificate (Exhibit A) and
the Form of Summary of Rights (Exhibit B) (incorporated by
reference to Exhibit 1 to Amendment No. 2 to the
Registration Statement on Form 8-A/A (filed with the
Commission on July 13, 2001))4.3
    
    
    
    First Amendment to Second Amended and Restated Rights
Agreement, dated as of April 16, 2003, by and between
AmSurg and SunTrust Bank, Atlanta (incorporated by
reference to Exhibit 4 of the Quarterly Report on Form
10-Q for the quarter ended June 30, 2003)10.1
    
    *
    
    Form of Indemnification Agreement with directors,
executive officers and advisors (incorporated by reference
to Exhibit 10.3 to the Registration Statement on Form 10
(filed with the Commission on March 11, 1997))10.2
    
    
    
    Third Amended and Restated Revolving Credit Agreement,
dated as of July 28, 2006, among AmSurg, SunTrust Bank, as
Administrative Agent, and various banks and other
financial institutions (incorporated by reference to
Exhibit 99.1 of the Current Report on Form 8-K, dated
August 1, 2006)10.3
    
    
    
    First Amendment to Third Amended and Restated Revolving
Credit Agreement, dated as of October 29, 2007, by and
among AmSurg Corp., the several banks and other financial
institutions from time to time party thereto (the
Lenders), and SunTrust Bank, in its capacity as
Administrative Agent for the Lenders (incorporated by
reference to Exhibit 10.1 of the Current Report on Form
8-K, dated November 2, 2007)10.4
    
    *
    
    Amended and Restated 1997 Stock Incentive Plan
(incorporated by reference to Exhibit 4.1 to the Quarterly
Report on Form 10-Q for the quarter ended June 30, 2004)10.5
    
    *
    
    First Amendment to Amended and Restated 1997 Stock
Incentive Plan (incorporated by reference to Exhibit 99.2
to the Current Report on Form 8-K, dated November 21,
2006)10.6
    
    *
    
    Form of Non-Qualified Stock Option Agreement  1997
Incentive Plan (incorporated by reference to Exhibit 99.1
to the Current Report on Form 8-K, dated February 2, 2005)10.7
    
    *
    
    Form of Restricted Stock Agreement for Non-Employee
Directors  1997 Incentive Plan (incorporated by
reference to Exhibit 10.1 to the Current Report on Form
8-K, dated May 24, 2005)10.8
    
    
    
    Lease Agreement dated February 24, 1999 between Burton
Hills III, LLC and AmSurg (incorporated by reference to
Exhibit 10.1 of the Quarterly Report on Form 10-Q for the
quarter ended June 30, 1999)10.9
    
    
    
    First Amendment to Lease Agreement dated June 27, 2001 by
and between Burton Hills III, LLC and AmSurg (incorporated
by reference to Exhibit 10 of the Quarterly Report on Form
10-Q for the quarter ended
September 30, 2002)10.10
    
    
    
    Second Amendment to Lease Agreement dated January 31, 2003
by and between Burton Hills III Partnership and AmSurg
(incorporated by reference to Exhibit 10.14 to the Annual
Report on Form 10-K for the year ended December 31, 2003)10.11
    
    
    
    Third Amendment to Lease Agreement dated September 1, 2003
by and between Burton Hills III Partnership and AmSurg
(incorporated by reference to Exhibit 10.15 to the Annual
Report on Form 10-K for the year ended December 31, 2003)10.12
    
    
    
    Fourth Amendment to Lease Agreement dated October 31, 2003
by and between Burton Hills III Partnership and AmSurg
(incorporated by reference to Exhibit 10.16 to the Annual
Report on Form 10-K for the year ended December 31, 2003)
 
 60




---



##### Table of Contents



(3) Exhibits  (continued)
 
 Exhibit
    
    
    
    Description10.13
    
    *
    
    Amended and Restated Supplemental Executive Retirement Savings
Plan, as amended (Restated for SEC electronic purposes only and
incorpated by reference to Exhibit 10.14 to the Annual Report on
Form 10-K for the year ended December 31, 2008)10.14
    
    *
    
    AmSurg Corp. 2006 Stock Incentive Plan, as amended (incorporated
by reference to Exhibit 10.1 to the Quarterly Report on Form
10-Q for the quarter ended
September 30, 2009)10.15
    
    *
    
    Form of Restricted Share Award Agreement for Non-Employee
Directors  2006 Incentive Plan (incorporated by reference to
Exhibit 99.3 to the Current Report on Form 8-K, dated February 21,
2007)10.16
    
    *
    
    Form of Non-Qualified Stock Option Agreement for Executive
Officers  2006 Incentive Plan (incorporated by reference to
Exhibit 99.1 to the Current Report on Form 8-K, dated February 21,
2007)10.17
    
    *
    
    Form of Restricted Share Award for Employees  2006 Incentive Plan10.18
    
    *
    
    Restricted Share Award Agreement, dated February 21, 2008, between
the Company and Ken P. McDonald (incorporated by reference to
Exhibit 10.20 to the Annual Report on Form 10-K for the year ended
December 31, 2007)10.19
    
    *
    
    Non-Qualified Stock Option Agreement, dated February 21, 2008,
between the Company and Ken P. McDonald (incorporated by reference
to Exhibit 10.21 to the Annual Report on Form 10-K for the year
ended December 31, 2007)10.20
    
    *
    
    AmSurg Corp. Long-Term Care Plan (incorporated by reference to
Exhibit 10.2 to the Quarterly Report on Form 10-Q for the quarter
ended June 30, 2005)10.21
    
    *
    
    Amended and Restated Employment Agreement, dated January 30, 2009,
between AmSurg and Christopher A. Holden (incorporated by
reference to Exhibit 99.1 to the Current Report on Form 8-K, dated
February 5, 2009)10.22
    
    *
    
    Second Amended and Restated Employment Agreement, dated January
30, 2009, between AmSurg and Claire M. Gulmi (incorporated by
reference to Exhibit 99.2 to the Current Report on Form 8-K, dated
February 5, 2009)10.23
    
    *
    
    Second Amended and Restated Employment Agreement, dated January
30, 2009, between AmSurg and David L. Manning (incorporated by
reference to Exhibit 99.3 to the Current Report on Form 8-K, dated
February 5, 2009)10.24
    
    *
    
    Amended and Restated Employment Agreement, dated February 7, 2008,
between AmSurg and Royce D. Harrell (incorporated by reference to
Exhibit 99.5 to the Current Report on Form 8-K, dated February 13,
2008)10.25
    
    *
    
    Second Amended and Restated Employment Agreement, dated January
30, 2009, between AmSurg and Billie A. Payne (incorporated by
reference to Exhibit 99.4 to the Current Report on Form 8-K, dated
February 5, 2009)10.26
    
    *
    
    Employment Agreement, dated January 30, 2009, between AmSurg and
Kevin D. Eastridge (incorporated by reference to Exhibit 99.5 to
the Current Report on Form 8-K, dated February 5, 2009)10.27
    
    *
    
    Employment Agreement, dated March 23, 2009, between AmSurg and
Phillip A. Clendenin (incorporated by reference to Exhibit 99.1 to
the Current Report on Form 8-K, dated March 27, 2009)10.28
    
    
    
    Schedule of Non-employee Director Compensation21.1
    
    
    
    Subsidiaries of AmSurg23.1
    
    
    
    Consent of Independent Registered Public Accounting Firm24.1
    
    
    
    Power of Attorney (appears on page 59)31.1
    
    
    
    Certification of Chief Executive Officer pursuant to Rule 13a-14(a)31.2
    
    
    
    Certification of Chief Financial Officer pursuant to Rule 13a-14(a)32.1
    
    
    
    Section 1350 Certifications
 
 *
    
    Management contract or compensatory plan, contract or arrangement 
 61




---



##### Table of Contents



Signatures
  AMSURG CORP.February 25, 2010
    By:
    /s/  Christopher A. HoldenChristopher A. Holden(President and Chief Executive Officer)   Signature
    
    Title
    
    Date/s/ Christopher A. Holden

  Christopher A. Holden
    
    President, Chief
Executive Officer and
Director (Principal
Executive Officer)
    
    February 25, 2010/s/ Claire M. Gulmi

  Claire M. Gulmi
    
    Executive Vice
President, Chief
Financial Officer,

Secretary and Director
(Principal Financial
and Accounting Officer)
    
    February 25, 2010/s/ Steven I. Geringer
    
    Chairman of the Board
    
    February 25, 2010Steven I. Geringer/s/ Thomas G. Cigarran
    
    Director
    
    February 25, 2010Thomas G. Cigarran/s/ James A. Deal
    
    Director
    
    February 25, 2010James A. Deal/s/ Debora A. Guthrie
    
    Director
    
    February 25, 2010Debora A. Guthrie/s/ Henry D. Herr
    
    Director
    
    February 25, 2010Henry D. Herr/s/ Kevin P. Lavender
    
    Director
    
    February 25, 2010Kevin P. Lavender/s/ Ken P. McDonald
    
    Director
    
    February 25, 2010Ken P. McDonald/s/ John W. Popp, Jr., M.D.
    
    Director
    
    February 25, 2010John W. Popp, Jr., M.D.
 
 62




---



##### Table of Contents



REPORT OF INDEPENDENT REGISTERED PUBLIC ACCOUNTING FIRM
 
  Business Combinations, Consolidation, Income Taxes
  
 
 S-1




---



##### Table of Contents



AmSurg Corp.
Schedule II  Valuation and Qualifying Accounts
For the Years Ended December 31, 2009, 2008 and 2007
(In thousands
 Additions
    
    DeductionsBalance at
    
    Charged to
    
    Charged to
    
    Charge-off
    
    BalanceBeginning
    
    Cost and
    
    Other
    
    Against
    
    at End ofof Period
    
    Expenses
    
    Accounts (1)
    
    Allowances
    
    PeriodAllowance for uncollectible
accounts included under the
balance sheet caption Accounts
receivable:Year ended December 31, 2009
    
    $
    11,757
    
    
    $
    16,844
    
    
    $
    1,359
    
    
    $
    (17,585
    )
    
    $
    12,375Year ended December 31, 2008
    
    $
    8,310
    
    
    $
    17,169
    
    
    $
    2,401
    
    
    $
    (16,123
    )
    
    $
    11,757Year ended December 31, 2007
    
    $
    6,628
    
    
    $
    14,286
    
    
    $
    1,885
    
    
    $
    (14,489
    )
    
    $
    8,310
 
 (1)
    
    Valuation of allowance for uncollectible accounts as of the acquisition date of physician
practice-based surgery centers, net of dispositions. See Item 8 Financial Statements and
Supplementary Data  Notes to the Consolidated Financial Statements  Note 2. 
 S-2