US Ultrasound Market: Utilization Economics, Fleet Replacement, and the AI Layer, 2024A-2035E

This report assesses the US ultrasound market from 2024A through 2035E, drawing on the Global Ultrasound Horizon model and developments through September 2026, with a Canada sidebar. Our view is that utilization economics, not device specifications alone, will decide the next phase: providers need more usable examinations per staffed session, and vendors need to keep accounts across hardware generations.

Key Questions Answered

• How should value be measured when the economic unit is the completed examination?
• What does the shift to compact and handheld formats mean for revenue, fleet mix and lifecycle service?
• Where can ultrasound AI earn recurring payment?
• How do the CY2027 Medicare proposals and trade actions change procurement?

Market Snapshot

The core ecosystem combines systems, service and aftermarket, and core AI recurring revenue across five hardware segments. Shipments outpace systems revenue as lower-priced formats broaden the installed base. Core AI recurring revenue grows fastest, yet hardware still supplies most incremental revenue through 2035.

Key Market Trends

1. Compact consoles become the scale engine. They become the largest systems revenue segment while holding monetization quality.
2. Handheld/POCUS leads volume. It becomes the largest shipment category as use spreads into emergency departments, ICUs, wards and offices.
3. Purchasing diversifies. Managed service, subscription and pay-per-use models outgrow capital purchase, putting upgrade rights and data-export terms into the buying decision.
4. Policy rewards operational proof. Lower proposed conversion factors and the interim Software as a Medical Service approach favor offers built on measurable workflow value over an assumed AI fee.

Competitive Structure

GE HealthCare and Philips are assessed as premium, workflow-oriented incumbents, FUJIFILM Sonosite as a bedside and procedural specialist, and Mindray as a price-performance challenger. Butterfly Network and Clarius represent handheld platforms. AI specialists such as Us2.ai and Koios Medical are reviewed by route to scale, and recent clearances from ThinkSono, RadNet/DeepHealth and ROPCA are treated as evidence milestones.

What's Inside

Market model: Revenue, shipments and installed base by hardware segment, 2024A-2035E.

Frameworks: The US Growth-Engine Matrix and an ARC-Index read across seven AI capabilities, plus the AI value-pool bridge.

Policy and trade: CY2027 fee schedule and OPPS proposals, service-specific coding, and Section 301 and 232 interaction.

Structure views and outlook: Purchase-model, end-market, application and operating-model allocations, signals to watch over 12-24 months, and implications by stakeholder.

Who Should Read This Report

• Ultrasound OEM strategy and product leaders
• Software and AI vendors planning US commercialization
• Investors and corporate development teams assessing ultrasound or imaging AI assets
• Hospital, IDN and outpatient leaders planning fleet replacement or point-of-care programs
• Consultants advising on imaging procurement

Why This Report

The report keeps AI value pools, purchasing models and end markets as reconciled views of one revenue base rather than separate markets to add together. It separates company-reported clearances from measured adoption and turns policy proposals into commercial tests.