Medical Office CMBS Loans6.5% to 7.75% Non Recourse 10 Year Fixed · $10 million and up
Talk to PeerSense. The capital source sets the terms. This includes health system anchored buildings, multi tenant physician assets, on campus and off campus MOB. Medical office is the office subtype conduits still want: clinical tenancy is sticky, demand is demographic, and the credit history has held while commodity office widened out. We position the tenancy evidence so the file prices as healthcare, not as office.
Health system anchored · multi tenant physician buildings · on campus and hospital adjacent · ambulatory surgery anchored · single asset and portfolio.
Last updated: ·By Ed Freeman, Capital Advisor. PeerSense
What are typical medical office CMBS rates in 2026?
Talk to PeerSense. The capital source sets the terms.5% to 7.75% non recourse 10 year fixed in July 2026, at the 60 to 65% LTV gold standard lane with 1.25x to 1.35x DSCR and debt yields clearing 9% to 10%. Health system anchored buildings with long weighted average lease terms price at the tight end; off campus multi tenant physician buildings with rollover price at the wide end. MOB prices materially inside commodity office CMBS because clinical build out makes tenants expensive to move, outpatient demand is demographic, and conduits that have closed to generic office still quote medical office weekly.
Published by PeerSense Capital Advisory · Written by Ed Freeman, Founder. Updated July 2026.
Medical Office CMBS Underwriting Matrix, Rate, LTV, DSCR by Deal Profile
CMBS conduits price medical office deals based on a tight underwriting grid: property class, sponsor credit, tenant concentration (single-tenant vs. multi-tenant), DSCR, and lease term. Pick your deal profile for typical CMBS spread pricing.
| Property Type | Max LTV | Min DSCR | Term | Amortization | Rate Range | Recourse |
|---|---|---|---|---|---|---|
| Health System Anchored (Long WALT) | 65 to 70% | 1.25x | 10-yr fixed | 30 yr (2 to 5 IO) | 6.5% to 7.0% | Non recourse |
| On Campus / Hospital Adjacent Multi Tenant | 65 to 70% | 1.25x | 10-yr fixed | 30 yr (2 to 4 IO) | 6.6% to 7.2% | Non recourse |
| Off Campus Multi Tenant Physician Building | 60 to 68% | 1.30x | 10-yr fixed | 30 yr (2 to 3 IO) | 6.85% to 7.5% | Non recourse |
| ASC Anchored Building (Credit Operator) | 60 to 65% | 1.30x | 10-yr fixed | 30 yr (1 to 3 IO) | 6.9% to 7.6% | Non recourse |
| Single Tenant Specialty (Imaging / Oncology) | 60 to 65% | 1.30x | 10-yr fixed | 30 yr (1 to 3 IO) | 6.8% to 7.6% | Non recourse |
| Rollover Heavy Building (Staggered WALT) | 58 to 65% | 1.35x | 10-yr fixed | 30 yr (1 to 2 IO) | 7.1% to 7.75% | Non recourse |
| MOB Portfolio (2+ Buildings) | 65 to 70% | 1.25x | 10-yr fixed | 30 yr (2 to 5 IO) | 6.6% to 7.3% | Non recourse |
| Cash Out Refinance (Stabilized) | 60 to 65% | 1.30x | 10-yr fixed | 30 yr (2 to 3 IO) | 6.6% to 7.5% | Non recourse |
Health System Anchored (Long WALT)6.5% to 7.0% · 65 to 70% LTV
- Max LTV
- 65 to 70%
- Min DSCR
- 1.25x
- Term
- 10-yr fixed
- Amortization
- 30 yr (2 to 5 IO)
- Rate Range
- 6.5% to 7.0%
- Recourse
- Non recourse
On Campus / Hospital Adjacent Multi Tenant6.6% to 7.2% · 65 to 70% LTV
- Max LTV
- 65 to 70%
- Min DSCR
- 1.25x
- Term
- 10-yr fixed
- Amortization
- 30 yr (2 to 4 IO)
- Rate Range
- 6.6% to 7.2%
- Recourse
- Non recourse
Off Campus Multi Tenant Physician Building6.85% to 7.5% · 60 to 68% LTV
- Max LTV
- 60 to 68%
- Min DSCR
- 1.30x
- Term
- 10-yr fixed
- Amortization
- 30 yr (2 to 3 IO)
- Rate Range
- 6.85% to 7.5%
- Recourse
- Non recourse
ASC Anchored Building (Credit Operator)6.9% to 7.6% · 60 to 65% LTV
- Max LTV
- 60 to 65%
- Min DSCR
- 1.30x
- Term
- 10-yr fixed
- Amortization
- 30 yr (1 to 3 IO)
- Rate Range
- 6.9% to 7.6%
- Recourse
- Non recourse
Single Tenant Specialty (Imaging / Oncology)6.8% to 7.6% · 60 to 65% LTV
- Max LTV
- 60 to 65%
- Min DSCR
- 1.30x
- Term
- 10-yr fixed
- Amortization
- 30 yr (1 to 3 IO)
- Rate Range
- 6.8% to 7.6%
- Recourse
- Non recourse
Rollover Heavy Building (Staggered WALT)7.1% to 7.75% · 58 to 65% LTV
- Max LTV
- 58 to 65%
- Min DSCR
- 1.35x
- Term
- 10-yr fixed
- Amortization
- 30 yr (1 to 2 IO)
- Rate Range
- 7.1% to 7.75%
- Recourse
- Non recourse
MOB Portfolio (2+ Buildings)6.6% to 7.3% · 65 to 70% LTV
- Max LTV
- 65 to 70%
- Min DSCR
- 1.25x
- Term
- 10-yr fixed
- Amortization
- 30 yr (2 to 5 IO)
- Rate Range
- 6.6% to 7.3%
- Recourse
- Non recourse
Cash Out Refinance (Stabilized)6.6% to 7.5% · 60 to 65% LTV
- Max LTV
- 60 to 65%
- Min DSCR
- 1.30x
- Term
- 10-yr fixed
- Amortization
- 30 yr (2 to 3 IO)
- Rate Range
- 6.6% to 7.5%
- Recourse
- Non recourse
Indicative only, as of May 2026. Not a quote, commitment or offer of credit. Final pricing, leverage and terms are determined by the lender at underwriting, after full transaction materials are reviewed. PeerSense sources the file. The lender sets pricing. What these terms mean.
Indicative ranges as of May 2026. Individual deal pricing depends on LTV, DSCR, property type, tenant credit, sponsor track record, and market spreads at the time of rate lock. Contact PeerSense for a deal specific indication.
Indicative only, as of October 1, 2026. Not a quote, commitment or offer of credit. Final pricing, leverage and terms are determined by the lender at underwriting, after full transaction materials are reviewed. PeerSense sources the file. The lender sets pricing. What these terms mean.
Why Conduits Treat Medical Office as Healthcare, Not Office
The office repricing did not spare the word 'office'. Yet it largely spared the asset class that happens to share it. Medical office tenancy is anchored by clinical build out that costs multiples of standard office TI: exam room plumbing, imaging shielding, med gas, licensed and credentialed locations. Tenants renew because moving is operationally and financially painful. Demand comes from demographics. An aging population consumes more outpatient care every year. Demand also comes from the structural migration of procedures out of hospitals into ambulatory settings. The result: MOB credit performance held while commodity office deteriorated, and the conduit market's appetite followed the performance. The underwriting work is proving your building deserves the healthcare treatment. That is the file PeerSense builds.
WALT and Tenant Credit Carry the File
Weighted average lease term and the credit behind it are the two numbers a conduit reads first. A rated health system on long paper underwrites close to credit tenant quality and lifts the whole building; granular physician suites are credited on retention history and practice durability. We present suite level renewal evidence. Clinical tenants renew at structurally high rates. This is a core exhibit rather than a footnote.
Clinical TI/LC Is Priced Honestly
Clinical space re tenants at higher TI cost than commodity office, and conduit stress tests apply those costs to the rollover schedule. Files that pre reserve honestly for clinical TI keep proceeds at committee; files that assume office standard costs get cut. Structuring rollover reserves correctly up front is cheaper than a retrade in week six.
Campus Proximity Is a Spread Line
On campus and hospital adjacent buildings carry the deepest appetite and tightest spreads because the campus anchors referral driven tenancy. Off campus MOB finances well. The ambulatory shift is pushing care into community settings. The file must prove submarket clinical re leasing depth. We position each asset on the right side of that line rather than letting the underwriter guess.
The Alternative Executions Are Real
Not every medical building belongs in conduit. Single tenant health system buildings can access credit tenant lease style executions; majority owner occupied practice real estate belongs in SBA 504 at long amortization; heavy operating exposure (surgical hospitals, inpatient behavioral) belongs with specialist healthcare credit. PeerSense routes each file to the execution that actually wins. Conduit applies when conduit is best.
Medical Office CMBS Deal Types We Structure
Health System Anchored Refinance
Your building is anchored by a rated health system on long term leases and the existing loan matures. CMBS locks 10 year fixed non recourse at 6.5% to 7.0% at the gold standard lane, with cash out where basis supports it.
On Campus MOB Acquisition
You're acquiring a stabilized on campus MOB from an institutional seller. Conduit execution at 65 to 70% LTV with interest only years, underwritten to the campus anchored rent roll.
Bridge to CMBS Stabilization Exit
You re tenanted a physician building toward health system credit on bridge debt (see /bridge-loans/medical-office). Once the rent roll seasons, CMBS locks the stabilized basis into long term non recourse debt.
ASC Anchored Building Financing
Your building is anchored by an ambulatory surgery center under a health system affiliated operator. CMBS finances the stabilized asset with the ASC lease underwritten to facility level rent coverage.
Cash Out on Long Held MOB
Your long held medical building has appreciated with the sector. Cash out CMBS refinance at 60 to 65% LTV pulls equity for the next acquisition while fixing 10 year non recourse debt on the existing asset.
Medical Office CMBS Loans, Frequently Asked Questions
What are typical medical office CMBS rates in 2026?+
Roughly 6.5% to 7.75% non recourse 10 year fixed in July 2026. Health system anchored buildings with long weighted average lease terms price at the tight end; stabilized multi tenant physician buildings in the middle; off campus assets with rollover at the wide end. MOB prices materially inside commodity office CMBS.
What LTV can I get on a medical office CMBS loan?+
Typically 65% to 70% maximum, with the 60 to 65% lane earning the tightest pricing. Health system credit, long remaining lease term, and on campus locations support the top of the band. Cash out refinances size about 5 points inside acquisition leverage.
Why does medical office price inside regular office CMBS?+
Clinical build out makes tenants expensive to move (renewals are structurally higher), outpatient demand is demographic rather than cyclical, and MOB credit performance held while commodity office deteriorated. Conduits that have closed to generic office still quote medical office weekly.
How is health system credit treated in underwriting?+
A rated health system on a long lease is underwritten close to credit tenant paper. Its rated debt informs the credit view, and its presence lifts the underwriting of smaller physician suites in the same building. Buildings without system credit lean on tenant diversity and suite level retention history.
Does on campus versus off campus matter?+
Yes. On campus and hospital adjacent buildings carry the deepest appetite and tightest spreads. Off campus MOB is very financeable, but underwriting leans harder on lease term, tenant credit, and the submarket's clinical re leasing depth.
What DSCR and debt yield does MOB CMBS require?+
Minimum DSCR typically 1.25x to 1.35x on trailing NOI. The requirement is 1.25x for health system anchored buildings. Debt yields generally clear 9% to 10%. Stress tests apply clinical level TI/LC costs to the rollover schedule, which are higher than office standard.
Can an ambulatory surgery center building get CMBS financing?+
Yes, when the lease is to a creditworthy operator or health system affiliated joint venture with sustainable facility level rent coverage. Heavier operating exposure moves the deal toward specialist healthcare credit rather than conduit execution.
Is medical office CMBS non recourse, and can I take cash out?+
Yes on both. Non recourse with standard bad boy carve outs, and cash out is standard for long held stabilized buildings, typically at 60 to 65% LTV. Majority owner occupied practice buildings route instead to SBA 504, which PeerSense pre screens.
Deals We Structure
Originators, factoring, CMBS, and bridge. Sizes and structures only. No counterparties named. PeerSense sources capital through a curated network of commercial lenders and capital sources.
Focus is 100 million a month. The desk will look at 10 million a month.
Tape first. 10 million is not the focus.
$20 million a month B2B invoices
Advance on the account debtor. Annual receivables is not facility size.
$10 million and up flagged hotel, CMBS refi
Cash in about 35 percent. Named takeout.
$10 million and up value add multifamily bridge
Named takeout first. Close follows the book.
Hyperscaler lease. Owner keeps the facility.
Up to 89 percent of contracted lease value. Do not name the source.
Revolving line against eligible originator receivables
Advance rates are set facility by facility by asset class. Often paired with a flow takeout.
Indicative only, as of October 1, 2026. Not a quote, commitment or offer of credit. Final pricing, leverage and terms are determined by the lender at underwriting, after full transaction materials are reviewed. PeerSense sources the file. The lender sets pricing. What these terms mean.
Talk to PeerSense
Property address, purchase price or payoff, trailing 12 NOI, occupancy, WALT, and exit plan. We'll return a CMBS spread indication and conduit shortlist.
Medical Office CMBS Loan: The desk will reach out. No obligation.
Ready to Lock Your Medical Office CMBS Rate?
Send us the property address, purchase price (or payoff balance), trailing 12 NOI, rent roll, and exit plan. We'll return a CMBS spread indication and conduit shortlist. Public floor is $10 million and up. Cash in about 35 percent.
Fee at closing only · Complimentary initial consultation
Published by PeerSense Capital Advisory · Written by Ed Freeman, Founder. Updated May 2026.
Disclaimer: Medical Office CMBS conduit rates, terms, and availability are subject to change based on property condition, sponsor qualifications, tenant concentration, market conditions, securitization schedule, and rating agency reviews. Rate ranges quoted reflect approximate May 2026 10 year fixed CMBS conduit pricing and may not reflect current market conditions at the time of reading. CMBS loans carry defeasance or yield maintenance prepayment structures, review the prepayment schedule carefully before closing. PeerSense sources capital through a curated network of commercial lenders and capital sources. All financing is provided by third party CMBS conduit lenders subject to their own underwriting criteria, rating agency review, and securitization timelines. Borrowers should consult qualified financial and legal professionals before making any financing decisions.