Medical Office CMBS Loans6.5% – 7.75% Non-Recourse 10-Year Fixed · $3M to $100M+
PeerSense structures medical office CMBS conduit financing from $5M to $100M — 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?
PeerSense places medical office CMBS at roughly 6.5%–7.75% non-recourse 10-year fixed in July 2026, at the 60–65% LTV gold-standard lane with 1.25x–1.35x DSCR and debt yields clearing 9%–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) | 65–70% | 1.25x | 10-yr fixed | 30-yr (2–5 IO) | 6.5% – 7.0% | Non-recourse |
| On-Campus / Hospital-Adjacent Multi-Tenant | 65–70% | 1.25x | 10-yr fixed | 30-yr (2–4 IO) | 6.6% – 7.2% | Non-recourse |
| Off-Campus Multi-Tenant Physician Building | 60–68% | 1.30x | 10-yr fixed | 30-yr (2–3 IO) | 6.85% – 7.5% | Non-recourse |
| ASC-Anchored Building (Credit Operator) | 60–65% | 1.30x | 10-yr fixed | 30-yr (1–3 IO) | 6.9% – 7.6% | Non-recourse |
| Single-Tenant Specialty (Imaging / Oncology) | 60–65% | 1.30x | 10-yr fixed | 30-yr (1–3 IO) | 6.8% – 7.6% | Non-recourse |
| Rollover-Heavy Building (Staggered WALT) | 58–65% | 1.35x | 10-yr fixed | 30-yr (1–2 IO) | 7.1% – 7.75% | Non-recourse |
| MOB Portfolio (2+ Buildings) | 65–70% | 1.25x | 10-yr fixed | 30-yr (2–5 IO) | 6.6% – 7.3% | Non-recourse |
| Cash-Out Refinance (Stabilized) | 60–65% | 1.30x | 10-yr fixed | 30-yr (2–3 IO) | 6.6% – 7.5% | Non-recourse |
Health-System-Anchored (Long WALT)6.5% – 7.0% · 65–70% LTV
- Max LTV
- 65–70%
- Min DSCR
- 1.25x
- Term
- 10-yr fixed
- Amortization
- 30-yr (2–5 IO)
- Rate Range
- 6.5% – 7.0%
- Recourse
- Non-recourse
On-Campus / Hospital-Adjacent Multi-Tenant6.6% – 7.2% · 65–70% LTV
- Max LTV
- 65–70%
- Min DSCR
- 1.25x
- Term
- 10-yr fixed
- Amortization
- 30-yr (2–4 IO)
- Rate Range
- 6.6% – 7.2%
- Recourse
- Non-recourse
Off-Campus Multi-Tenant Physician Building6.85% – 7.5% · 60–68% LTV
- Max LTV
- 60–68%
- Min DSCR
- 1.30x
- Term
- 10-yr fixed
- Amortization
- 30-yr (2–3 IO)
- Rate Range
- 6.85% – 7.5%
- Recourse
- Non-recourse
ASC-Anchored Building (Credit Operator)6.9% – 7.6% · 60–65% LTV
- Max LTV
- 60–65%
- Min DSCR
- 1.30x
- Term
- 10-yr fixed
- Amortization
- 30-yr (1–3 IO)
- Rate Range
- 6.9% – 7.6%
- Recourse
- Non-recourse
Single-Tenant Specialty (Imaging / Oncology)6.8% – 7.6% · 60–65% LTV
- Max LTV
- 60–65%
- Min DSCR
- 1.30x
- Term
- 10-yr fixed
- Amortization
- 30-yr (1–3 IO)
- Rate Range
- 6.8% – 7.6%
- Recourse
- Non-recourse
Rollover-Heavy Building (Staggered WALT)7.1% – 7.75% · 58–65% LTV
- Max LTV
- 58–65%
- Min DSCR
- 1.35x
- Term
- 10-yr fixed
- Amortization
- 30-yr (1–2 IO)
- Rate Range
- 7.1% – 7.75%
- Recourse
- Non-recourse
MOB Portfolio (2+ Buildings)6.6% – 7.3% · 65–70% LTV
- Max LTV
- 65–70%
- Min DSCR
- 1.25x
- Term
- 10-yr fixed
- Amortization
- 30-yr (2–5 IO)
- Rate Range
- 6.6% – 7.3%
- Recourse
- Non-recourse
Cash-Out Refinance (Stabilized)6.6% – 7.5% · 60–65% LTV
- Max LTV
- 60–65%
- Min DSCR
- 1.30x
- Term
- 10-yr fixed
- Amortization
- 30-yr (2–3 IO)
- Rate Range
- 6.6% – 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 does not lend and does not set 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 July 21, 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 does not lend and does not set pricing. What these terms mean.
Why Conduits Treat Medical Office as Healthcare, Not Office
The office repricing did not spare the word 'office' — but 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 consuming more outpatient care every year — and 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 — as 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 — but 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 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%–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 65–70% 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 60–65% 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%–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%–70% maximum, with the 60–65% 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–1.35x on trailing NOI — 1.25x for health-system-anchored buildings — with debt yields generally clearing 9%–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 60–65% LTV. Majority owner-occupied practice buildings route instead to SBA 504, which PeerSense pre-screens.
Deals We Structure
Representative deal profiles showing our typical financing structures and terms.
$12M Hilton-Flag Hotel, Charlotte, NC
6.75% fixed | 65% LTV | 52-day close
$8M Value-Add Multifamily, Tampa, FL
SOFR +395 | 75% LTC | 14-day close
$6.5M Mixed-Use Development, Austin, TX
80% LTC | Interest-only | 18-mo term
$2.8M QSR Franchise (3 Units) Indianapolis, IN
Prime +2.75% | 25-yr term | 10% down
$3.2M/mo Manufacturing AR, Cleveland, OH
1.5% factor fee | 90% advance | 48-hr funding
$1.8M 6-Unit Rental Portfolio, Phoenix, AZ
7.25% | 75% LTV | No income docs | 1.25x DSCR
Indicative only, as of July 21, 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 does not lend and does not set pricing. What these terms mean.
Tell Us About Your Medical Office CMBS Deal
Property address, purchase price or payoff, trailing-12 NOI, occupancy, WALT, and exit plan. We'll return a CMBS spread indication and conduit shortlist within 48 hours.
Medical Office CMBS Loan: Response within 24–48 hours. 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 within 48 hours.
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 is a capital advisory firm, not a lender. We do not originate, fund, or service loans. 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.