<Page> Exhibit 12.1 UNITED SURGICAL PARTNERS INTERNATIONAL, INC. STATEMENT RE: COMPUTATION OF RATIO OF EARNINGS TO FIXED CHARGES (Dollars in thousands) <Table> <Caption> Pro Forma As Adjusted -------------------------- Nine Months Nine Months Ended Year Ended Ended Year ended September 30, December 31, September 30, ---------------------------- ----------------- ------------ ------------- 1998 1999 2000 2000 2001 2000 2001 -------- -------- -------- --------- ------- ------------ ------------- Income (loss) from continuing operations before income taxes $(4,229) $(6,393) $(7,093) $(3,278) $ 5,234 $(14,213) $ 3,038 Less: Equity in (earnings) loss of unconsolidated affiliates 40 236 (844) (487) (4,134) (2,174) (5,218) Minority interest in income (loss) of consolidated subsidiaries (23) 118 2,332 1,179 5,175 2,373 5,258 Add: Cash distributions received from unconsolidated affiliates - 506 2,387 2,192 2,871 2,387 2,871 Interest component of rent expense 147 496 1,140 934 1,232 1,250 1,253 Interest, net of capitalized portion 497 3,144 11,986 8,382 13,235 21,878 17,195 Amortization of discounts and capitalized debt issue costs - - 645 504 1,126 669 502 -------- -------- -------- --------- ------- ------------ ------------- Income (loss), as adjusted (3,568) (1,893) 10,553 9,426 24,739 12,170 24,899 -------- -------- -------- --------- ------- ------------ ------------- Fixed charges: Interest component of rent expense 147 496 1,140 934 1,232 1,250 1,253 Interest expense, net of capitalized portion 497 3,144 11,986 8,382 13,235 21,878 17,195 Capitalized interest - - 219 - 302 219 302 Amortization of discounts and capitalized debt issue costs - - 645 504 1,126 669 502 Preferred stock dividends(1) 428 1,696 5,971 5,018 2,251 2,894 - -------- -------- -------- --------- ------- ------------ ------------- Total fixed charges 1,072 5,336 19,961 14,838 18,146 26,910 19,252 -------- -------- -------- --------- ------- ------------ ------------- Ratio of earnings to fixed charges 1.36x 1.29x Fixed charge coverage deficiency 4,640 7,229 9,408 5,412 n/a 14,740 n/a </Table> (1) Preferred stock dividends are not reflected net of an effective tax rate in the above table as the Company's consolidated U.S. operations, which operations would bear the repayment of those dividends, generated or benefited from net operating losses for the periods reflected above. Had the Company used its consolidated effective tax rate of approximately 24% for the nine months ended September 30, 2001, the ratio of earnings to fixed charges would have been 1.32x.