Though its loss narrowed in the fourth quarter of 2009, surgery center operator Symbion spent another quarter in the red and saw its annual loss worsen by 8 percent.

The Nashville-based company saw revenues climb 3 percent to $87.4 million in Q4 and its net loss shrink to $4.5 million from $15.8 million in late 2008.

For the full year, revenues improved 4.5 percent to $347 million. However, operating expenses grew as a percent of revenue, and the impact of its surgical hospital acquisition in Austin, Texas, took a 1.3 percent chunk out of its margin.

Total net loss for the year grew about 8 percent to $22.5 million.

At the end of 2009, Symbion owned and operated 59 surgery centers. Including those it manages but doesn’t own, the total was 67.