Ambulatory surgery center operator AmSurg has renegotiated several of its bank covenants to permit it to invest “in foreign subsidiaries,” setting the stage for the company to grow beyond the United States.

In a June 29 filing with the Securities and Exchange Commission, the Nashville-based concern also said it has renegotiated some loan terms, resulting in greater borrowing capacity and significantly lower interest costs.

It’s unclear exactly what AmSurg has in mind regarding the scope and direction of its global growth push. The company has alluded to this possibility since at least 2010 when, in a conference call, company CFO Claire Gulmi said AmSurg intended to expand internationally. Gulmi wasn’t available immediately for comment Monday.

AmSurg last week renegotiated its debt with several — but not all — of its lenders, according to the SEC filing. The results are significant. Loan maturity dates have been extended to 2017, $25 million has been added to the company’s borrowing capacity — setting the limit at $475 million — and an approximate 50-basis point (one-half of one percent) reduction in loan rates were agreed to.

AmSurg shares (Ticker: AMSG) are down slightly in Monday trading. Year to date, they've risen about 15 percent.