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      STATES</strong></font></div>
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      AND EXCHANGE COMMISSION</strong></font></div>
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      D.C. 20549</strong></font></div>
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                8-K</strong></font></div>
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    <div style="DISPLAY: block; MARGIN-LEFT: 0pt; TEXT-INDENT: 0pt; LINE-HEIGHT: 1.25; MARGIN-RIGHT: 0pt" align="center"><font style="DISPLAY: inline; FONT-SIZE: 10pt; FONT-FAMILY: Times New Roman"><strong>CURRENT
      REPORT</strong></font></div>
    <div style="DISPLAY: block; MARGIN-LEFT: 0pt; TEXT-INDENT: 0pt; LINE-HEIGHT: 1.25; MARGIN-RIGHT: 0pt" align="center"><font style="DISPLAY: inline; FONT-SIZE: 10pt; FONT-FAMILY: Times New Roman"><strong>PURSUANT
      TO SECTION 13 OR 15(D) OF THE SECURITIES EXCHANGE ACT OF
      1934</strong></font></div>
    <div style="DISPLAY: block; MARGIN-LEFT: 0pt; TEXT-INDENT: 0pt; LINE-HEIGHT: 1.25; MARGIN-RIGHT: 0pt" align="justify">&#160;</div>
    <div style="DISPLAY: block; MARGIN-LEFT: 0pt; TEXT-INDENT: 0pt; LINE-HEIGHT: 1.25; MARGIN-RIGHT: 0pt" align="center"><font style="DISPLAY: inline; FONT-SIZE: 10pt; FONT-FAMILY: Times New Roman">Date
      of
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      29, 2006</strong></font></div>
    <div style="DISPLAY: block; MARGIN-LEFT: 0pt; TEXT-INDENT: 0pt; LINE-HEIGHT: 1.25; MARGIN-RIGHT: 0pt" align="justify">&#160;</div>
    <div style="DISPLAY: block; MARGIN-LEFT: 0pt; TEXT-INDENT: 0pt; LINE-HEIGHT: 1.25; MARGIN-RIGHT: 0pt" align="center"><font style="DISPLAY: inline; FONT-SIZE: 10pt; FONT-FAMILY: Times New Roman">NOVAMED,
      INC.</font></div>
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      name of registrant as specified in its charter)</font></div>
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            <td valign="top" width="33%" style="border-bottom: black thin solid;">
              <div style="MARGIN-LEFT: 0pt; TEXT-INDENT: 0pt; MARGIN-RIGHT: 0pt" align="center"><font size="2">DELAWARE</font></div>
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              <div style="MARGIN-LEFT: 9pt; TEXT-INDENT: -9pt; MARGIN-RIGHT: 0pt" align="center"><font size="2">0-266251</font></div>
            </td>
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              <div style="MARGIN-LEFT: 0pt; TEXT-INDENT: 0pt; MARGIN-RIGHT: 0pt" align="center">&#160;<font style="DISPLAY: inline; FONT-SIZE: 10pt; FONT-FAMILY: Times New Roman">36-4116193</font></div>
            </td>
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              <div style="MARGIN-LEFT: 0pt; TEXT-INDENT: 0pt; MARGIN-RIGHT: 0pt" align="center">&#160;<font size="2">(State
                or other jurisdiction
                of</font></div>
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              <div style="MARGIN-LEFT: 0pt; TEXT-INDENT: 0pt; MARGIN-RIGHT: 0pt" align="center"><font style="DISPLAY: inline; FONT-SIZE: 10pt; FONT-FAMILY: Times New Roman">(Commission
                File</font></div>
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              <div style="MARGIN-LEFT: 0pt; TEXT-INDENT: 0pt; MARGIN-RIGHT: 0pt" align="center">&#160;&#160;<font style="DISPLAY: inline; FONT-SIZE: 10pt; FONT-FAMILY: Times New Roman">
                (I.R.S. Employer</font></div>
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              <div style="MARGIN-LEFT: 0pt; TEXT-INDENT: 0pt; MARGIN-RIGHT: 0pt" align="center"><font style="DISPLAY: inline; FONT-SIZE: 10pt; FONT-FAMILY: Times New Roman">Identification
                No.)</font></div>
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                <div style="MARGIN-LEFT: 0pt; TEXT-INDENT: 0pt; MARGIN-RIGHT: 0pt" align="center">&#160;<font size="2">980
                  North Michigan Avenue, Suite 1620,
                  Chicago, Illinois</font></div>
              </td>
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                <div style="MARGIN-LEFT: 0pt; TEXT-INDENT: 0pt; MARGIN-RIGHT: 0pt" align="center"><font size="2">60611</font></div>
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                <div style="MARGIN-LEFT: 0pt; TEXT-INDENT: 0pt; MARGIN-RIGHT: 0pt" align="center">&#160;<font size="2">(Address
                  of Principal Executive
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    <div style="DISPLAY: block; MARGIN-LEFT: 0pt; TEXT-INDENT: 0pt; LINE-HEIGHT: 1.25; MARGIN-RIGHT: 0pt" align="center"><font style="DISPLAY: inline; FONT-SIZE: 10pt; FONT-FAMILY: Times New Roman">Registrant&#8217;s
      telephone number, including area code: (312) 664-4100.</font></div>
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    <div style="DISPLAY: block; MARGIN-LEFT: 0pt; TEXT-INDENT: 0pt; LINE-HEIGHT: 1.25; MARGIN-RIGHT: 0pt" align="center"><font style="DISPLAY: inline; FONT-SIZE: 10pt; FONT-FAMILY: Times New Roman">(Former
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      the
      appropriate box below if the Form 8-K filing is intended to simultaneously
      satisfy the filing obligation of the registrant under any of the following
      provisions:</font></div>
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    <div style="DISPLAY: block; MARGIN-LEFT: 18pt; TEXT-INDENT: -18pt; LINE-HEIGHT: 1.25; MARGIN-RIGHT: 0pt" align="left"><font style="DISPLAY: inline; FONT-SIZE: 10pt; FONT-FAMILY: Times New Roman">[
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      communications pursuant to Rule 425 under the Securities Act (17 CFR
      230.425)</font></div>
    <div style="DISPLAY: block; MARGIN-LEFT: 0pt; TEXT-INDENT: 0pt; LINE-HEIGHT: 1.25; MARGIN-RIGHT: 0pt" align="justify">&#160;</div>
    <div style="DISPLAY: block; MARGIN-LEFT: 18pt; TEXT-INDENT: -18pt; LINE-HEIGHT: 1.25; MARGIN-RIGHT: 0pt" align="left"><font style="DISPLAY: inline; FONT-SIZE: 10pt; FONT-FAMILY: Times New Roman">[
      ]</font><font id="TAB2" style="COLOR: black; LETTER-SPACING: 27pt">&#160;</font><font style="DISPLAY: inline; FONT-SIZE: 10pt; FONT-FAMILY: Times New Roman">Soliciting
      material pursuant to Rule 14a-12 under the Exchange Act (17 CFR
      240.14a-12)</font></div>
    <div style="DISPLAY: block; MARGIN-LEFT: 0pt; TEXT-INDENT: 0pt; LINE-HEIGHT: 1.25; MARGIN-RIGHT: 0pt" align="justify">&#160;</div>
    <div style="DISPLAY: block; MARGIN-LEFT: 18pt; TEXT-INDENT: -18pt; LINE-HEIGHT: 1.25; MARGIN-RIGHT: 0pt" align="left"><font style="DISPLAY: inline; FONT-SIZE: 10pt; FONT-FAMILY: Times New Roman">[
      ]</font><font id="TAB2" style="COLOR: black; LETTER-SPACING: 27pt">&#160;</font><font style="DISPLAY: inline; FONT-SIZE: 10pt; FONT-FAMILY: Times New Roman">Pre-commencement
      communications pursuant to Rule 14d-2(b) under the Exchange Act (17 CFR
      240.14d-2(b))</font></div>
    <div style="DISPLAY: block; MARGIN-LEFT: 0pt; TEXT-INDENT: 0pt; LINE-HEIGHT: 1.25; MARGIN-RIGHT: 0pt" align="justify">&#160;</div>
    <div style="DISPLAY: block; MARGIN-LEFT: 18pt; TEXT-INDENT: -18pt; LINE-HEIGHT: 1.25; MARGIN-RIGHT: 0pt" align="left"><font style="DISPLAY: inline; FONT-SIZE: 10pt; FONT-FAMILY: Times New Roman">[
      ]</font><font id="TAB2" style="COLOR: black; LETTER-SPACING: 27pt">&#160;</font><font style="DISPLAY: inline; FONT-SIZE: 10pt; FONT-FAMILY: Times New Roman">Pre-commencement
      communications pursuant to Rule 13e-4(c) under the Exchange Act (17 CFR
      240.13e-4(c))</font></div>
    <div style="DISPLAY: block; MARGIN-LEFT: 0pt; TEXT-INDENT: 0pt; LINE-HEIGHT: 1.25; MARGIN-RIGHT: 0pt" align="justify">&#160;</div>
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        </div>
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    <div style="DISPLAY: block; MARGIN-LEFT: 0pt; TEXT-INDENT: 0pt; LINE-HEIGHT: 1.25; MARGIN-RIGHT: 0pt" align="justify"><font style="DISPLAY: inline; FONT-SIZE: 10pt; FONT-FAMILY: Times New Roman"><strong>Section
      1 - Registrant&#8217;s Business and Operations</strong></font></div>
    <div style="DISPLAY: block; MARGIN-LEFT: 0pt; TEXT-INDENT: 0pt; LINE-HEIGHT: 1.25; MARGIN-RIGHT: 0pt" align="justify"><br></div>
    <div style="DISPLAY: block; MARGIN-LEFT: 0pt; TEXT-INDENT: 0pt; LINE-HEIGHT: 1.25; MARGIN-RIGHT: 0pt" align="justify"><font style="DISPLAY: inline; FONT-SIZE: 10pt; FONT-FAMILY: Times New Roman"><strong>Item
      1.01 </strong></font><font id="TAB2" style="COLOR: black; LETTER-SPACING: 27pt">&#160;</font><font style="DISPLAY: inline; FONT-SIZE: 10pt; FONT-FAMILY: Times New Roman"><strong>Entry
      into a Material Definitive Agreement</strong></font></div>
    <div style="DISPLAY: block; MARGIN-LEFT: 0pt; TEXT-INDENT: 0pt; LINE-HEIGHT: 1.25; MARGIN-RIGHT: 0pt" align="justify"><br></div>
    <div style="DISPLAY: block; MARGIN-LEFT: 0pt; TEXT-INDENT: 0pt; LINE-HEIGHT: 1.25; MARGIN-RIGHT: 0pt" align="justify"><font id="TAB1" style="MARGIN-LEFT: 36pt"></font><font style="DISPLAY: inline; FONT-SIZE: 10pt; FONT-FAMILY: Times New Roman">Effective
      June 29, 2006, NovaMed, Inc. entered into a Fifth Amended and Restated Credit
      Agreement with National City Bank of The Midwest, as agent and lender, LaSalle
      Bank National Association, as documentation agent and lender, and The Northern
      Trust Company, Associated Bank, N.A. and Charter One Bank as the other
      participating lenders. By amending our credit facility, we increased the maximum
      commitment available under the facility from $50 million to $80 million, and
      extended the expiration date by approximately one year to June 29, 2009. The
      amended facility also includes an option allowing us to increase the maximum
      commitment available to $100 million under certain conditions. Maximum borrowing
      availability and applicable interest rates under the facility have always been
      calculated based on a ratio of our total indebtedness to our earnings before
      interest, taxes, depreciation and amortization (EBITDA), all as more fully
      defined in our facility. This ratio was generally increased for purposes of
      calculating our maximum borrowing availability. Interest on borrowings under
      the
      facility are payable at an annual rate equal to our lender&#8217;s published base rate
      plus the applicable borrowing margin ranging from 0% to 0.5% or LIBOR plus
      a
      range from 1.25% to 2.25%, varying depending upon our ratios and ability to
      meet
      other financial covenants. The credit agreement continues to contain covenants
      that include limitations on indebtedness, liens, capital expenditures,
      acquisitions, investments and share repurchases, as well as restrictions on
      the
      payment of dividends; however, many of these limitations were changed to provide
      us with greater flexibility. </font></div>
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    <div style="DISPLAY: block; MARGIN-LEFT: 0pt; TEXT-INDENT: 0pt; LINE-HEIGHT: 1.25; MARGIN-RIGHT: 0pt" align="justify"><font id="TAB1" style="MARGIN-LEFT: 36pt"></font><font style="DISPLAY: inline; FONT-SIZE: 10pt; FONT-FAMILY: Times New Roman">The
      foregoing summary does not purport to be complete and is qualified in its
      entirety by reference to the full text of the Fifth Amended and Restated Credit
      Agreement which is filed herewith as Exhibit 10.45 and is incorporated herein
      by
      reference. </font></div>
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      9 - Financial Statements and Exhibits</strong></font></div>
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      9.01 Financial Statements and Exhibits</strong></font></div>
    <div style="DISPLAY: block; MARGIN-LEFT: 0pt; TEXT-INDENT: 0pt; LINE-HEIGHT: 1.25; MARGIN-RIGHT: 0pt" align="justify"><br></div>
    <div style="DISPLAY: block; MARGIN-LEFT: 0pt; TEXT-INDENT: 0pt; LINE-HEIGHT: 1.25; MARGIN-RIGHT: 0pt" align="justify"><font style="DISPLAY: inline; FONT-SIZE: 10pt; FONT-FAMILY: Times New Roman">(c)</font><font id="TAB2" style="COLOR: black; LETTER-SPACING: 27pt">&#160;</font><font style="DISPLAY: inline; FONT-SIZE: 10pt; FONT-FAMILY: Times New Roman">Exhibits</font></div>
    <div style="DISPLAY: block; MARGIN-LEFT: 0pt; TEXT-INDENT: 0pt; LINE-HEIGHT: 1.25; MARGIN-RIGHT: 0pt" align="justify">&#160;</div>
    <div style="DISPLAY: block; MARGIN-LEFT: 0pt; TEXT-INDENT: 0pt; LINE-HEIGHT: 1.25; MARGIN-RIGHT: 0pt" align="justify"><br>&#160;</div>
    <div align="center">
      <table bgcolor="white" cellpadding="0" cellspacing="0" width="100%">

          <tr bgcolor="white">
            <td width="10%" style="border-bottom: black thin solid;">&#160;<font size="2">Exhibit
              Number </font></td>
            <td width="10%" style="border-bottom: #ffffff solid;">&#160;</td>
            <td width="80%" style="border-bottom: black thin solid;"><font size="2">Title</font></td>
          </tr>
          <tr bgcolor="white">
            <td valign="top" width="10%">&#160;<font size="2">10.45*</font></td>
            <td width="10%">&#160;</td>
            <td width="80%"><font size="2">Fifth Amended and Restated Credit Agreement
              dated as of June 29, 2006, by and among NovaMed, Inc., National City
              Bank
              of The Midwest, as agent, and LaSalle National Bank Association, as
              documentation agent.</font></td>
          </tr>

      </table>
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    <div align="center">&#160;</div>
    <div style="MARGIN-LEFT: 0pt; TEXT-INDENT: 0pt; MARGIN-RIGHT: 0pt" align="left"><font size="2">*
      Portions of this Exhibit have been omitted based upon
      a request for confidential treatment of this document; omitted portions have
      been filed separately with the Commission.</font></div>
    <div style="DISPLAY: block; MARGIN-LEFT: 54pt; TEXT-INDENT: 36pt; LINE-HEIGHT: 1.25; MARGIN-RIGHT: 0pt" align="justify"><font id="TAB2" style="COLOR: black; LETTER-SPACING: 16.5pt"></font>&#160;</div>
    <div style="DISPLAY: block; MARGIN-LEFT: 0pt; TEXT-INDENT: 0pt; LINE-HEIGHT: 1.25; MARGIN-RIGHT: 0pt" align="justify">&#160;</div>
    <div id="PGBRK" style="MARGIN-LEFT: 0pt; TEXT-INDENT: 0pt; MARGIN-RIGHT: 0pt">
      <div id="FTR">
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        </div>
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        </div>
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    <div style="DISPLAY: block; MARGIN-LEFT: 0pt; TEXT-INDENT: 0pt; LINE-HEIGHT: 1.25; MARGIN-RIGHT: 0pt" align="justify"><br></div>
    <div style="DISPLAY: block; MARGIN-LEFT: 0pt; TEXT-INDENT: 36pt; LINE-HEIGHT: 1.25; MARGIN-RIGHT: 0pt" align="justify"><font style="DISPLAY: inline; FONT-SIZE: 10pt; FONT-FAMILY: Times New Roman">Pursuant
      to the requirements of the Securities Exchange Act of 1934, the registrant
      has
      duly caused this report to be signed on its behalf by the undersigned hereunto
      duly authorized.</font></div>
    <div style="DISPLAY: block; MARGIN-LEFT: 0pt; TEXT-INDENT: 0pt; LINE-HEIGHT: 1.25; MARGIN-RIGHT: 0pt" align="justify"><br></div>
    <div style="DISPLAY: block; MARGIN-LEFT: 0pt; TEXT-INDENT: 0pt; LINE-HEIGHT: 1.25; MARGIN-RIGHT: 0pt" align="justify"><br></div>
    <div style="DISPLAY: block; MARGIN-LEFT: 0pt; TEXT-INDENT: 0pt; LINE-HEIGHT: 1.25; MARGIN-RIGHT: 0pt" align="justify"><font id="TAB1" style="MARGIN-LEFT: 36pt"></font><font id="TAB1" style="MARGIN-LEFT: 36pt"></font><font id="TAB1" style="MARGIN-LEFT: 36pt"></font><font id="TAB1" style="MARGIN-LEFT: 36pt"></font><font id="TAB1" style="MARGIN-LEFT: 36pt"></font><font style="DISPLAY: inline; FONT-SIZE: 10pt; FONT-FAMILY: Times New Roman"><font id="TAB2" style="LETTER-SPACING: 9pt">&#160;&#160;
</font>NovaMed,
      Inc.</font></div>
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    <div style="DISPLAY: block; MARGIN-LEFT: 0pt; TEXT-INDENT: 0pt; LINE-HEIGHT: 1.25; MARGIN-RIGHT: 0pt" align="justify"><br></div>
    <div style="DISPLAY: block; MARGIN-LEFT: 0pt; TEXT-INDENT: 0pt; LINE-HEIGHT: 1.25; MARGIN-RIGHT: 0pt" align="justify"><font style="DISPLAY: inline; FONT-SIZE: 10pt; FONT-FAMILY: Times New Roman">Dated:
      July 6, 2006</font><font id="TAB2" style="COLOR: black; LETTER-SPACING: 27pt">&#160;</font><font id="TAB2" style="COLOR: black; LETTER-SPACING: 27pt">&#160;<font id="TAB2" style="LETTER-SPACING: 9pt">&#160;&#160;&#160;</font>&#160;<font id="TAB2" style="LETTER-SPACING: 9pt">&#160;&#160;&#160;</font>&#160;</font><font id="TAB2" style="COLOR: black; LETTER-SPACING: 27pt">&#160;</font><font style="DISPLAY: inline; FONT-SIZE: 10pt; FONT-FAMILY: Times New Roman">By:</font><u><font style="DISPLAY: inline; FONT-SIZE: 10pt; FONT-FAMILY: Times New Roman">
      /s/
      Scott T. Macomber</font><font id="TAB2" style="COLOR: black; LETTER-SPACING: 27pt">&#160;</font><font style="DISPLAY: inline; FONT-SIZE: 10pt; FONT-FAMILY: Times New Roman">&#160;&#160;&#160;&#160;&#160;&#160;&#160;&#160;&#160;&#160;&#160;&#160;&#160;&#160;&#160;&#160;&#160;&#160;&#160;&#160;&#160;&#160;&#160;&#160;&#160;&#160;&#160;&#160;&#160;&#160;&#160;&#160;&#160;&#160;&#160;&#160;&#160;&#160;&#160;&#160;&#160;&#160;&#160;&#160;&#160;&#160;&#160;
      </font></u></div>
    <div style="DISPLAY: block; MARGIN-LEFT: 0pt; TEXT-INDENT: 0pt; LINE-HEIGHT: 1.25; MARGIN-RIGHT: 0pt" align="justify"><font id="TAB1" style="MARGIN-LEFT: 36pt"></font><font id="TAB1" style="MARGIN-LEFT: 36pt"></font><font id="TAB1" style="MARGIN-LEFT: 36pt"></font><font id="TAB1" style="MARGIN-LEFT: 36pt"></font><font id="TAB1" style="MARGIN-LEFT: 36pt"></font><font id="TAB1" style="MARGIN-LEFT: 27pt"></font><font style="DISPLAY: inline; FONT-SIZE: 10pt; FONT-FAMILY: Times New Roman">Scott
      T.
      Macomber</font></div>
    <div style="DISPLAY: block; MARGIN-LEFT: 0pt; TEXT-INDENT: 0pt; LINE-HEIGHT: 1.25; MARGIN-RIGHT: 0pt" align="justify"><font id="TAB1" style="MARGIN-LEFT: 36pt"></font><font id="TAB1" style="MARGIN-LEFT: 36pt"></font><font id="TAB1" style="MARGIN-LEFT: 36pt"></font><font id="TAB1" style="MARGIN-LEFT: 36pt"></font><font id="TAB1" style="MARGIN-LEFT: 36pt"></font><font id="TAB1" style="MARGIN-LEFT: 27pt"></font><font style="DISPLAY: inline; FONT-SIZE: 10pt; FONT-FAMILY: Times New Roman">Executive
      Vice President and Chief Financial Officer</font></div>
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      INDEX</strong></font></div>
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          <tr bgcolor="white">
            <td width="10%" style="border-bottom: black thin solid;"><font size="2">Exhibit
              No.</font></td>
            <td width="10%" style="border-bottom: #ffffff solid;">&#160;</td>
            <td width="80%" style="border-bottom: black thin solid;"><font size="2">Exhibit</font></td>
          </tr>
          <tr bgcolor="white">
            <td valign="top" width="10%"><font size="2">10.45*</font></td>
            <td width="10%">&#160;</td>
            <td width="80%"><font style="DISPLAY: inline; FONT-SIZE: 10pt; FONT-FAMILY: Times New Roman">Fifth
              Amended and Restated Credit Agreement dated as of June 29, 2006, by
              and
              among NovaMed, Inc., National City Bank of The Midwest, as agent, and
              LaSalle National Bank&#160; Association, as documentation
              agent.</font></td>
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      <div style="MARGIN-LEFT: 0pt; TEXT-INDENT: 0pt; MARGIN-RIGHT: 0pt" align="left"><font size="2">*
        Portions of this Exhibit have been omitted based upon
        a request for confidential treatment of this document; omitted portions have
        been filed separately with the Commission.</font></div><br></div>
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{"company-data": {"conformed-name": "NOVAMED INC", "cik": "0001086939", "assigned-sic": "8741", "irs-number": "364116193", "state-of-incorporation": "DE", "fiscal-year-end": "1231"}, "filing-values": {"form-type": "8-K", "act": "34", "file-number": "000-26625", "film-number": "06948678"}, "business-address": {"street1": "980 N MICHIGAN AVENUE", "street2": "SUITE 1620", "city": "CHICAGO", "state": "IL", "zip": "60611", "phone": "3126644100"}, "mail-address": {"street1": "980 N MICHIGAN AVENUE", "street2": "SUITE 1620", "city": "CHICAGO", "state": "IL", "zip": "60611"}, "former-company": {"former-conformed-name": "NOVAMED EYECARE INC", "date-changed": "19990521"}}
UNITED
      STATES
SECURITIES
      AND EXCHANGE COMMISSION
WASHINGTON,
      D.C. 20549
FORM
                8-K
CURRENT
      REPORT
PURSUANT
      TO SECTION 13 OR 15(D) OF THE SECURITIES EXCHANGE ACT OF
      1934
Date
      of
      Report (Date of earliest event reported):
June
      29, 2006
NOVAMED,
      INC.
(Exact
      name of registrant as specified in its charter)
DELAWARE
0-266251
36-4116193
(State
                or other jurisdiction
                of
(Commission
                File
(I.R.S. Employer
incorporation
                or organization)
Number)
Identification
                No.)
980
                  North Michigan Avenue, Suite 1620,
                  Chicago, Illinois
60611
(Address
                  of Principal Executive
                  Offices)
(Zip
                  Code)
Registrant's
      telephone number, including area code: (312) 664-4100.
NOT
      APPLICABLE
(Former
      name or former address, if changed since last report)
Check
      the
      appropriate box below if the Form 8-K filing is intended to simultaneously
      satisfy the filing obligation of the registrant under any of the following
      provisions:
[
      ]
Written
      communications pursuant to Rule 425 under the Securities Act (17 CFR
      230.425)
[
      ]
Soliciting
      material pursuant to Rule 14a-12 under the Exchange Act (17 CFR
      240.14a-12)
[
      ]
Pre-commencement
      communications pursuant to Rule 14d-2(b) under the Exchange Act (17 CFR
      240.14d-2(b))
[
      ]
Pre-commencement
      communications pursuant to Rule 13e-4(c) under the Exchange Act (17 CFR
      240.13e-4(c))
Section
      1 - Registrant's Business and Operations
Item
      1.01
Entry
      into a Material Definitive Agreement
Effective
      June 29, 2006, NovaMed, Inc. entered into a Fifth Amended and Restated Credit
      Agreement with National City Bank of The Midwest, as agent and lender, LaSalle
      Bank National Association, as documentation agent and lender, and The Northern
      Trust Company, Associated Bank, N.A. and Charter One Bank as the other
      participating lenders. By amending our credit facility, we increased the maximum
      commitment available under the facility from $50 million to $80 million, and
      extended the expiration date by approximately one year to June 29, 2009. The
      amended facility also includes an option allowing us to increase the maximum
      commitment available to $100 million under certain conditions. Maximum borrowing
      availability and applicable interest rates under the facility have always been
      calculated based on a ratio of our total indebtedness to our earnings before
      interest, taxes, depreciation and amortization (EBITDA), all as more fully
      defined in our facility. This ratio was generally increased for purposes of
      calculating our maximum borrowing availability. Interest on borrowings under
      the
      facility are payable at an annual rate equal to our lender's published base rate
      plus the applicable borrowing margin ranging from 0% to 0.5% or LIBOR plus
      a
      range from 1.25% to 2.25%, varying depending upon our ratios and ability to
      meet
      other financial covenants. The credit agreement continues to contain covenants
      that include limitations on indebtedness, liens, capital expenditures,
      acquisitions, investments and share repurchases, as well as restrictions on
      the
      payment of dividends; however, many of these limitations were changed to provide
      us with greater flexibility.
The
      foregoing summary does not purport to be complete and is qualified in its
      entirety by reference to the full text of the Fifth Amended and Restated Credit
      Agreement which is filed herewith as Exhibit 10.45 and is incorporated herein
      by
      reference.
Section
      9 - Financial Statements and Exhibits
Item
      9.01 Financial Statements and Exhibits
(c)
Exhibits
Exhibit
              Number
Title
10.45*
Fifth Amended and Restated Credit Agreement
              dated as of June 29, 2006, by and among NovaMed, Inc., National City
              Bank
              of The Midwest, as agent, and LaSalle National Bank Association, as
              documentation agent.
*
      Portions of this Exhibit have been omitted based upon
      a request for confidential treatment of this document; omitted portions have
      been filed separately with the Commission.
SIGNATURE
Pursuant
      to the requirements of the Securities Exchange Act of 1934, the registrant
      has
      duly caused this report to be signed on its behalf by the undersigned hereunto
      duly authorized.
NovaMed,
      Inc.
Dated:
      July 6, 2006
By:
/s/
      Scott T. Macomber
Scott
      T.
      Macomber
Executive
      Vice President and Chief Financial Officer
EXHIBIT
      INDEX
Exhibit
              No.
Exhibit
10.45*
Fifth
              Amended and Restated Credit Agreement dated as of June 29, 2006, by
              and
              among NovaMed, Inc., National City Bank of The Midwest, as agent, and
              LaSalle National Bank  Association, as documentation
              agent.
*
        Portions of this Exhibit have been omitted based upon
        a request for confidential treatment of this document; omitted portions have
        been filed separately with the Commission.