Stephen Shih, a partner at Bain and co-author of the survey, said: "Business in China is at a turning point, and companies with interests here will have to decide whether to continue pursuing growth and investment in China, or whether to prioritize other growth opportunities."

However, progress in the economic restructuring to "the new normal" of slower, more sustainable growth driven by consumption is being seen favorably by US companies. Growth in domestic consumption was cited as a key opportunity for business by almost half of the companies.

The services sector was the most optimistic concerning investment environment, difficulty in approvals and how welcome foreign firms were in China.

A lot of hopes hang on the bilateral investment treaty, in discussion since 2008, that is expected to deepen economic ties between China and the US.

"The BIT represents a major opportunity to improve the regulatory environment, which can enhance the ability of US companies to invest and innovate and compete in China for the benefit of the country's economy," said Zimmerman.