Surgical Solutions Expert

Specializing in surgical suites for ICL's and OBS

CMS published its 2026 Hospital Outpatient Prospective Payment System and Ambulatory Surgical Center Final Rule Nov. 21. The update included:

• A 2.6% increase to ASC payments via the hospital market basket update. HOPDs will also receive a 2.6% payment increase, and the hospital market basket update will be used again for ASCs next year.

• Finalized plans to phase out the inpatient-only list over the next three years, removing 285 primarily musculoskeletal procedures from the list in 2026. CMS will add 547 codes to the ASC-covered procedure list, including 271 coming off the inpatient-only list.

• Plans to align payment rates for select outpatient services between HOPDs and off-campus facilities to avoid higher copays based on site of service.

Payer and employer pressure to lower healthcare costs is accelerating the shift of surgical procedures into ambulatory surgery centers, according to Jeffrey Flynn, COO of Gramercy Healthcare and president of the New York State Association of Ambulatory Surgery Centers.

As payer-driven site-of-care pressure increases, Mr. Flynn said ASCs should focus on absorbing more complex cases rather than worrying about lower-acuity procedures migrating to office-based settings. Cataracts are one example of procedures now being performed in office-based settings.

“Cataracts eventually will be, in the next two or three years, in the office-based setting,” he said. “I don’t think that’s a thing to be concerned about. I think we embrace the higher acuity procedures as we bring those to us.”

By: Laura Dyrda, Beckers December 22,2025

https://www.beckersasc.com/asc-coding-billing-and-collections/payer-economics-drive-asc-expansion/