The Ambulatory Surgery Center Association submitted formal comments to the Centers for Medicare & Medicaid Services on Aug. 31, 2026, urging the agency to eliminate the ASC weight scalar in the proposed calendar year 2027 Outpatient Prospective Payment System and Ambulatory Surgical Center payment rule.
ASCA warns that reimbursement for the top 100 ASC procedures by volume will drop from 53% of the hospital outpatient department rate this year to 44% in 2027 if CMS finalizes the rule as proposed. The association says 85 of those top 100 codes face reimbursement cuts under the proposal.
ASCs saved Medicare $5.1 billion in 2024 simply by existing as a lower-cost alternative to hospitals, according to research ASCA cited in the letter. The organization counts 6,640 Medicare-certified ASCs as of June 2026, more than half of which operate with two or fewer operating rooms.
Citing a report from KNG Health, ASCA wrote that “CMS could permanently align the updated indices of ASCs to HOPDs to prevent further widening of reimbursement differences.”
The letter, addressed to CMS Administrator Dr. Mehmet Oz and signed by ASCA CEO William Prentice, also asks CMS to continue using the hospital market basket as the annual ASC payment update mechanism, apply wage index floors and geographic reclassifications to rural ASCs, and allow ASCs to bill for unlisted procedure codes. The proposed rule would add 618 codes to the ASC Covered Procedures List for 2027.
At the Becker’s 32nd Annual Meeting: The Business and Operations of ASCs, taking place October 29-31 in Chicago, ASC leaders, surgeons and healthcare executives will explore strategies to drive growth, enhance operational performance, navigate reimbursement challenges and prepare for the future of ambulatory surgery. Apply for complimentary registration now.
