Patient decisions accounted for 34.1% of ASC case cancellations with a recorded reason in 2025, according to HST Pathways’ 2026 State of the ASC Industry Report.
The report draws on data from 682 surgery centers in 45 states. Cancellation reasons were recorded for 317,382 cases.
Here are five things to know:
1. ASCs canceled 647,287 cases in 2025, 20% of all scheduled cases. The rate has stayed between 20% and 21% since 2023.
2. Patients and providers account for more than half of cancellations. Patient decisions made up 34.1% and provider cancellations 20.7%. Reschedules made up 8.6% and patient health issues 6.8%. Another 12.8% were labeled “other.”
3. Insurance issues caused 4.7% of cancellations and financial reasons 2.3%. When pre-authorization was required, it was completed on 32% of cases in 2025, up from 21% in 2023.
4. Few cancellations came from inside the ASC. Scheduling errors made up 3.6%, ASC-initiated cancellations 2.2%, labs 1.4% and anesthesia 1.2%. Staffing or supply issues and equipment each accounted for less than 1%.
5. Cancellations leave holes in the schedule. Block utilization ranged from 51% to 61% across center sizes in 2025. When anesthesia providers don’t have back-to-back cases, they often charge ASCs a stipend to make up the lost revenue, the report said. HST recommends managing each case in one place shared by the whole care team, and sending text reminders that let patients confirm.
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.
