CMS released the 2026 proposed payment rule for hospital outpatient departments and ASCs on July 15.
The proposal included the addition of 276 procedures to the Covered Procedures List for ASCs. It also proposed phasing out the inpatient-only list, beginning with the removal of 285 mostly musculoskeletal procedures. Most of these will be added to the CPL list for ASCs.
While the addition of the new procedures ushers in a new wave of opportunity for ASC growth, leaders emphasize the need for ASCs to have the proper infrastructure and case evaluation standards for managing complex cases.
Four leaders recently joined Becker’s to share their thoughts on what procedures promise the most growth and what ASCs need to do to prepare for them.
Editor’s note: Responses have been lightly edited for clarity and length:
Brian Bizub. CEO of Raleigh (N.C.) Orthopaedic Clinic: The proposed updates to the CMS CPL, including the expansion of total joint replacement codes (shoulder, hip, and ankle) and spine procedures, represent a significant advancement for patients and orthopedic ASCs. These additions will improve access to care, reduce healthcare costs and support the continued shift of appropriate cases from inpatient to outpatient settings, which will have a positive impact on financial outcomes over the next five years.
ASCs offer a patient-centered, high-quality surgical environment, often exceeding hospital-based care in safety and efficiency. Dedicated specialty teams, streamlined workflows and focused care protocols and standards help reduce complications and improve outcomes.
Patient selection remains critical to ASC success. Surgeons and anesthesiologists are best equipped to determine the suitability of outpatient care, ensuring that patient safety and clinical appropriateness are prioritized over site-of-service decisions.
Pat Lara. Service Line Administrator at Heart Institute at the University of Washington (Seattle): To my mind, the 93650-93657 codes will be the most impactful. The [electrophysiology] space in cardiology is growing rapidly and with capacity constraints moving this to the ASC space, [it] will improve access and the patient experience.
Larry Sobal. CEO of Heart and Vascular Institute of Wisconsin (Appleton): My understanding is that the inpatient-only list will be phased out over a three-year period. This will open the door for a variety of procedures to be considered for an ASC setting. However, it will also place greater responsibility on ASCs to be focused on screening for patient appropriateness taking into account the patient’s medical condition and risk factors, the expertise of the physician, and the location of the ASC. What may be safe for an ASC located on a hospital campus (with an experienced physician) may not be appropriate for an ASC in a rural community with an early career physician.
Ed Tolentino. Administrator of Outpatient Surgery Center of Central Florida (Wildwood): The proposed addition of electrophysiology procedures, particularly catheter ablations and device implants, will have the most significant impact on ASC growth over the next five years. These are high-acuity, high-reimbursement procedures that have traditionally been limited to the hospital setting. The movement of these cases into the ASC environment is a natural evolution driven by advancements in technology, improved patient selection criteria, and the overarching push toward cost-efficiency in healthcare.
If finalized, these additions will open new avenues for partnerships with cardiology groups, increase case volume, and expand the scope of services that ASCs can offer without compromising safety or outcomes. That said, ASCs must be thoughtful about their infrastructure, credentialing and readiness to handle these complex procedures. For centers that are willing to invest and align with experienced providers, this shift represents a major opportunity for strategic growth and long-term sustainability.
