All 10 of the highest-volume procedures performed in ASCs will see lower Medicare payments in 2027, even with a 2.3% average rate update in CMS’ final 2027 payment rule, according to an analysis from the Ambulatory Surgery Center Association.
Pain management procedures face the steepest cuts by percentage, averaging about 3.7% across the four pain codes in the top 10. Gastroenterology codes face the smallest cuts, at about 1.8% to 1.9%. The figures are national rates and don’t include local wage adjustments.
Here are the 10 procedures, ranked by percentage cut:
| Rank | Specialty | Code | Procedure | 2026 rate | 2027 rate | $ change | % change |
| 1 | Pain management | 64635 | Destruction of lumbar/sacral facet joint nerves | $948.66 | $909.47 | -$39.19 | -4.1% |
| 2 | Ophthalmology | 66821 | Laser surgery after cataract surgery | $301.90 | $290.54 | -$11.36 | -3.8% |
| 3 | Pain management | 64483 | Transforaminal epidural injection, lumbar/sacral, single level | $485.51 | $467.67 | -$17.84 | -3.7% |
| 3 | Pain management | 64493 | Paravertebral facet joint injection, lumbar/sacral, single level | $485.51 | $467.67 | -$17.84 | -3.7% |
| 5 | Pain management | 62323 | Interlaminar epidural injection, lumbar/sacral | $387.46 | $373.96 | -$13.50 | -3.5% |
| 6 | Ophthalmology | 66984 | Cataract removal with lens implant | $1,255.73 | $1,220.03 | -$35.70 | -2.8% |
| 7 | Gastroenterology | G0105 | Colorectal cancer screening, high-risk individual | $510.49 | $500.61 | -$9.88 | -1.9% |
| 8 | Gastroenterology | 45385 | Colonoscopy with lesion removal | $656.75 | $644.77 | -$11.98 | -1.8% |
| 8 | Gastroenterology | 45380 | Colonoscopy with biopsy | $656.75 | $644.77 | -$11.98 | -1.8% |
| 10 | Gastroenterology | 43239 | Upper GI endoscopy with biopsy | $497.85 | $488.90 | -$8.95 | -1.8% |
Source: ASCA analysis of CMS’ 2027 final rule. Percentages calculated by Becker’s.
“While the addition of hundreds of new procedures to the ASC-CPL greatly expands the potential capacity of surgery centers, ASCA continues to be deeply concerned on the reimbursement effects for many high-volume procedures already performed in ASCs,” ASCA President Todd Currier said. “Unless these declines are mitigated, patients risk losing access to care and driving up costs to the Medicare program.”
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.
