The 10 most-performed ASC procedures accounted for a significant share of total Medicare dollars in both 2025 and projected 2026, with cataract surgery alone representing nearly one-fifth of all ASC Medicare payments, according to a 2025 report from VMG Health.
While several top procedures are expected to see modest year-over-year payment growth, others, particularly certain joint replacements and GI procedures, are projected to decline in 2026.
Here’s a breakdown of the Medicare pay in 2025 compared to 2026 for the 10 top procedures performed by ASCs:
Extracapsular cataract removal with insertion of intraocular lens prosthesis (one-stage procedure), without endoscopic cyclophotocoagulation (CPT 66984):
- Estimated 2025 payments: $1,371 million
- Percentage of total Medicare (2025): 17.5%
- Estimated 2026 payments: $1,426 million
- Percentage of total Medicare (2026): 17.7%
- Estimated 2026 change: +4%
Total knee arthroplasty (CPT 27447)
- Estimated 2025 payments: $428 million
- Percentage of total Medicare (2025): 5.5%
- Estimated 2026 payments: $437 million
- Percentage of total Medicare (2026): 5.4%
- Estimated 2026 change: +2%
Insertion or replacement of spinal neurostimulator pulse generator or receiver, direct or inductive coupling (CPT 63685)
- Estimated 2025 payments: $385 million
- Percentage of total Medicare (2025): 4.9%
- Estimated 2026 payments: $400 million
- Percentage of total Medicare (2026): 5%
- Estimated 2026 change: +4%
Colonoscopy with removal of tumors, polyps or other lesions by snare technique (CPT 45385)
- Estimated 2025 payments: $265 million
- Percentage of total Medicare (2025): 3.4%
- Estimated 2026 payments: $276 million
- Percentage of total Medicare (2026): 3.4%
- Estimated 2026 change: +4%
Colonoscopy with biopsy, single or multiple (CPT 45380)
- Estimated 2025 payments: $261 million
- Percentage of total Medicare (2025): 3.3%
- Estimated 2026 payments: $258 million
- Percentage of total Medicare (2026): 3.2%
- Estimated 2026 change: −1%
Percutaneous implantation of neurostimulator electrode array (epidural) (CPT 63650)
- Estimated 2025 payments: $223 million
- Percentage of total Medicare (2025): 2.9%
- Estimated 2026 payments: $227 million
- Percentage of total Medicare (2026): 2.8%
- Estimated 2026 change: +2%
Total hip arthroplasty (total hip replacement) (CPT 27130)
- Estimated 2025 payments: $215 million
- Percentage of total Medicare (2025): 2.8%
- Estimated 2026 payments: $213 million
- Percentage of total Medicare (2026): 2.6%
- Estimated 2026 change: −1%
Esophagogastroduodenoscopy with biopsy, single or multiple (CPT 43239)
- Estimated 2025 payments: $182 million
- Percentage of total Medicare (2025): 2.3%
- Estimated 2026 payments: $175 million
- Percentage of total Medicare (2026): 2.2%
- Estimated 2026 change: −4%
Reconstruction of shoulder joint (total shoulder arthroplasty) (CPT 23472)
- Estimated 2025 payments: $150 million
- Percentage of total Medicare (2025): 1.9%
- Estimated 2026 payments: $123 million
- Percentage of total Medicare (2026): 1.5%
- Estimated 2026 change: −18%
Insertion or replacement of peripheral or gastric neurostimulator pulse generator (CPT 64590)
- Estimated 2025 payments: $146 million
- Percentage of total Medicare (2025): 1.9%
- Estimated 2026 payments: $156 million
- Percentage of total Medicare (2026): 1.9%
- Estimated 2026 change: +7%
At the Becker's 23rd Annual Spine, Orthopedic and Pain Management-Driven ASC + The Future of Spine Conference, taking place June 11-13 in Chicago, spine surgeons, orthopedic leaders and ASC executives will come together to explore minimally invasive techniques, ASC growth strategies and innovations shaping the future of outpatient spine care. Apply for complimentary registration now.
