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%
