The last 10 years has seen significant growth in the ASC space as new waves of surgical innovation, patient preferences and the shift to value-based care has supported a migration of procedures out of hospitals and into outpatient facilities—but ASCs still face an array of challenges.
Here are 10 stats on how the ASC industry has changed over the last 10 years and what obstacles it continues to adapt to
1. Between 2017 and 2026, annual net inflation adjustments for ASCs have averaged 2.5%, according to a recent VMG Health report, which many ASC leaders say has failed to keep pace with rising costs.
2. Commercial insurers paid an average of $1,489 more for common procedures at hospital outpatient departments than at ASCs in 2024, a 78% mark-up, according to a study published in Health Affairs. Medicare also paid more when those procedures were performed in HOPDs, but the difference was smaller in dollars: $633 more per case, a 97% mark-up. Among the commercial payers, Cigna had the narrowest gap, at $327.
3. For hip and knee arthroplasty procedures performed in ASCs, Medicare professional fees for surgeons declined from 2018 to 2024, even after adjusting for inflation, according to a July 2025 report on Science Direct. Over that period, unicompartmental knee arthroplasty professional fees fell from about $1,487 to around $1,148.
4. In it’s annual report to Congress released March 12, the Medicare Payment Advisory Commission found that the number of ASCs nationwide grew over 2% per year on average between 2019 and 2024.
5. The volume of ASC surgical procedures per FFS beneficiary increased 3.5% in 2024, after growing at an average annual rate of 1.3% from 2019–2023.
6. Medicare spending per FFS beneficiary on ASC services rose at an average annual rate of 9.4% from 2019 through 2023, and then by a striking 15.9% from 2023 to 2024.
7. About 68% of ASCs that billed FFS Medicare in 2024 specialized in a single clinical area. Gastroenterology and ophthalmology were the most common single-specialty types. Among multispecialty facilities, pain management and orthopedics were most common.
8. The concentration of ASCs varies widely by state, ranging from more than 36 ASCs per 100,000 Part B beneficiaries in Maryland to 3 or fewer in DC, West Virginia, and Vermont.
9. ASCs are more likely to open in counties with stronger healthcare infrastructure and higher socioeconomic advantage, according to a study published in Health Affairs Scholar. Counties in the least-deprived (best-off) area-deprivation index quartile had an adjusted ASC opening rate of 31.9%, compared with 19.9% in the most-deprived quartile. Additionally, the odds of an opening fell steadily as deprivation increased.
10. The strongest predictor of a new opening was the presence of an existing ASC. Adjusted opening rates were 44.7% in counties that already had an ASC, compared with 13.8% in counties without one.
