ASC leaders have been wrestling with a shared dilemma in recent years as AI-powered technologies and platforms have proliferated healthcare, but are rarely designed for outpatient facilities specifically.
“EHR interoperability between ASC, hospital and physicians office has a long way to go,” Jeffrey Carlson, MD, president of Newport News, Va.-based Orthopaedic & Spine Center, told Becker’s. This rings especially true for hospital-affiliated ASCs, who may be beholden to inpatient-centered systems.
“Coordinating care should be seamless between agreeable parties. All too often hospital owned ASCs will want to have every physician office use the hospital-owned EHR,” Dr. Carlson said. “Unfortunately, hospital EHRs are too cumbersome for ASC efficiency and too expensive for physician offices. For surgeons to place patients on the operative schedule, it may require entering three EHRs with different passwords and different hard stops programmed into their system.
At least one company is looking to fill the technology gap that exists in the ASC industry. Procode, an AI-powered medical billing and revenue cycle management company geared towards private practice surgeons, announced a $10 million Series A funding round led by Health Velocity Capital July 28.
Procode recently acquired The Auctus Group, a leading RCM company for plastic surgeons and dermatologists. The company said in the announcement that it planned to expand its AI-powered platform through additional acquisitions to accelerate its growth in surgical specialty practices and ASC billing.
“We’re on track to double The Auctus Group’s revenue and quintuple its EBITDA margin,” said Jeff Cripe, CEO of Procode. “That matters because we bill on contingency — we only get paid when our clients get paid — so our growth is proof our AI is putting more dollars in providers’ pockets, not just automating paperwork. Large health systems have had incredible technology companies innovating on their most pressing problems for years. We’re proud to innovate on behalf of the massive, long tail of RCM companies serving private practice surgeons.”
The expansion of AI-powered RCM platforms for ASCs could be a game changer as surgical coding becomes increasingly complex and contested by payers. In its first peer-reviewed research, published in Plastic & Reconstructive Surgery Global Open, Procode’s AI tool was tested against Open AI GPT-5, Google Gemini 2.5 Pro, Anthropic Claude 2.5 and external professional auditors in reviewing operative reports at three different difficult levels. A total of 120 case reports were analyzed.
Procode achieved 86.7% overall accuracy — more than double the best-performing LLM (OpenAI, 35.8%) and more than twice the accuracy of human auditors (42.5%). On easy cases, Procode was perfect: 100%. On the hardest cases (defined as including 4 or more CPT codes), it achieved 80% while general-purpose LLMs ranged from 5% to 12.5%.
“Our research shows that AI trained specifically for surgical coding can reliably outperform both humans and generic models,” said Kameron Rezzadeh, MD, cofounder and chief medical officer of Procode. “That’s a step change in what billing accuracy looks like for private practice surgeons.”
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.