CMS’ 2026 Hospital Outpatient Prospective Payment System and ASC Payment System Final Rule marked the largest single-year expansion of outpatient-eligible surgery since at least 2018, surpassing, in one year, the 59 procedures Becker’s tracked as added to the ASC-covered list over the entire five-year span from 2018 to 2023.
Two policy changes drove it: a revision of the ASC covered procedures list criteria, and the start of a three-year phase-out of the inpatient-only list. CMS finalized the addition of 289 surgical procedures to the ASC covered procedures list for CY 2026, and separately added 271 of the codes removed from the inpatient-only list to that same list. Combined, more than 500 procedures became newly eligible for the outpatient/ASC setting in a single year.
Here’s a breakdown of the newly eligible procedures by specialty:
Orthopedics and joint replacement
CMS added 168 orthopedic codes to the ASC-covered procedure list, opening the door to procedures that had never been eligible for the outpatient setting before:
- Revision total hip arthroplasty
- Revision total knee arthroplasty
- Partial shoulder revisions
- 285 musculoskeletal procedures removed from the inpatient-only list as part of the first year of its three-year phase-out
The expansion builds on a fast-growing base: More than 600 ASCs are performing total joint replacements as of 2026.
Spine
- Posterior lumbar interbody fusion (CPT 22630)
- Combined posterior lumbar and posterior lumbar interbody fusion (CPT 22633)
Posterior lumbar interbody fusion was added to the ASC-covered list in 2021, then withdrawn the following year; both codes were requested again by ASCA in 2025 rulemaking, and CMS added them for 2026.
Cardiac and electrophysiology
- 6 cardiac ablation procedure codes
- 7 additional electrophysiology procedure codes, added after being requested through public comment
- Electrophysiology studies and ablations: CPT 93650, 93653, 93654, 93656
- Percutaneous coronary intervention: C9602, C9604, C9607
- Vascular embolization or occlusion: CPT 37244
GI and endoscopy
- POEM (peroral endoscopic myotomy)
- EndoFLIP
Both had previously required a hospital-based setting in most cases.
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.
