ASC Payment Rates

ASC services are those surgical procedures that are identified by CMS on an annually updated ASC listing. The Medicare definition of covered facility services includes services that would be covered if furnished on an inpatient or outpatient basis in connection with a covered surgical procedure. View the ASC procedures and payment amounts grouped by the Core-Based Statistical Area (CBSA) code. See the 'Urban Area/State Code' and be sure to select the appropriate CBSA to view fees for your facility.

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2017

Effective July 1, 2017 - For dates of service on/after 7/1/16 - CMS Change Request (CR)10138

Effective January 1, 2017 - For dates of service on/after 1/1/17 - CMS Change Request (CR)9923

HI/Pacific Islands

  • Rural - 12 [Excel]
  • Guam - 65 [Excel]
  • Kalawao, Maui including Kahului-Wailuku-Lahaina - 27980 [Excel]
  • Urban Honolulu - 46520 [Excel]

Nevada

  • Rural - 29 [Excel]
  • Carson City - 16180 [Excel]
  • Las Vegas - 29820 [Excel]
  • Reno-Sparks - 39900 [Excel]

Northern California

  • California - 05 [Excel]
  • Bakersfield, Kern County - 12540 [Excel]
  • Chico, Butte County - 17020 [Excel]
  • Fresno, Fresno County - 23420 [Excel]
  • Hanford-Corcoran, Kings County - 25260 [Excel]
  • Madera, Madera County - 31460 [Excel]
  • Merced, Merced County - 32900 [Excel]
  • Modesto, Stanislaus County - 33700 [Excel]
  • Napa, Napa County - 34900 [Excel]
  • Oakland-Hayward-Berkeley, Alameda County, Contra Costa County - 36084 [Excel]
  • Redding, Shasta County - 39820 [Excel]
  • Riverside-San Bernardino-Ontario, Riverside County, San Bernardino County - 40140 [Excel]
  • Sacramento-Arden-Arcade-Roseville, El Dorado County, Placer County, Sacramento County, Yolo County - 40900 [Excel]
  • Salinas, Monterey County - 41500 [Excel]
  • San Francisco-Redwood City-South San Francisco, San Francisco County, San Mateo County - 41884 [Excel]
  • San Jose-Sunnyvale-Santa Clara, San Benito County, Santa Clara County - 41940 [Excel]
  • San Rafael, Marin County - 42034 [Excel]
  • Santa Cruz-Watsonville, Santa Cruz County - 42100 [Excel]
  • Santa Rosa, Sonoma County - 42220 [Excel]
  • Stockton-Lodi, San Joaquin County - 44700 [Excel]
  • Vallejo-Fairfield, Solano County - 46700 [Excel]
  • Visalia-Porterville, Tulare County - 47300 [Excel]
  • Yuba City, Sutter County, Yuba County - 49700 [Excel]

Southern California

  • Santa Ana-Anaheim-Irvine, Orange County - 11244 [Excel]
  • El Centro, Imperial County - 20940 [Excel]
  • Los Angeles-Long Beach-Glendale, Los Angeles County - 31084 [Excel]
  • Oxnard-Thousand Oaks-Ventura, Ventura County - 37100 [Excel]
  • San Diego-Carlsbad, San Diego County - 41740 [Excel]
  • San Luis Obispo-Paso Robles-Arroyo Grande, San Luis Obispo County - 42020 [Excel]
  • Santa Barbara-Santa Maria, Santa Barbara County - 42200 [Excel]

2016

Effective October 1, 2016 - For dates of service on/after 10/1/16 - CMS CR9773

Effective July 1, 2016 - For dates of service on/after 7/1/16 - CMS CR9668

Effective January 1, 2016 - For dates of service on/after 1/1/16 - CMS CR9484

HI/Pacific Islands

  • Rural - 12 [Excel]
  • Guam - 65 [Excel]
  • Kalawao, Maui including Kahului-Wailuku-Lahaina - 27980 [Excel]
  • Urban Honolulu - 46520 [Excel]

Nevada

  • Rural - 29 [Excel]
  • Carson City - 16180 [Excel]
  • Las Vegas - 29820 [Excel]
  • Reno-Sparks - 39900 [Excel]

Northern California

  • California - 05 [Excel]
  • Bakersfield, Kern County - 12540 [Excel]
  • Chico, Butte County - 17020 [Excel]
  • Fresno, Fresno County - 23420 [Excel]
  • Hanford-Corcoran, Kings County - 25260 [Excel]
  • Madera, Madera County - 31460 [Excel]
  • Merced, Merced County - 32900 [Excel]
  • Modesto, Stanislaus County - 33700 [Excel]
  • Napa, Napa County - 34900 [Excel]
  • Oakland-Hayward-Berkeley, Alameda County, Contra Costa County - 36084 [Excel]
  • Redding, Shasta County - 39820 [Excel]
  • Riverside-San Bernardino-Ontario, Riverside County, San Bernardino County - 40140 [Excel]
  • Sacramento-Arden-Arcade-Roseville, El Dorado County, Placer County, Sacramento County, Yolo County - 40900 [Excel]
  • Salinas, Monterey County - 41500 [Excel]
  • San Francisco-Redwood City-South San Francisco, San Francisco County, San Mateo County - 41884 [Excel]
  • San Jose-Sunnyvale-Santa Clara, San Benito County, Santa Clara County - 41940 [Excel]
  • San Rafael, Marin County - 42034 [Excel]
  • Santa Cruz-Watsonville, Santa Cruz County - 42100 [Excel]
  • Santa Rosa, Sonoma County - 42220 [Excel]
  • Stockton-Lodi, San Joaquin County - 44700 [Excel]
  • Vallejo-Fairfield, Solano County - 46700 [Excel]
  • Visalia-Porterville, Tulare County - 47300 [Excel]
  • Yuba City, Sutter County, Yuba County - 49700 [Excel]

Southern California

  • Santa Ana-Anaheim-Irvine, Orange County - 11244 [Excel]
  • El Centro, Imperial County - 20940 [Excel]
  • Los Angeles-Long Beach-Glendale, Los Angeles County - 31084 [Excel]
  • Oxnard-Thousand Oaks-Ventura, Ventura County - 37100 [Excel]
  • San Diego-Carlsbad, San Diego County - 41740 [Excel]
  • San Luis Obispo-Paso Robles-Arroyo Grande, San Luis Obispo County - 42020 [Excel]
  • Santa Barbara-Santa Maria, Santa Barbara County - 42200 [Excel]

2015

Effective October 1, 2015 - For dates of service on/after 10/1/15 and processed on/after 10/1/15 - CMS CR9310

Effective July 1, 2015

HI/Pacific Islands

  • Rural - 12 [Excel]
  • Guam - 65 [Excel]
  • Kalawao, Maui including Kahului-Wailuku-Lahaina - 27980 [Excel]
  • Urban Honolulu - 46520 [Excel]

Nevada

  • Rural - 29 [Excel]
  • Carson City - 16180 [Excel]
  • Las Vegas - 29820 [Excel]
  • Reno-Sparks - 39900 [Excel]

Northern California

  • California - 05 [Excel]
  • Bakersfield, Kern County - 12540 [Excel]
  • Chico, Butte County - 17020 [Excel]
  • Fresno, Fresno County - 23420 [Excel]
  • Hanford-Corcoran, Kings County - 25260 [Excel]
  • Madera, Madera County - 31460 [Excel]
  • Merced, Merced County - 32900 [Excel]
  • Modesto, Stanislaus County - 33700 [Excel]
  • Napa, Napa County - 34900 [Excel]
  • Oakland-Hayward-Berkeley, Alameda County, Contra Costa County - 36084 [Excel]
  • Redding, Shasta County - 39820 [Excel]
  • Riverside-San Bernardino-Ontario, Riverside County, San Bernardino County - 40140 [Excel]
  • Sacramento-Arden-Arcade-Roseville, El Dorado County, Placer County, Sacramento County, Yolo County - 40900 [Excel]
  • Salinas, Monterey County - 41500 [Excel]
  • San Francisco-Redwood City-South San Francisco, San Francisco County, San Mateo County - 41884 [Excel]
  • San Jose-Sunnyvale-Santa Clara, San Benito County, Santa Clara County - 41940 [Excel]
  • San Rafael, Marin County - 42034 [Excel]
  • Santa Cruz-Watsonville, Santa Cruz County - 42100 [Excel]
  • Santa Rosa, Sonoma County - 42220 [Excel]
  • Stockton-Lodi, San Joaquin County - 44700 [Excel]
  • Vallejo-Fairfield, Solano County - 46700 [Excel]
  • Visalia-Porterville, Tulare County - 47300 [Excel]
  • Yuba City, Sutter County, Yuba County - 49700 [Excel]

Southern California

  • Santa Ana-Anaheim-Irvine, Orange County - 11244 [Excel]
  • El Centro, Imperial County - 20940 [Excel]
  • Los Angeles-Long Beach-Glendale, Los Angeles County - 31084 [Excel]
  • Oxnard-Thousand Oaks-Ventura, Ventura County - 37100 [Excel]
  • San Diego-Carlsbad, San Diego County - 41740 [Excel]
  • San Luis Obispo-Paso Robles-Arroyo Grande, San Luis Obispo County - 42020 [Excel]
  • Santa Barbara-Santa Maria, Santa Barbara County - 42200 [Excel]

Effective January 1, 2015 to June 30, 2015

HI/Pacific Islands

  • Rural - 12 [Excel]
  • Guam - 65 [Excel]
  • Kalawao, Maui including Kahului-Wailuku-Lahaina - 27980 [Excel]
  • Urban Honolulu - 46520 [Excel]

Nevada

  • Rural - 29 [Excel]
  • Carson City - 16180 [Excel]
  • Las Vegas - 29820 [Excel]
  • Reno-Sparks - 39900 [Excel]

Northern California

  • California - 05 [Excel]
  • Bakersfield, Kern County - 12540 [Excel]
  • Chico, Butte County - 17020 [Excel]
  • Fresno, Fresno County - 23420 [Excel]
  • Hanford-Corcoran, Kings County - 25260 [Excel]
  • Madera, Madera County - 31460 [Excel]
  • Merced, Merced County - 32900 [Excel]
  • Modesto, Stanislaus County - 33700 [Excel]
  • Napa, Napa County - 34900 [Excel]
  • Oakland-Hayward-Berkeley, Alameda County, Contra Costa County - 36084 [Excel]
  • Redding, Shasta County - 39820 [Excel]
  • Riverside-San Bernardino-Ontario, Riverside County, San Bernardino County - 40140 [Excel]
  • Sacramento-Arden-Arcade-Roseville, El Dorado County, Placer County, Sacramento County, Yolo County - 40900 [Excel]
  • Salinas, Monterey County - 41500 [Excel]
  • San Francisco-Redwood City-South San Francisco, San Francisco County, San Mateo County - 41884 [Excel]
  • San Jose-Sunnyvale-Santa Clara, San Benito County, Santa Clara County - 41940 [Excel]
  • San Rafael, Marin County - 42034 [Excel]
  • Santa Cruz-Watsonville, Santa Cruz County - 42100 [Excel]
  • Santa Rosa, Sonoma County - 42220 [Excel]
  • Stockton-Lodi, San Joaquin County - 44700 [Excel]
  • Vallejo-Fairfield, Solano County - 46700 [Excel]
  • Visalia-Porterville, Tulare County - 47300 [Excel]
  • Yuba City, Sutter County, Yuba County - 49700 [Excel]

Southern California

  • Santa Ana-Anaheim-Irvine, Orange County - 11244 [Excel]
  • El Centro, Imperial County - 20940 [Excel]
  • Los Angeles-Long Beach-Glendale, Los Angeles County - 31084 [Excel]
  • Oxnard-Thousand Oaks-Ventura, Ventura County - 37100 [Excel]
  • San Diego-Carlsbad, San Diego County - 41740 [Excel]
  • San Luis Obispo-Paso Robles-Arroyo Grande, San Luis Obispo County - 42020 [Excel]
  • Santa Barbara-Santa Maria, Santa Barbara County - 42200 [Excel]

Resources

Last Updated Jun 30, 2017