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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.

The complete lists of ASC covered surgical procedures and ASC covered ancillary services, the applicable payment indicators, payment rates for each covered surgical procedure and ancillary service before adjustment for regional wage variations, the wage adjusted payment rates, and wage indices are available at http://www.cms.gov/ascpayment/ This link takes you to an external website on the CMS website. Instructions are also available in the CMS Internet Only Manual (IOM), Publication 100-04, Medicare Claims Processing Manual, Chapter 14, Sections 30 and 40 This link takes you to an external website

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. 

 

2017

Effective January 1, 2017

For dates of service on/after 1/1/17 – CMS Change Request (CR)9923

2016

Effective October 1, 2016

For dates of service on/after 10/1/16 – CMS Change Request (CR) 9773

Effective July 1, 2016

For dates of service on/after 7/1/16 – CMS Change Request (CR) 9668

Effective January 1, 2016

For dates of service on/after 1/1/16 – CMS Change Request (CR)9484

2015

Effective October 1, 2015

For dates of service on/after 10/1/15 and processed on/after 10/1/15 - CMS Change Request 9310

  • All States [Excel] - Contains State Specific Tabs

Effective July 1, 2015

Effective January 1, 2015 - June 30, 2015

Last Updated Mar 10, 2017