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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2019

Effective January 1, 2019 - For dates of service on/after 1/1/19 - CMS Change Request (CR) 11108

Alaska

  • Aleutians East Borough, Aleutians West Census Area, Bethel Census Area, Bristol Bay Borough, Denali Borough, Dillingham Census Area, Haines Borough, Juneau Bay, Kenai Peninsula Borough, Ketchikan Gateway Borough, Kodiak Island Borough, Lake and Peninsula Borough, Nome Census Area, North Slope Borough, Northwest Arctic Borough, Prince of Wales-Outer Ketchikan Census Area, Sitka Borough, Southeast Fairbanks Census Area, Valdez-Cordova Census Area, Wade Hampton Census Area, Wrangell-Petersburg Census Area, Yakutat Borough, Yukon-Koyukuk Census Area - 02 [Excel]
  • Anchorage, Matanuska-Susitna Borough - 11260 [Excel]
  • Fairbanks North Star Borough - 21820 [Excel]

Arizona

  • Apache, Coconino, Gila, Graham, Greenlee, La Paz, Navajo, Pinal, Santa Cruz - 03 [Excel]
  • Coconino, Navajo, Yavapai - 22380 [Excel]
  • Mohave - 29420 [Excel]
  • Gila, Maricopa, Pinal - 38060 [Excel]
  • Yavapai - 39140 [Excel]
  • Cochise - 43420 [Excel]
  • Pima - 46060 [Excel]
  • Yuma - 49740 [Excel]

Idaho

  • Bonner, Power - 13 [Excel]
  • Ada, Boise, Canyon, Gem, Owyhee - 14260 [Excel]
  • Kootenai - 17660 [Excel]
  • Bonneville, Butte, Jefferson - 26820 [Excel]
  • Nez Perce - 30300 [Excel]
  • Franklin - 30860 [Excel]
  • Bannock - 38540 [Excel]
  • Twin Falls - 46300 [Excel]

Montana

  • Anaconda-Deer Lodge, Beaverhead, Big Horn, Blaine, Broadwater, Butte-Silver Bow, Chouteau, Custer, Daniels, Dawson, Fallon, Fergus, Flathead, Gallatin, Garfield, Glacier, Granite, Hill, Jefferson, Judith Basin, Lake, Lewis and Clark, Liberty, Lincoln, Madison, McCone, Meagher, Mineral, Musselshell, Park, Petroleum, Phillips, Pondera, Powder River, Powell, Prairie, Ravalli, Richland, Roosevelt, Rosebud, Sanders, Sheridan, Stillwater, Sweet Grass, Teton, Toole, Treasure, Valley, Wheatland, Wibaux - 27 [Excel]
  • Carbon, Carter, Golden Valley, Yellowstone - 13740 [Excel]
  • Cascade - 24500 [Excel]
  • Missoula - 33540 [Excel]

North Dakota

  • Adams, Barnes, Benson, Billings, Bottineau, Bowman, Burke, Cavalier, Dickey, Divide, Dunn, Eddy, Edley, Emmons, Foster, Golden Valley, Grant, Griggs, Hettinger, Kidder, Lamoure, Logan, McHenry, McIntosh, McKenzie, Mclean, Mercer, Mountrail, Nelson, Pembina, Pierce, Ramsey, Ransom, Renville, Richland, Rolette, Sargent, Sheridan, Slope, Stark, Steele, Stutsman, Towner, Trail, Walsh, Ward, Wells, Williams - 35 [Excel]
  • Burleigh, Morton, Oliver, Sioux - 13900 [Excel]
  • Cass - 22020 [Excel]
  • Grand Forks - 24220 [Excel]

Oregon

  • Baker, Clatsop, Coos, Crook, Curry, Douglas, Gilliam, Grant, Harney, Hood River, Jefferson, Klamath, Lake, Lincoln, Malheur, Morrow, Sherman, Tillamook, Umatilla, Union, Wallowa, Wasco, Wheeler - 38 [Excel]
  • Linn - 10540 [Excel]
  • Deschutes - 13460 [Excel]
  • Benton - 18700 [Excel]
  • Lane - 21660 [Excel]
  • Josephine - 24420 [Excel]
  • Jackson - 32780 [Excel]
  • Clackamas, Columbia, Multnomah, Washington, Yamhill - 38900 [Excel]
  • Marion, Polk - 41420 [Excel]

South Dakota

  • Aurora, Beadle, Bennett, Bon Homme, Brookings, Brown, Brule, Buffalo, Burle, Butte, Campbell, Charles Mix, Clark, Clay, Codington, Corson, Dvison, Day, Devel, Dewey, Douglas, Edmonds, Edmunds, Fall River, Faulk, Grant, Gregory, Hamlin, Hamlin, Hamline, Hand, Hanson, Harding, Hughes, Hutchinson, Hyde, Jackson, Jerauld, Jones, Kingsburg, Lake, Lawrence, Lyman, Marshall, McPherson, Meade, Meilette, Miner, Moody, Perkins, Potter, Roberts, Sanborn, Shannon, Spink, Stanley, Sully, Todd, Tripp, Walworth, Yankton, Zieback - 43 [Excel]
  • Custer, Haakon, Meade, Pennington - 39660 [Excel]
  • Union - 43580 [Excel]
  • Lincoln, McCook, Minnehaha, Turner - 43620 [Excel]

Utah

  • Beaver, Carbon, Daggett, Duchesne, Emery, Garfield, Grand, Iron, Kane, Millard, Piute, Rich, Salt Lake, San Juan, Sanpete, Sevier, Summit, Uintah, Wasatch, Wayne - 46 [Excel]
  • Cache - 30860 [Excel]
  • Box Elder, David, Davis, Morgan, Weber - 36260 [Excel]
  • Juab, Utah - 39340 [Excel]
  • Washington - 41100 [Excel]
  • Salt Lake, Tooele - 41620 [Excel]

Washington

  • Adams, Clallam, Ferry, Garfield, Grant, Grays Harbor, Island, Jefferson, Kittitas, Klickitat, Lewis, Lincoln, Mason, Okanogan, Pacific, San Juan, Wahkiakum, Whitman - 50 [Excel]
  • Whatcom - 13380 [Excel]
  • Kitsap - 14740 [Excel]
  • Benton, Franklin - 28420 [Excel]
  • Astoin - 30300 [Excel]
  • Cowlitz - 31020 [Excel]
  • Skagit - 34580 [Excel]
  • Thurston - 36500 [Excel]
  • Clark, Skamania - 38900 [Excel]
  • King, Snohomish - 42644 [Excel]
  • Pend Oreille, Spokane, Stevens - 44060 [Excel]
  • Pierce - 45104 [Excel]
  • Columbia, Walla Walla - 47460 [Excel]
  • Chelan, Douglas - 48300 [Excel]
  • Yakima - 49420 [Excel]

Wyoming

  • Albany, Big Horn, Campbell, Carbon, Converse, Crook, Fremont, Goshen, Hot Spring, Johnson, Lincoln, Niobrara, Park, Sheridan, Sublette, Sweetwater, Teton, Uinta, Washakie, Weston - 53 [Excel]
  • Natrona - 16220 [Excel]
  • Laramie - 16940 [Excel]

2018

Effective October 1, 2018 - For dates of service on/after 10/1/2018 – CMS Change Request (CR) 10932

Effective July 1, 2018 - For dates of service on/after 7/1/18 - CMS Change Request (CR)10788

Effective April 1, 2018 – For dates of service on/after 4/1/2018 – CMS Change Request (CR) 10530

Effective February 13, 2018 - For dates of service on/after 1/1/18 – CMS Change Request (CR)10441

Effective January 1, 2018 - For dates of service on/after 1/1/18 - CMS Change Request (CR)10441

2017

Effective October 1, 2017 - For dates of service on/after 10/1/17 - CMS Change Request (CR)10259

Effective July 1, 2017 - For dates of service on/after 7/1/17 - CMS Change Request (CR)10138

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

Resources

 

Last Updated Jan 07, 2019