Future of the ASC Industry
- Fastest-growing ASC specialties, 2023–2024: orthopedics (+18.9%), respiratory (+8.3%), cardiology (+6.3%)
- Projected ASC volume growth over the next decade: 24%
- Projected average ORs per ASC in 2029: 3.01
- Projected average ORs for single-specialty ASCs in 2029: 2.43
- Projected average ORs for multi-specialty ASCs in 2029: 3.61
Noteworthy Procedures Added to CMS ASC Covered Procedures List (ASC-CPL) for 2026
- Electrophysiology studies and ablations
- Percutaneous coronary intervention
- Cardioversion
- Posterior lumbar interbody fusion
- Combined posterior lumbar and posterior lumbar interbody fusion
- Vascular embolization or occlusion
Noteworthy Procedures Proposed for the ASC-CPL for 2027
- CMS proposes removing nearly 640 services from the inpatient-only list and adding 618 codes to the ASC-CPL
- Laparoscopic colectomy
- Partial nephrectomy
- Sleeve lobectomy
- Prostatectomy
Cost Savings to Medicare
- Medicare savings from care delivered in ASCs (2024): $5.1 billion
- Projected annual Medicare savings by 2034: $12.5 billion
- Projected total Medicare savings, 2025-2034: nearly $85 billion
- Fee-for-service Medicare payments to ASCs (2024): $7.5 billion, up from $5.3 billion in 2019
Ownership Structure
(Percentage total 100%)
- Physician only: 52%
- Physician-hospital: 22%
- Physician-corporation: 13%
- Physician-hospital-corporation: 3%
- Corporate only: 3%
- Hospital only: 2%
- Other: 5%
Facility Size
- Small (1-2 ORs): 54%
- Medium (3-4 ORs): 31%
- Large (5-6 ORs): 10%
- Mega (7+ ORs): 5%
Financial Metrics (Median)
- Salaries, wages, and benefits as % of net revenue: 23%
- Benefit cost as % of total compensation: 15.0%
- Salaries and wages as % of net revenue: 29.3%
- Supply cost as % of net revenue: 27.8%
- Number of days cash on hand: 56
- Days in A/R: 35-45 days
- A/R over 90 days: <15%
- Clean claims: 98%
- Denial date: <5%
Case Volume Metrics (Median)
- Annual surgical cases per OR: 1,104
- Annual procedures per procedure room: 1,357
- Annual orthopedic cases per room: 800
- Annual ophthalmology cases per room: 1,400
- Annual gastroenterology cases per room: 1,500
Medicare-Certified ASCs by Specialty Type
Percentages don’t add up to 100—centers may have more than one specialty.
- Pain: 36% (2,229)
- Orthopedic: 36% (2,223)
- Ophthalmology: 34% (2,096)
- Endoscopy: 32% (1,982)
- Plastic: 28% (1,722)
- Podiatry: 27% (1,659)
- Otolaryngology: 23% (1,416)
- Obstetrics/Gynecology: 18% (1,106)
- Dental: 8% (472)
Single-Specialty, Medicare-Certified ASCs by Specialty Type
- Endoscopy: 27% (862)
- Ophthalmology: 25% (797)
- Pain: 13% (410)
- Plastic: 6% (186)
- Orthopedic: 6% (182)
- Podiatry: 3% (91)
- Dental: 2% (54)
- Obstetrics/Gynecology: 1% (33)
- Otolaryngology: 1% (39)
Multi-Specialty, Medicare-Certified ASCs by Specialty Type
Percentages do not add up to 100—centers may have more than one specialty.
- Orthopedic: 36% (2,041)
- Pain: 36% (1,819)
- Podiatry: 34% (1,568)
- Plastic: 32% (1,536)
- Otolaryngology: 28% (1,377)
- Ophthalmology: 27% (1,299)
- Endoscopy: 23% (1,120)
- Obstetrics/Gynecology: 18% (1,073)
- Dental: 8% (418)
Revenue Per Case by Specialty (Median)
- Orthopedics: $3,764
- Gynecology: $2,933
- Podiatry: $2,688
- Otolaryngology: $2,543
- Urology: $1,887
- General Surgery: $2,458
- Plastic Surgery: $2,010
- Ophthalmology: $1,442
- Pain Management: $968
- Gastroenterology: $800
The Impact of Ambulatory Surgery Centers
The ASC statistics shared above provide a glimpse into an industry that's not only cemented itself as critical to healthcare today but is poised to take on even greater importance going forward. The migration of surgical care out of the inpatient setting and into outpatient settings, largely ASCs, shows no signs of slowing down.
Given the rapidly changing healthcare environment, how can ASCs better ensure success today and tomorrow? Revisit what ASC leaders said during our webinar, "What's Next for the ASC Industry."
Sources: Advisory Board, Ambulatory Surgery Center Association (ASCA), ASC Data, ASC Focus, Avanza Healthcare Strategies, Centers for Medicare & Medicaid Services, Definitive Healthcare, KNG Health Consulting, MedPAC, Sg2, Vizient, VMG Health
Frequently Asked Questions
What is an ambulatory surgery center?
An ASC is a facility where patients receive same-day surgical procedures and return home after recovery.
How many ASCs operate in the U.S.?
More than 6,600 Medicare-certified ASCs, with 18,000+ operating rooms.
Which ASC specialties are growing fastest?
Orthopedics, respiratory, and cardiology
What is the projected growth for ASCs?
ASC volume is projected to grow 24% over the next decade.
How much does the ASC industry save Medicare?
ASCs saved Medicare $5.1 billion in 2024, with savings projected to reach $12.5 billion annually by 2034.
What is the average number of ORs per ASC?
The average ASC has 2.89 ORs, increasing to 3.01 ORs by 2029.
