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This past Friday, November 21, the Centers for Medicare & Medicaid Services (CMS) dropped big news for our ambulatory surgery center (ASC) community: The 2026 final payment rule for ASCs and hospital outpatient departments (HOPD) is now official. And for ASCs, it's safe to say that this year's rule isn't just incremental progress. It's a defining moment.
The 2026 final rule signals a clear acknowledgment from CMS that surgery centers are ready for more. More procedures. More responsibility. More opportunity to serve Medicare beneficiaries safely, efficiently, and cost-effectively. That's something worth celebrating.
Surgical Information Systems (SIS) sees these changes not only as further validation of what ASCs can do, but as fuel for a year of momentum in which forward-thinking centers can truly Operate Smart™.
Sweeping Expansion of the ASC Covered Procedures List
The most transformative element of the rule is the impressive and extensive overhaul of the ASC Covered Procedures List (ASC-CPL). CMS finalized major changes to the criteria governing which procedures can be added, removing several long-standing exclusion categories.
The result is the substantial addition of nearly 550 codes to the ASC-CPL for 2026.
This growth comes from two sources:
Procedures added under revised criteria
CMS will add 276 new procedures based on the updated standards, with many align with codes specifically requested by the Ambulatory Surgery Center Association (ASCA) and in areas including cardiovascular, spine, and vascular.
Codes transitioning from the inpatient-only list (IOL)
CMS is also beginning the three-year process of eliminating the IPO list. As part of that transition, 271 procedures being removed from IPO status in 2026 will be added directly to the ASC-CPL.
Together, these policy shifts make the 2026 ASC-CPL expansion one of the largest in the Medicare program's history.
Beneficial Alignment Extension
CMS finalized an average 2.6% payment increase for ASC-covered procedures. This comes from a 3.3% inflation update — tied to the hospital market basket — minus the standard productivity adjustment of 0.7 percentage points.
But the headline here concerns CMS agreeing to continue using the same update factor — hospital market basket — for ASCs and HOPDs through 2026, extending the policy ASCA championed. This is very encouraging as it would seem to send a message that CMS continues to value consistency in how outpatient surgical care is supported across settings.
Quality Reporting: Meaningful Changes and a Breather for ASCs
The rule also brings a few significant adjustments to the ASC Quality Reporting (ASCQR) Program, largely simplifying the landscape for surgery centers. CMS finalized the removal of:
- ASC-20: COVID-19 Vaccination Coverage Among Health Care Personnel
- ASC-22: Screening for Social Drivers of Health (SDOH)
- ASC-23: Screen Positive Rate for SDOH
- ASC-24: Facility Commitment to Health Equity
In addition, CMS chose not to finalize the adoption of the Information Transfer PRO-PM measure — another area where ASCA's advocacy made a clear impact.
Transformative Year Ahead for Ambulatory Surgery Centers
The 2026 CMS final payment rule for ASCs sets the stage for what is sure to be one of the most opportunity-rich years in recent memory for surgery centers. At SIS, we view this moment as a turning point — a time when the combination of smart systems, strong processes, and well-supported clinical and business operations will help ASCs make the most of these new possibilities.
As the volume and complexity of ASC-approved procedures grows, SIS remains committed to providing the tools and insights that help centers Operate Smart, stay compliant, optimize performance, and deliver outstanding patient care.
2026 is shaping up to be a milestone year for the ASC industry. And SIS is excited to help lead the way.
