Advances in medical technology have expanded the types of patients who can be treated outside the hospital. Despite these advances, the Centers for Medicare & Medicaid Services’ (CMS) payment policies have traditionally lagged innovation, and many procedures, such as total joints, are currently on the inpatient-only (IPO) list. Promising, though, is CMS’ recent proposal to remove total knee arthroplasty (TKA), code 27447, from the IPO list for 2018. The agency also is requesting feedback on the potential removal of total hip arthroplasty (THA) and partial hip arthroplasty (PHA) from the IPO list. For these procedures to migrate to the ASC setting, however, the industry will need to pursue changes to regulations that currently serve as roadblocks and continue to provide supporting data proving what it already knows: these procedures are being done safely and effectively in the ASC setting at a lower cost to payers and patients.