CY 2021 brought policy and reimbursement changes that would seem to position ASCs favorably for an obvious migration of cases from the hospital outpatient department (HOPD) to the ASC. The Centers for Medicare & Medicaid Services (CMS) automatically added more than 267 cases to the CMS Covered Procedures List (CMS-CPL) due to a revision of the exclusionary criteria which removed the top five exclusions criteria that originally prevented certain types of cases from being performed in an ASC setting. Current quality data and surgical procedure transparency tools provide the consumer a semblance of control when determining the site of care for common procedures. Yet, a higher volume of cases could migrate from the HOPD to the ASC if a few hurdles could be overcome.