As ASC leaders know, Medicare reimbursement rates vary significantly based on the site of service, or where the care is provided. In the case of surgical care, hospital outpatient departments (HOPD) are reimbursed, on average, twice as much as ASCs for the same services. Over the past decade, the Medicare Payment Advisory Commission (MedPAC) and bipartisan policymakers have all recommended site-neutral payment reforms to reduce Medicare spending.