Background

ASCs perform roughly 6.8 million vital surgical, diagnostic and preventive procedures for Medicare beneficiaries each year, according to the Centers for Medicare & Medicaid Services’ (CMS) 2018 data. That includes 75 percent of beneficiary cataract removals, 50 percent of colonoscopies and well over 100,000 colorectal cancer screenings, contributing to the decades-long decline in colorectal cancer incidence and mortality, according to the American Cancer Society. Despite the wide range of services available at ASCs, a small number of procedures have historically represented a large percentage of the surgical volume performed on Medicare beneficiaries. For example, cataract removal with intraocular lens insertion (Healthcare Common Procedure Coding System [HCPCS] 66984) and upper gastrointestinal procedure with biopsy (HCPCS 43239) have been the top two most common codes performed at ASCs on Medicare beneficiaries since at least 2008. According to the Medicare Payment Advisory Commission (MedPAC), just 28 procedures account for 75 percent of all Medicare volume at ASCs.