ASC Spending Is Up Nearly 16%: What It Means for Your Center

The Medicare Payment Advisory Commission (MedPAC) released its March 2026 Report to Congress earlier this month. For ASC leaders, one number stands out: Medicare spending on ASC services grew nearly 16% from 2023 to 2024. 

That's not a coincidence. It's a trend — and it has real implications for how your center operates. 

What MedPAC found 

Each March, MedPAC advises Congress on Medicare payment adequacy across care settings. This year's ASC chapter tells a clear story: the sector is growing, and the pace is accelerating. 

The key numbers from Chapter 11: 

• About 6,400 ASCs treated 3.4 million Medicare fee-for-service beneficiaries in 2024 

• Total FFS Medicare and beneficiary spending on ASC services reached approximately $7.5 billion 

• Spending per beneficiary had been rising at 9.4% annually from 2019 to 2023, then jumped to 15.9% in a single year 

• The number of ASCs grew 2.2%, with 248 new centers opening in 2024 

• Procedure volume per FFS beneficiary increased 3.5% 

That acceleration from roughly 9% to nearly 16% in one year is worth paying attention to. It reflects real shifts in case mix, patient volume, and the expanding role ASCs play in outpatient care delivery. 

Why ASC volume and spending keep climbing 

The growth isn't accidental. Behind that 16% figure are three shifts that every ASC leader should understand:

High-acuity cases are moving outpatient 

Hip, knee, and shoulder replacements — once exclusive to the hospital setting, are increasingly being performed in ASCs. Better anesthesia, improved surgical techniques, and leaner post-op protocols have made this shift not just possible, but preferred for many patients. MedPAC specifically flags continued growth in arthroplasties performed in ambulatory settings. 

Cardiology and pain management are leading the charge 

These were the two fastest-growing ASC specialties from 2023 to 2024 according to the report. Both are complex, high-acuity service lines, and their migration into ASCs signals that the definition of what belongs in an outpatient center keeps expanding. 

Regulatory barriers are coming down 

Certificate-of-need law changes in South Carolina, Georgia, and North Carolina have reduced barriers to ASC entry and expansion in recent years. Fewer restrictions mean more centers opening and more volume moving through the ones already operating. 

What MedPAC is watching 

Alongside the growth data, MedPAC flagged two issues that ASC leaders shouldn't ignore:

Cost data transparency 

MedPAC has now recommended for multiple consecutive years that Congress require ASCs to submit cost data to CMS, something hospitals and other provider types are already required to do. Their concern: without cost data, policymakers can't tell whether Medicare's ASC payment rates are appropriately calibrated. As ASC spending scales, that push for transparency will only get louder. This is a policy conversation worth following closely. 

Quality reporting alignment 

The Commission is also pushing CMS to better align the ASC Quality Reporting Program with hospital outpatient quality measures, making it easier for patients and policymakers to compare care across settings. More standardized quality data is coming. Being ahead of that curve is a competitive advantage. 

What this means for your ASC operations 

More volume is good news. But it comes with added complexity, especially on the controlled substance side. 

Higher case volume means more medication utilization. More complex procedures like total joints, cardiac cases, and pain management mean more DEA-scheduled drugs moving through your facility. And as MedPAC's scrutiny of the ASC sector grows, the bar for compliance and documentation is rising with it. 

Curious how MedServe fits in?

MedServe is purpose-built for ambulatory surgery centers. We help ASCs manage controlled substances compliantly, reduce the risk of drug diversion, and cut the administrative burden that comes with manual tracking. As your case volume grows, we make sure your medication management keeps pace — without the complexity of systems designed for hospitals.

Learn how ASCs like yours are making it work. Talk to our team.