Total joints keep moving: Medicare TKA volume in ASCs rose 27.6% in 2024
MedPAC's March report counts 49,258 total knee replacements in ASCs in 2024 — up from roughly 10,800 in 2020, the year Medicare first covered the procedure there.
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Total joint replacement is still the fastest-moving procedure line in ambulatory surgery. In its March 2026 Report to the Congress, MedPAC counts 49,258 total knee arthroplasties performed in Medicare-certified ASCs in 2024 — up 27.6% in a single year, and up from roughly 10,800 in 2020, the first year fee-for-service Medicare covered TKA in the setting.
Hips moved even faster: total hip arthroplasty volume in ASCs grew 28.7% from 2023 to 2024. Both knee and hip replacement were once inpatient-only procedures; MedPAC notes their ASC volume has climbed since CMS removed them from that list and made them covered services under the ASC payment system. Total shoulder arthroplasty, covered for the first time in 2024, logged 11,047 Medicare cases in its first year.
The clinical evidence keeps pace with the volume. A Michigan registry study of 24,596 knee replacements found 9.3% were performed in ASCs — and that ASC patients had the lowest 30- and 90-day readmission rates of any setting.
Policy is set to accelerate the trend. The CY2026 OPPS/ASC final rule begins a three-year phase-out of the inpatient-only list and added 271 of those codes to the ASC covered procedures list, including total hip revision and a slate of spinal procedures, per MedPAC’s summary of the rule.
These figures are fee-for-service Medicare only — Medicare Advantage and commercial volume sit on top of them.