Medicare ASC spending jumped 13% to $7.5B in 2024, MedPAC reports
The commission's March 2026 report counts 6,436 Medicare-certified ASCs — a net 140 more than 2023 — treating 3.4 million beneficiaries across 6.4 million services.
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- FFS Medicare paid ASCs $7.5 billion in 2024 (program payments plus beneficiary cost sharing), up 13.0% from $6.6 billion in 2023.
- The number of Medicare-certified ASCs rose 2.2% to 6,436 — 248 opened, 108 closed.
- Volume per 1,000 Part B beneficiaries grew 3.5%; payments per beneficiary using ASCs hit $2,211.
- Cataract surgery with IOL insertion remains the single largest line at 18% of all ASC volume; the top 20 procedures account for 67.9%.
Medicare’s advisory commission delivered the sector’s clearest annual snapshot in its March 2026 Report to the Congress: fee-for-service Medicare paid ambulatory surgery centers $7.5 billion in 2024, up 13.0% from $6.6 billion the year before — and up from $5.3 billion in 2019.
The facility base grew far more slowly than the dollars. Medicare-certified ASCs rose 2.2% to 6,436, with 248 openings against 108 closures. The gap between 13% spending growth and 2% facility growth is the simplest bull case for the sector: more procedures, at higher acuity, flowing through roughly the same number of doors.
Volume tells the same story. ASCs treated 3.4 million FFS beneficiaries across 6.4 million services in 2024; volume per 1,000 Part B beneficiaries grew 3.5%. Cataract removal with lens insertion is still the anchor at 18% of all volume, and half of all ASC volume sits in just seven procedure families.
Margins, where they’re visible, are strong. ASCs file no Medicare cost reports, so no national margin exists — but Pennsylvania’s all-payer data, which MedPAC cites, shows a 29.5% operating margin for that state’s ASCs in 2024, the highest reading in a decade.
All figures are fee-for-service Medicare unless noted; Medicare Advantage volume is additive to everything above.