The ASC Reimbursement Tracker
A standing reference: the CY2026 update, the conversion-factor gap, and national rates for the sector's marquee codes. Updated with our reimbursement coverage.
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This page anchors our reimbursement coverage. The rates below the fold on the Pro tracker come straight from the CMS ASC payment addenda (currently the April 2026 Addendum AA); this article explains what we track and how to read it.
What the tracker covers
National unadjusted Medicare ASC rates for the sector’s highest-volume covered procedures — cataract with IOL (66984: $1,255.73), diagnostic colonoscopy (45378: $510.49), total knee arthroplasty (27447: $9,393.16), rotator-cuff repair (29827: $3,695.53), total shoulder arthroplasty (23472: $13,911.66) — plus the conversion-factor math that moves all of them. The CY2026 update is +2.6% per the final rule; the ASC conversion factor stands at $56.32 against $90.97 for hospital outpatient departments, per MedPAC.
How to read it
Published rates are national and unadjusted — your payment varies with the wage index, and quarterly addenda revise individual codes. Treat the table as the modeling baseline, not the remittance forecast.
When it updates
Rates update when CMS posts a quarterly addendum or finalizes a rule, and whenever our coverage moves a number. CY2027 rates don’t exist yet: the proposed rule is expected in July, the final rule in November. The briefing flags every update.