Image by Kevin Schneider from PixabayThe number of Medicare-certified ambulatory surgical centers (ASCs) climbed to 6,299 in 2023, up 13% from 2017, according to recently released data from the Medicare Payment Advisory Commission (MedPAC).
At the same time, total Medicare payments to ASCs surged to $6.8 billion – an 11.6% jump over the prior year.
The figures, published in MedPAC’s July 2025 Data Book, underscore the growing role of ASCs in the outpatient care landscape, particularly as policymakers and payers look to shift procedures away from higher-cost hospital outpatient departments (HOPDs).
Volume per 1,000 Medicare Part B fee-for-service beneficiaries rose to 222 in 2023, up from 174 in 2020, according to MedPAC.
The year-over-year payment growth outpaced the 5.8% increase recorded in 2022 and the 17.6% spike seen in 2021, when COVID-19 disruptions began to recede. According to MedPAC, the acceleration in 2023 was driven not just by a greater number of procedures, but also by an increase in the complexity of services provided at ASCs.
Many industry experts anticipate the ASC market to continue this growth moving forward.
“The number of Medicare-certified ASCs grew at an average annual rate of 2.1% from 2017 through 2023,” MedPAC wrote in the data book. “In this same period, an annual average of 230 new facilities entered the market, while an average of 112 closed or merged with other facilities.”
The most common ASC procedures were cataract removal with lens insertion, upper gastrointestinal endoscopy, colonoscopy and nerve procedures, according to MedPAC.
Medicare Advantage, fee-for-service dynamics
The broader Medicare landscape also continues to shift in ways that affect ASC operators.
While traditional fee-for-service (FFS) Medicare payments are climbing, enrollment in Medicare Advantage (MA) plans continues to swell. As of 2025, 56% of Medicare beneficiaries with both Part A and B are enrolled in Medicare Advantage, compared with just 21% in traditional FFS.
This enrollment trend has financial implications for ASCs, of course. MA plans often negotiate lower rates than FFS Medicare and may impose stricter prior authorization requirements – something that ASC executives frequently cite as a pain point.
Yet the FFS spending data remains a critical barometer of federal policy and programmatic intent. And according to MedPAC, Medicare’s share of national personal health care spending – already at $956 billion in 2023 – is expected to nearly double to $1.9 trillion by 2032.
