The decision from the U.S. Centers for Medicare & Medicaid Services (CMS) to allow cardiac catheter ablation procedures in ambulatory surgery centers (ASCs) for the first time marks an important step in the evolution of outpatient cardiovascular care.
Finalized in the 2026 payment rule, the change reflects growing confidence that ablations can be performed safely in well-equipped outpatient settings, supported by advances in technology, clinical evidence and care pathways that enable same-day discharge. For ASCs, the move brings both opportunity and complexity, raising questions around infrastructure, staffing, patient selection and reimbursement.
In a conversation with ASC News, Michael Bodner, company group chair of electrophysiology and neurovascular at Johnson & Johnson MedTech, discusses why CMS was comfortable approving ablation in ASCs, how quickly adoption could ramp and what barriers could slow uptake. He also outlines the core capabilities ASCs need from Day 1 and what stakeholders should watch as CMS continues to push more cardiovascular procedures into the outpatient setting.
Highlights from the conversation are below, edited for length, style and clarity.
ASC News: CMS has now approved catheter ablation for ASCs for the first time. From your vantage point, what does this signal about the broader evolution of cardiovascular care delivery?
Bodner: CMS’ approval marks a meaningful step toward expanding access to arrhythmia care, where fewer than 5% of eligible patients currently receive ablation. The decision reinforces the strong body of clinical evidence that cardiac ablations can be performed safely by highly trained electrophysiologists in well-equipped ASCs. It also reflects a broader shift toward high-efficiency cardiovascular care models that expand access through shorter wait times and same-day discharge, supporting a more streamlined experience for patients.
For Johnson & Johnson MedTech, this decision validates years of investment in integrated technologies and clinical evidence that enable safe, efficient and cost-effective workflows. We are well positioned to support this shift as our portfolio is flexible enough to treat a wide range of patients, is backed by a proven safety profile and offers an integrated ecosystem of RF, PFA, ultrasound and 3D-mapping technologies.
J&J MedTech plays across both hospital electrophysiology suites and outpatient settings. What specific clinical or technological advancements made CMS comfortable moving ablation into the ASC environment now?
Johnson & Johnson MedTech has been advancing the science and practice of electrophysiology for more than 30 years. CMS’ decision reinforces the clinical evidence showing that cardiac ablations can be performed safely by highly trained electrophysiologists in well-equipped ASCs.
We are uniquely positioned to support ASCs as our portfolio offers flexibility to treat a wide range of arrhythmias. First, our VARIPULSE Platform (Pulse Field Ablation technology) is particularly well-suited for ASC adoption, offering a proven safety profile, precise and durable lesion sets, and zero-fluoroscopy. Recognizing the limitations of general anesthesia in ASCs settings, the VARIPULSE Platform integrated with our CARTO System is compatible with deep sedation. In addition, the CARTO System and our ultrasound integrated catheters offer high-resolution 3D mapping. And when paired with VARIPULSE, these technologies provide precise and consistent workflows that are essential in ASCs.
Clinical evidence underscores the readiness of our VARIPULSE Platform: a new admIRE subanalysis published in Eurospace showed that same-day discharge after VARIPULSE PFA was as safe and effective as overnight hospitalization. Real-world data from the REAL-AF registry also supports this, with nearly 85% of VARIPULSE patients discharged the same day.
How quickly do you expect adoption to ramp, and what barriers – operational, financial, or cultural – could slow ASC entry into electrophysiology?
Cardiac ablation in ASCs is still early in its adoption curve, but we expect to see acceleration as the CMS decision is implemented. Many of our customers already performing ablations in ASCs recognize the value of our CARTO System and integrated catheters, and with the federal policy change, we anticipate broader adoption driven by the efficiency, safety, and workflow advantages our platforms offer – especially as more physicians and patients seek the benefits of the ASC setting.
Adoption timelines will vary based on federal and state level regulations, an ASC’s infrastructure, staffing and technology. J&J MedTech is ready to actively help centers navigate these barriers through clinical education, staff training, workflow planning and technology integration.
Patient selection will remain essential, but the overall impact is clear: more flexibility for clinicians and broader access for patients.
For ASCs that are considering offering ablation, what infrastructure or capability investments are essential from Day 1?
For ASCs that are considering offering cardiac ablation, essential investments from Day 1 include building the right clinical, operational and safety infrastructure. This starts with having appropriately trained staff, integrated procedural technologies like mapping and imaging, clear risk management and robust discharge protocols. Equally important – as shared in an HRS/ACC Scientific Statement – is establishing shared decision-making practices that prioritize patient safety, access, informed consent and overall well-being.
Each ASC is unique, and we work closely with our customers to support sustainable adoption of electrophysiology services. That includes providing reimbursement education and coding guidance. We also offer multiple capital pathways, including financing, rental, and catheter-based programs, to ensure flexibility for centers evaluating how best to invest.
Electrophysiology is known for long procedure times and specialized staffing. How is J&J MedTech thinking about workflow efficiency, training, or support models tailored to the ASC setting?
To help ASC teams adopt EP procedures with confidence, we deliver comprehensive clinical education, including CARTO training, catheter onboarding, PFA education and workflow best practices, and we offer on-site case support. Our operational and economic resources include reimbursement education, coding guidance, reprocessed and OEM options, and capital pathways such as financing, rental, and catheter-based programs. Across all of this, we will continue collaborating closely with providers to maintain high standards of safety, efficiency, and patient care.
Looking ahead, do you see additional cardiovascular procedures becoming viable in ASCs – and what should stakeholders watch for in future CMS rulemaking?
ASCs are already becoming an important part of the future of MedTech, and they are increasingly shaping the future of cardiovascular care. CMS has also announced it will be phasing out the Inpatient Only List over the next 3 years, which we anticipate will allow for more cardiovascular procedures to move to the ASC. So, as more procedures move into these high-efficiency outpatient settings, ASCs are driving demand for devices that are simpler, more affordable, and optimized for streamlined workflows.
Our role is to ensure that we keep delivering the tools, training, and support needed to enable safe, efficient, and sustainable arrhythmia care across all settings. We remain focused on ensuring that our innovations and best practices translate seamlessly into the ASC environment, helping providers expand access and improve outcomes for more patients.
