The Ambulatory Surgery Center Association (ASCA) is calling on CMS to revise its proposed 2027 payment rule, warning that reimbursement reductions could limit surgery centers’ ability to expand access to lower-cost outpatient care.

Although the proposal includes an average 2.4% payment update and would add 618 procedures to the ASC Covered Procedures List, ASCA projects that payments would decline for 85 of the 100 most frequently performed ASC procedures. The association primarily attributes those reductions to CMS’ ASC weight scalar and is urging the agency to eliminate it.

ASCA also asked CMS to:

• Permanently align annual ASC and hospital outpatient payment updates.
• Extend hospital wage-index protections to rural surgery centers.
• Allow ASCs to receive reimbursement for unlisted procedure codes.
• Remove quality measures that do not directly improve patient outcomes.
• Delay the ASC-21 patient-reported outcomes measure until it has been evaluated in inpatient settings.

For healthcare supply chain and operations leaders, the reimbursement dispute could influence where procedures migrate and how health systems invest in ambulatory capacity. Lower payments for high-volume services may place additional pressure on ASC purchasing, staffing and capital budgets, even as CMS seeks to move more procedures into outpatient settings. The rule remains a proposal, and CMS could revise its provisions before issuing the final 2027 rule.