Mind the gap: Why Medicare pays ASCs less than HOPDs—and what that means

For decades, ambulatory surgery centers (ASCs) have shown their ability to deliver high-quality surgical care at substantially lower cost than hospital outpatient departments (HOPDs). ASCs achieve these savings through leaner operations, streamlined staffing models, and specialty-focused efficiencies, not by compromising safety or outcomes. Studies consistently highlight procedures performed in ASCs are less expensive to both Medicare and commercial payers. An example: the median cost of a colonoscopy in Texas is 38% lower in an ASC compared with an HOPD, while surgery times in ASCs average 25% to 39% shorter. While a routine procedure such as cataract surgery costs Medicare upwards of $1,000 in an HOPD, performing that same procedure in an ASC is some $400 to $500 less.