2027 AMBULATORY SURGICAL CENTER (ASC) PAYMENT SYSTEM AND QUALITY REPORTING (ASCQR) PROGRAM
FINAL RULE RELEASED
2027 ASC Conversion Factor Finalized at $57.721 for
ASCs Meeting Quality Reporting Requirements
Today, the Centers for Medicare & Medicaid Services (CMS) issued the Calendar Year (CY) 2027 Hospital Outpatient Prospective Payment System (OPPS) and Ambulatory Surgical Center (ASC) Payment System Policy Changes and Payment Rates final rule, along with an accompanying fact sheet. The policies will be effective beginning January 1, 2027.
ASC Conversion Factor
For CY 2027, CMS will adjust the CY 2026 ASC conversion factor ($56.322) by a wage index budget neutrality factor of 1.0018 in addition to the finalized productivity-adjusted hospital market basket update of 2.3%, which results in a final CY 2027 ASC conversion factor of $57.721 for ASCs meeting the quality reporting requirements.
For ASCs not meeting the quality reporting requirements, CMS will adjust the CY 2026 ASC conversion factor ($56.322) by the wage index budget neutrality factor of 1.0018 in addition to the quality reporting/productivity-adjusted hospital market basket update of 0.3%, which results in a CY 2027 ASC conversion factor of $56.592.
ASC Market Basket Update
For CY27, CMS finalized extending utilization of the hospital market basket update as the update factor for the ASC payment system for one additional year, through CY 2027.
Estimated Impact of Final CY 2027 Update to ASC Payment System on Aggregate Payment for Eye and Ocular Adnexa Procedures
CMS estimates that the final update to CY 2027 ASC payment rates will result in a 1% decrease in aggregate payment amounts to eye and ocular adnexa procedures. The decrease is attributable to the 2.3% hospital market basket update being offset by the reduction in the ASC weight scaler. The reduction in the ASC weight scaler from 0.872 in CY 2026 to 0.814 for CY 2027 is attributable to the increase in device portions under the ASC payment system as a result of the increase in OPPS payment rates for clinical services for CY 2027 and their policy to treat device portions of device-intensive procedures as constant between the OPPS and ASC payment system.
Estimated Impact of Final CY 2027 Update to ASC Payment System on Aggregate Payment for Cataract Surgery (66984)
Table 114 in the rule shows the estimated impact of the updates to the revised ASC payment system on aggregate ASC payments for selected surgical procedures, including 66984 for CY 2027. The finalized ASC payment rate for cataract surgery, CPT 66984, is estimated to decrease by 2%.
Non-Opioid Treatments for Pain Relief Continue to be Paid Separately in Both the ASC and HOPD Settings
CMS finalized a policy that non-opioid pain management drugs or biologicals that function as a supply in a surgical procedure are eligible for separate payment if the drug or biological does not have transitional pass-through payment status and is not already separately payable in the OPPS or ASC payment system. CMS finalized its proposal to continue this policy for CY 2027. As a result, Omidria (J1097) and Dextenza (J1096) will continue to receive separate payments in the ASC and HOPD settings.
ASC Quality Reporting (ASCQR) Program
The ASCQR Program is a pay-for-reporting quality program for the ASC setting. The ASCQR Program requires ASCs to meet program requirements or receive a reduction in their annual fee schedule update.
CMS did not finalize any changes to the Cataracts: Improvement in Patient's Visual Function within 90 Days Following Cataract Surgery (ASC-11) measure, which will remain voluntary in 2027. ASCRS continues to strongly oppose the inclusion of this measure and will continue to work to ensure that the reporting does not become mandatory in the future.
Measure Removals
CMS finalized the removal of one measure beginning with the 2027 performance year—Endoscopy/Polyp Surveillance: Appropriate Follow-Up Interval for Normal Colonoscopy in Average Risk Patients.
Additional Details to Come
ASCRS is reviewing the 1,270-page final rule, and additional information will be detailed in upcoming editions of Washington Watch Weekly.
ASCRS submitted comments on the proposed rule on August 31, 2026.
