Medicare & Ambulatory Surgery Center

Medicare covers approved surgical procedures performed in an ambulatory surgery center. But you will still be responsible for some out-of-pocket costs including any facility fees that Medicare does not cover.

Terry Turner, writer and researcher for RetireGuide
  • Written by
    Terry Turner

    Terry Turner

    Senior Financial Writer and Financial Wellness Facilitator

    Terry Turner has more than 30 years of journalism experience, including covering benefits, spending and congressional action on federal programs such as Social Security and Medicare. He is a Certified Financial Wellness Facilitator through the National Wellness Institute and the Foundation for Financial Wellness and a member of the Association for Financial Counseling & Planning Education (AFCPE®).

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  • Edited By
    Lee Williams
    Lee Williams, senior editor for RetireGuide.com

    Lee Williams

    Senior Financial Editor

    Lee Williams is a professional writer, editor and content strategist with 10 years of professional experience working for global and nationally recognized brands. He has contributed to Forbes, The Huffington Post, SUCCESS Magazine, AskMen.com, Electric Literature and The Wall Street Journal. His career also includes ghostwriting for Fortune 500 CEOs and published authors.

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  • Published: May 4, 2021
  • Updated: November 1, 2022
  • 4 min read time
  • This page features 6 Cited Research Articles
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APA Turner, T. (2022, November 1). Medicare & Ambulatory Surgery Center. RetireGuide.com. Retrieved December 7, 2022, from https://www.retireguide.com/medicare/services/ambulatory-surgery-center/

MLA Turner, Terry. "Medicare & Ambulatory Surgery Center." RetireGuide.com, 1 Nov 2022, https://www.retireguide.com/medicare/services/ambulatory-surgery-center/.

Chicago Turner, Terry. "Medicare & Ambulatory Surgery Center." RetireGuide.com. Last modified November 1, 2022. https://www.retireguide.com/medicare/services/ambulatory-surgery-center/.

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Ambulatory Surgery Center (ASC) Coverage at a Glance
Medicare PlanAmbulatory Surgery Center Coverage
Part A (Inpatient) N/A
Part B (Outpatient) Covers 80% of approved surgical procedure costs after you have reached your Part B deductible.
Part C (Medicare Advantage) Coverage mirrors Part B. Select plans may offer additional benefits.
Part D (Prescription Drugs) N/A
Supplemental InsuranceCan help cover out-of-pocket surgical costs. Coverage varies by plan.

Does Medicare Cover Ambulatory Surgery Centers?

Medicare Part B medical insurance covers service fees associated with approved surgical procedures at an ambulatory surgery center (ASC). To be covered, you should be expected to be released from the center within 24 hours of your surgery.

Examples of Ambulatory Surgery Center Services Covered by Medicare
  • Nursing services
  • Recovery care
  • Anesthetics
  • Drugs supplied while in the ASC
  • Supplies necessary for your procedure
  • Fees for doctors and anesthesiologists

Medicare covers all procedures that do not pose a significant risk if they are performed in an ambulatory surgery center so long as they don’t require an overnight stay.

Different parts of Medicare may cover different costs assoiciated with your care at an ambulatory surgery center.

As of 2022, there were roughly 3,800 different types of procedures performed at ambulatory surgery centers which were covered by Medicare, according to the Medicare Payment Advisory Commission (MedPAC).

The 2022 MedPAC report to Congress, using the most recent numbers from 2020, said there were 5,930 Medicare-certified ambulatory surgery centers in the U.S. They provided services to roughly three million Medicare beneficiaries that year at a cost of $4.9 billion to the program.

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Your Share of Costs for Ambulatory Surgery Center Services Under Medicare

If you have Medicare Part B and have a procedure at an ambulatory surgery center, Medicare will cover up to 80 percent of the cost.

You are responsible for the Medicare Part B deductible and for 20 percent of the Medicare-approved cost of your procedure and 20 percent of the doctor fees.

You also have to pay all facility fees for any procedure that Medicare does not cover in an ambulatory surgery center.

How Much Does It Cost?
If you are considering a procedure at an ambulatory surgery center, you can look up a ballpark estimate for its cost, and your share, at Medicare’s Procedure Price Lookup tool.
Source: U.S. Centers for Medicare & Medicaid Services

Medicare covers all costs for certain preventive services performed in an ASC, so you’ll have no out-of-pocket costs for those services.

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Differences Between an Ambulatory Surgical Center and a Hospital

Ambulatory surgery centers are freestanding outpatient facilities. They may be run by hospitals but perform outpatient services — meaning procedures that can be done without requiring a patient be admitted to a hospital.

Hospitals are equipped to handle inpatient services — meaning you are admitted to a hospital and may stay there overnight or longer. Hospitals also typically provide wide ranging services beyond those needed for ASC services. These can include MRI departments, intensive care units and other advanced care facilities and services.

Ambulatory Surgery Centers vs. Hospitals
Ambulatory Surgery CentersHospitals
Focused on specific care for a specific procedureProvides full services from surgery to intensive care to in house testing and imaging
Patients tend to be healthier, treated for a specific procedurePatients may have a wide range of health conditions and needed treatments
Stays limited to 24 hour or lessStays may last 24 hours or longer
Typically lower procedure costsTypically higher procedure costs

Because ambulatory surgery centers are focused on specific procedures, they do not need the full range of services available at a hospital. This lower overhead allows an ASC to perform certain procedures at a lower cost than what the same procedure might cost in a hospital.

But it also may limit the type of procedures available at an ambulatory surgery center. At the same time, ASCs are a practical alternative for several procedures that can be safely performed without the need for a hospital’s full range of resources and in which you don’t need to stay overnight.

Most Common Medicare-Approved Procedures in Ambulatory Surgical Centers
  • Cataract removal with lens insertion
  • Upper gastrointestinal endoscopy
  • Colonoscopy
  • Nerve-related procedures

Not every patient or procedure is suited for an ambulatory surgery center. You should talk with your doctor about whether an ASC or a hospital is the best location for your procedure.

Last Modified: November 1, 2022

6 Cited Research Articles

  1. MedPAC. (2022, March) Report to the Congress; Chapter 5: Ambulatory Surgical Center Services. Retrieved from https://www.medpac.gov/wp-content/uploads/2022/03/Mar22_MedPAC_ReportToCongress_Ch5_SEC.pdf
  2. MedPAC. (2018, October). Ambulatory Surgical Center Services Payment System. Retrieved from https://www.medpac.gov/wp-content/uploads/import_data/scrape_files/docs/default-source/reports/mar18_medpac_ch5_sec.pdf
  3. U.S. Centers for Medicare & Medicaid Services. (n.d.). Ambulatory Surgical Centers. Retrieved from https://www.medicare.gov/coverage/ambulatory-surgical-centers
  4. U.S. Centers for Medicare & Medicaid Services. (n.d.). Procedure Price Lookup. Retrieved from https://www.medicare.gov/procedure-price-lookup/
  5. Xenon Health. (n.d.). Choosing a Hospital vs. a Surgery Center. Retrieved from https://xenonhealth.com/choosing-hospital-vs-surgery-center/
  6. Summit Orthopedics. (n.d.). What Are the Differences Between an Ambulatory Surgery Center and a Hospital? Retrieved from https://www.summitortho.com/services/surgery/differences-ambulatory-surgery-center-hospital/