ASC Series: Part 1 – The Basics
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An Ambulatory Surgery Center (ASC) is a healthcare facility that specializes in providing outpatient surgical care. These centers are designed for procedures that do not require an overnight hospital stay.
What are the benefits of having surgery in an ASC?
- ASCs offer specialized care that focuses on specific types of surgeries and diagnostic procedures that are typically less complex and minimally invasive.
- Procedures at ASCs generally cost less than those performed in hospitals due to lower facility fees.
- Patients can go home the same day, which is often more convenient and comfortable.
- Many patients report higher satisfaction levels due to the efficiency and personalized care provided at ASCs.
Although not an all-inclusive list, the most common procedures performed at ambulatory surgery centers include joint arthroscopy, cataract surgery, colonoscopy, and hernia repair. Most ASCs have a list of their commonly performed procedures.
Outpatient Surgical Procedure-Related Groups (PRGs)
RPGs are outpatient surgical procedure code groupings that payers use for reimbursing services performed in the ASC. These lists are largely proprietary by payer. You can find them in your credentialing packet. Some payers have carved out pricing for cosmetic procedures. Always make sure you review these proprietary PRG lists prior to signing on the dotted line.
Next in our series:
Ambulatory Surgery Center Series: Part 2 – Coding and Billing
Resources
Novitas ASC Search Page
Novitas ASC – Terminated Procedures
Novitas ASC – Billing Tips
Novitas ASC – 2025 Fee Schedule
Novitas ASC – Billing Modifiers
ASCA – 2025 Final Rule ASC Summary
CMS MLN Matters – 2025 ASC Payment Update