ASC - Ambulatory Surgical Center Fee Schedule

Ambulatory surgical center payment data by provider and HCPCS, including national rates, wage adjustments, and device portions.

Select ASC - Ambulatory Surgical Center Fee Schedule in the Medicare dataset picker to work with this data. There is one row per ASC and HCPCS code.

Packaged payment indicators carry no separate payment. Exclude them when computing percent of Medicare.

Fields

Field Name	UI Name	Description / Sample Value
NPI	NPI	Unique 10-digit National Provider Identifier of the ambulatory surgical center. e.g. 1013463157
FIPS_Code	FIPS Code	U.S. Census Federal Information Processing Standards geographic code — a 5-digit value combining a 2-digit state code and a 3-digit county code. e.g. 37021
HCPCS_Code	HCPCS Code	Healthcare Common Procedure Coding System procedure code. e.g. 65600
Payment_Indicator	Payment Indicator	ASC payment status indicator determining payment status and bundling logic. e.g. P3 (office-based), A2 (surgical procedure priced under OPPS relative weight), N1 (packaged)
Addendum	Addendum	CMS ASC payment addendum the row comes from. e.g. AA
National_Rate	National Rate	Unadjusted national payment rate for the procedure, taken from Addendum AA or BB. e.g. $296.07
Wage_Index	Wage Index	Geographic wage index adjustment factor for the ASC's county. e.g. 0.8847
Device_Portion	Device Portion	Device-intensive payment portion amount. This portion is not wage-adjusted. e.g. $70.13
Medicare_Rate	Medicare Rate	Final calculated Medicare reimbursement amount. e.g. $296.07
Adjustment	Adjustment	How the rate was adjusted for this ASC — wage-adjusted versus unadjusted for device-intensive or flat-rated codes. e.g. national

ASC wage indexes are tied to FIPS, not to CBSA (as in OPPS) or CCN (as in IPPS). The county of the ASC's practice location drives the adjustment.

How the rate is calculated

Medicare Rate = National Rate × ((0.5 × Wage Index) + 0.5)

Half of the national rate is treated as labor and exposed to the wage index. Where a procedure has a device component, the unadjusted device portion is added on top of that result to get the true Medicare rate.

For payment indicator J8, the national service portion rate is calculated by subtracting the device offset amount (Addendum FF) from the payment rate (Addendum AA) for the HCPCS.

CMS ASC addenda

Rates in this dataset are drawn from Addendum AA and Addendum BB. The full set of CMS ASC addenda is:

Addendum	Contents
AA	Surgical procedures payable under the ASC payment system
BB	Covered ancillary services
DD1	Payment indicator definitions
DD2	Comment indicators
EE	Surgical procedures excluded from payment
FF	Device offset percentages