As medical technology advances and guidelines for routine inpatient surgeries are relaxed, physicians are able to perform a greater number of procedures in the outpatient care setting.  This is generally beneficial for patients, as procedural costs at an ambulatory surgery center (ASC) are lower on average than at a hospital or other inpatient facility.

While most hospitals offer outpatient surgery options, ASCs have been praised as a superior choice for certain procedures.  This preference is largely due to facility efficiencies and greater regulatory controls for reimbursements under the outpatient prospective payment system. 

Definitive Healthcare tracks nearly 3,000 procedure types performed at over 9,000 ASCs. The following lists rank the top 25 procedures performed at surgery centers by procedure volume as well as by total charges.

What is the most commonly performed procedure at an ASC?

 In 2018, CPT code 66984—extracapsular cataract removal—was the most performed procedure at ambulatory surgery centers, with over 1.2 million total procedures reported. Botox injections and esophagogastroduodenoscopy (EGD) were the second and third most performed procedures, with 894,793 and 527,817 total procedures reported, respectively. 

Many of the most common surgery center procedures are diagnostic procedures of the gastrointestinal (GI) system, such as colonoscopies and esophagogastroduodenoscopies. These procedure types appeared 8 times on this list, with a combined total of over 1.8 million total procedures in 2018. Cataract-related surgeries also topped this list, with more than 1.6 million procedures reported in 2018.

In addition to cataract and GI-related procedures, epidural injections are the next most commonly-performed procedures. This trend is consistent with the role of ASCs in healthcare delivery, which is to offer affordable and effective care that does not require overnight observation or other hospitalization.

Top 25 Most Performed Procedures at Ambulatory Surgery Centers

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RankHCPCS/CPT CodeHCPCS DescriptionNumber of ProceduresTotal ChargesExplore These Claims
1. 66984EXTRACAPSULAR CATARACT REMOVAL W/ INSERTION OF IO LENS PROSTHESIS W/O ENDOSCOPIC CYCLOPHOTOCOAGULATION1,251,164$1,203,836,786Explore This Code
2. J0585INJECTION, ONABOTULINUMTOXINA894,793$5,462,609Explore This Code
3. 43239EGD BIOPSY SINGLE/MULTIPLE527,817$166,052,761Explore This Code
4. 45380COLONOSCOPY AND BIOPSY459,209$187,755,470Explore This Code
5. 45385COLONOSCOPY W/LESION REMOVAL409,019$196,440,448Explore This Code
6. 64483INJ FORAMEN EPIDURAL L/S315,173$98,275,396Explore This Code
7. 66821AFTER CATARACT LASER SURGERY279,440$67,857,702Explore This Code
8. 64493INJ PARAVERT F JNT L/S 1 LEV226,368$64,234,232Explore This Code
9. 62323NJX INTERLAMINAR LMBR/SAC184,148$50,642,428Explore This Code
10. G0105COLORECTAL SCRN; HI RISK IND138,269$47,348,253Explore This Code
11. 45378DIAGNOSTIC COLONOSCOPY115,168$36,627,045Explore This Code
12. 64635DESTROY LUMB/SAC FACET JNT112,369$79,517,957Explore This Code
13. G0121COLON CA SCRN NOT HI RSK IND111,684$38,509,195Explore This Code
14. J3300TRIAMCINOLONE A INJ PRS-FREE109,465$419,165Explore This Code
15. G0260INJ FOR SACROILIAC JT ANESTH95,144$22,245,165Explore This Code
16. 66982COMPLEX REMOVAL OF CATARACT WITH INSERTION OF LENS91,686$88,594,583Explore This Code
17. 52000CYSTOSCOPY82,909$23,479,992Explore This Code
18. 64490INJ PARAVERT F JNT C/T 1 LEV75,257$21,967,363Explore This Code
19. 62321NJX INTERLAMINAR CRV/THRC65,815$18,197,660Explore This Code
20. 15823REVISION OF UPPER EYELID59,700$36,619,604Explore This Code
21. 43235EGD DIAGNOSTIC BRUSH WASH59,512$19,254,754Explore This Code
22. 43248EGD GUIDE WIRE INSERTION50,542$17,342,958Explore This Code
23. 64721CARPAL TUNNEL SURGERY48,889$36,582,656Explore This Code
24. 26055INCISE FINGER TENDON SHEATH43,294$24,982,443Explore This Code
25. J7328GELSYN-3 INJECTION 0.1 MG42,349$91,989Explore This Code

Fig 1. Data from Surgery Centers database based on 2018 Medicare Ambulatory Surgery Center Limited Data Set. Calendar year data is projected to be released each January by the CMS. The most recent data is from calendar year 2018; 2019 data is scheduled to be released in January 2021. Accessed May 2020.

The following list details the top 25 procedures performed at ASCs by total charges. Extracapsular cataract removal, CPT code 66984, had the highest total charges, followed by the insertion or replacement of spinal neurostimulator pulse generator, CPT code 63685, with $259.3 million in total charges. 

Top 25 Procedures Performed at Surgery Centers by Total Charges

Definitive's Healthcare Insights are developed with data from the Definitive Healthcare platform. Want even more insights? Start a Free Trial now and get access to the highest quality data and intelligence on hospitals, physicians, and other healthcare providers.

RankHCPCS/CPT CodeHCPCS DescriptionNumber of ProceduresTotal ChargesExplore These Claims
1. 66984EXTRACAPSULAR CATARACT REMOVAL W/ INSERTION OF IO LENS PROSTHESIS W/O ENDOSCOPIC CYCLOPHOTOCOAGULATION1,251,164$1,203,836,786Explore This Code
2. 63685INSRT/REDO SPINE N GENERATOR11,325$259,397,185Explore This Code
3. 45385COLONOSCOPY W/LESION REMOVAL409,019$196,440,448Explore This Code
4. 45380COLONOSCOPY AND BIOPSY459,209$187,755,470Explore This Code
5. 63650IMPLANT NEUROELECTRODES40,151$185,590,750Explore This Code
6. 43239EGD BIOPSY SINGLE/MULTIPLE527,817$166,052,761Explore This Code
7. 64483INJ FORAMEN EPIDURAL L/S315,173$98,275,396Explore This Code
8. 0191TINSERT ANT SEGMENT DRAIN INT36,510$94,373,543Explore This Code
9. 66982COMPLEX REMOVAL OF CATARACT WITH INSERTION OF LENS91,686$88,594,583Explore This Code
10. 64635DESTROY LUMB/SAC FACET JNT112,369$79,517,957Explore This Code
11. 66821AFTER CATARACT LASER SURGERY279,440$67,857,702Explore This Code
12. 64493INJ PARAVERT F JNT L/S 1 LEV226,368$64,234,232Explore This Code
13. 29827ARTHROSCOP ROTATOR CUFF REPR25,897$63,564,800Explore This Code
14. 64590INSRT/REDO PN/GASTR STIMUL3,246$51,779,518Explore This Code
15. 62323NJX INTERLAMINAR LMBR/SAC184,148$50,642,428Explore This Code
16. 36902INTRO CATH DIALYSIS CIRCUIT18,446$47,501,204Explore This Code
17. G0105COLORECTAL SCRN; HI RISK IND138,269$47,348,253Explore This Code
18. C9740CYSTO IMPL 4 OR MORE6,628$41,130,006Explore This Code
19. G0121COLON CA SCRN NOT HI RSK IND111,684$38,509,195Explore This Code
20. V2785CORNEAL TISSUE PROCESSING9,630$37,718,222Explore This Code
21. 45378DIAGNOSTIC COLONOSCOPY115,168$36,627,045Explore This Code
22. 15823REVISION OF UPPER EYELID59,700$36,619,604Explore This Code
23. 64721CARPAL TUNNEL SURGERY48,889$36,582,656Explore This Code
24. 22869INSJ STABLJ DEV W/O DCMPRN2,649$32,414,982Explore This Code
25. 29881KNEE ARTHROSCOPY/SURGERY23,628$29,793,651Explore This Code

Fig 2. Data from Surgery Centers database based on 2018 Medicare Ambulatory Surgery Center Limited Data Set. Calendar year data is projected to be released each January by the CMS. The most recent data is from calendar year 2018; 2019 data is scheduled to be released in January 2021. Accessed May 2020.