Physician-owners and administrators running independent ambulatory surgery centers (ASCs) are racing to capture high-margin surgical procedures—orthopedics, spine, GI, ophthalmology—that are rapidly migrating out of hospital systems. With CMS adding 573 new procedure codes to the ASC list in 2026 and the U.S. ASC market valued at $93.25 billion and growing, independent operators who can't win surgeons, negotiate payer contracts, and control implant costs will get squeezed out or absorbed by private equity.
CMS added 573 new procedure codes to the ASC-approved list in 2026—one of the largest single-year expansions ever—unlocking complex spine and cardiac cases that were previously hospital-only and giving independent ASCs a direct shot at high-revenue volume they couldn't touch before (CertifyHealth, May 2026).
The U.S. ASC market hit $93.25 billion in 2026 growing at 5.2% CAGR, driven by payers aggressively steering complex procedures to lower-cost outpatient settings—every procedure a payer redirects from a hospital to an ASC is a new revenue opportunity for the ASC that captures it (Research and Markets, August 2026).
61% of ASCs named recruiting new surgeons their biggest physician-related risk for 2026 according to a VMG Health survey, and hospital systems are using 'no-leakage' employment contracts to lock surgeons in—making surgeon acquisition the single biggest competitive lever for independent operators right now (Becker's ASC, June 2026).
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