ASC (Ambulatory Surgery Center)

An ASC is a freestanding facility that performs same-day outpatient surgical procedures — colonoscopies, cataract surgery, arthroscopies, hernia repairs, many orthopedic and ENT procedures. Patients arrive, have surgery, and go home the same day. ASCs are Medicare-certified, state-licensed, and often physician-owned in whole or part.

The cost difference versus a hospital outpatient department (HOPD) is dramatic and consistent. Medicare pays ASCs roughly 55 to 60 percent of what it pays hospitals for the same procedure, and commercial rates typically follow the same pattern. Texas Free Market Surgery in Austin publishes a bundled all-in cash price of about $4,150 for a knee arthroscopy; the same procedure at a hospital outpatient department in Austin might carry a $22,000 negotiated rate. Northwest Surgery Center in Dallas and Surgery Center of Oklahoma across the border operate on the same transparent bundled-price model. Not every procedure is safe for an ASC — anything requiring overnight observation or unusual anesthesia risk belongs in a hospital — but for the procedures ASCs do handle, the outcomes are as good or better and the cost is 40 to 70 percent lower.

The takeaway: for any planned outpatient surgery, get an ASC quote alongside the hospital quote. On self-funded plans, steering to ASCs is one of the highest-ROI utilization-management moves available.