C
ardiac surgery is the next frontier for
same-day surgery. The movement of
cardiovascular care from hospitals to
freestanding surgery centers is being
driven by reimbursement trends, for-
ward-thinking facilities and the steady beat of
progress. "Cardiology is another step in providing
more surgical care on an outpatient basis for more
patients, while saving the healthcare system a sig-
nificant amount of money," says Bill Prentice, CEO
of the Ambulatory Surgery Center Association. The
fledging service line is packed with promise — and
plenty of questions that need to be answered.
What's the payment landscape?
could be reimbursed by CMS were implantations of
defibrillators and pacemakers — what cardiology
pros call "device work." The 17 cardiac-specific ASC
codes CMS added for 2019 focused exclusively on
diagnostic cardiac catheterization procedures that
physicians were already performing in HOPDs.
These allowed ASCs to diagnose cardiac issues, but
not yet perform "surgery-like" minimally invasive
interventions. Six more cardiac ASC codes came
online in 2020, this time adding minimally invasive
procedures referred to as percutaneous coronary
interventions (PCI), specifically placing stents and
angioplasty. This year, 11 additional, more complex
PCI procedures were added, including lower
extremity intravascular lithotripsy and atherectomy.
Mr. Prentice says CMS reimbursement for ASC-
Before 2019, the only procedures for which ASCs
2 4 • O U T P A T I E N T S U R G E R Y M A G A Z I N E • F E B R U A R Y 2 0 2 1
Joe Paone | Senior Associate Editor
Cardiovascular Care Is the Next Big Thing
Procedures are shifting to surgery centers,
but adding the cases is not for the faint of heart.
MESSAGE STENT In 2020, CMS began reimbursing ASCs for minimally invasive cardiac procedures such as stent placements.
