If you caught the ASC News webinar this past week, you heard what we've been telling our partners for months: 2026 isn't business as usual for ambulatory surgery centers.

Stacy LaLonde, Vice President of Payer Strategy at Compass Surgical Partners, joined industry leaders to decode the 2026 payment landscape — from CMS's new final rule to commercial payer reimbursement trends.

Look out for both opportunities and landmines ahead. Here's what you need to know.

Cardiac Ablation Is Finally Here (And Medicare is Leading the Way)

CMS’ Final 2026 OPPS Rule added cardiac catheter ablation codes (CPT® 93653, 93654, 93656) to the ASC Covered Procedures List (CPL). This isn't just adding a few codes. It enables a whole new cardiovascular service line that hasn’t existed in the ASC setting before.

Here's what's interesting: Commercial payers typically add new ASC procedures ahead of Medicare. Think total joints. But with cardiac ablation, Medicare got there first. As Stacy noted, this reversal signals that Medicare just might become a trailblazer in the ASC reimbursement landscape.

What this means for you: With only about 200 cardiovascular ASCs operating nationwide, there's significant room for new development and growth, noted webinar co-presenter Kara Newbury, Chief Advocacy Officer at ASCA. If you are a physician or health system interested in developing a CV ASC, it’s time to seize the day.

Caveat: Retrofitting an existing ASC for CV isn't simple. CV requires more infrastructure investment than even total joints. Future-proofing means thinking about ceiling infrastructure, equipment storage, and workflow from day one.

Smaller, Independent ASCs Risk Missing Out on Historic CPL Expansion

CMS added 560 procedures to the ASC-CPL this year, making more than 5,000 codes reimbursable in ASC settings. And CMS has promised to eliminate the Inpatient Only (IPO) list over the next three years. It’s an unprecedented opportunity for ASCs to expand their service lines and capture new case volumes.

Larger ASCs will be able to act quickly to make the most of this opportunity. But smaller, independent ASCs may struggle to keep pace, constrained by limited capital, space limitations, and the operational complexity required to launch new procedures.

This is where Compass's partnership model shines for physicians who own ASCs. Physicians can partner directly with us or include a health system in the partnership, whatever structure fits your vision and strategic goals. Either way, your ASC gains access to the capital, operational expertise, and payer relationships needed to capture this unique opportunity for development and expansion, without the struggle of going it alone.

The Direct-to-Employer Opportunity Is Real — If You’re Savvy about Structure

DTE arrangements resonate strongly with physicians, noted Stacy and webinar co-presenter Geri Eaves, BSN, RN, CASC, CNOR, CEO/Administrator at Bone and Joint Institute of Tennessee Surgery Center.

In a DTE arrangement, employers contract directly with ASCs (and physicians) to provide surgical services to their employees at pre-negotiated bundled rates, bypassing traditional insurance networks. It's a win for employers seeking cost predictability, and it can be a win for ASCs, if the economics work.

These arrangements typically come through physicians working on both the professional and facility fee sides. The key is making sure the bundled payment to the facility is adequate. Don't let enthusiasm on the professional fee side, or the promise of higher case volumes, drive facility reimbursement to unsustainable levels, Stacy and Geri cautioned.

DTE arrangements don't run themselves. Someone needs to negotiate terms, track utilization, verify adequate payment, and manage day-to-day execution.

ASCs Remain a Value-Add for Medicare Advantage

While MA is leveling off in some service lines, it remains a growing opportunity for ASCs, especially those within health systems.

There’s a catch, though. Traditional Medicare allows newly accredited ASCs to see enrollees immediately, while MA plans have mandated waiting periods, Stacy explained. If the ASC you are developing will serve a significant MA population, you need to plan for delayed revenue ramp-up. Factor those credentialing timelines into your financial projections from day one.

Automatic Payer Incentives for ASC Utilization Are Disappearing

For years, commercial payers incentivized ASC utilization with favorable contract terms. Now that ASCs are being utilized more broadly, those incentives don’t come quite as easily.

Stacy's advice? The site-of-service shift value proposition still holds. ASCs deliver high-quality care and real savings compared to hospital outpatient departments. If payers come to the table proposing reimbursement cuts, harness your data and push back.

Prepare for Site Neutrality with Data-Driven Strategy

Here's the risk everyone's talking about but nobody wants: site neutrality policies that lower reimbursement to the “lowest common denominator,” potentially even physician office rates.

Yes, ASCs are the lower-cost alternative. But ASCs still need adequate reimbursement to stay in business and continue delivering the safety and efficiency outcomes that serve our patients optimally.

Stacy's take? Price transparency is your ally. Data is your defense. Site neutrality risk assessments, outcome metrics, and cost comparisons aren’t ‘nice-to-haves’ anymore. They’re essential negotiation tools.

Learn How Compass Surgical Partners Can Support Your ASC Strategy‍

Compass creates strategic partnerships with independent physician groups and health systems to develop and manage high-performing ASC networks. From physician ownership pathways to operational excellence and sustainable growth, Compass delivers solutions that expand access to high-quality, lower-cost surgical care.

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