Medicare ASC Fee Schedule Lookup by Code and County
Medicare pays an ambulatory surgical center on its own schedule, not on the physician fee schedule and not on hospital outpatient rates. Type a code, a date of service and the county the center sits in. This tool returns the national amount and the wage-adjusted amount from the CMS release in force that day, for every release back to Jan 1, 2020. Free for 5 codes a day.
The surgery center’s rate, per date of service and county
Results
29881. New York, date of service Oct 1, 2026.
The release behind these figures
Every amount above is computed from the CMS file below, held in a pinned archive so a number printed in a report can be produced again later, unchanged. The date of service chooses the file. Archive last rebuilt Oct 5, 2026.
- Release
- pfs-2026-10
- CMS file
- 2026 October (quarterly MPFSDB update, CR 14588)
- Prices dates of service
- Oct 1, 2026 onward
- Conversion factor
- $33.40
All 17 CMS physician releases in this archive
Source & method
- Amounts: CMS’s “ASC Approved HCPCS Code and Payment Rates” addenda, every release from January 2020 to July 2026. A date of service is priced under the release CMS had in force that day. The figures on this page come from the July 2026 ASC addenda, read from July 2026 ASC Addenda.07.08.26.xlsx inside the archived CMS file july-2026-asc-addenda.zip (sha256 f2d6e0a94df507f0), and checked against CMS’s own 508 CSV copies of Addenda AA, BB and FF on every build.
- Three instruments decide an amount, not one. The quarterly addendum is the first. CMS also restates drug and biological prices after the fact, on its own correction pages, and it creates and reprices codes retroactively in the narrative of its quarterly transmittals. A reader that knows only the addendum is wrong on all three. Where a restatement and a transmittal both cover a date, the restatement supplies the amount and the transmittal supplies the payment indicator, and both are shown.
- Wage adjustment: the pre-floor, pre-reclassified hospital wage index for the CBSA the center maps to, applied to half the rate. CMS: “the labor related portion of the payment rate is 50 percent and the remaining non-labor related portion is 50 percent.” (Medicare Claims Processing Manual, Pub. 100-04, ch. 14, s40.2 (Rev. 11793)). Seven payment indicators are not adjusted at all, and the tool says which and quotes CMS’s reason. A county CMS publishes no index for gets the national amount and the reason, never a neighboring county’s index.
- A zero is never a price. 1,656 of the 7,380 codes in the current release publish no amount. Every one of them renders as CMS’s own definition of its payment indicator instead of a dollar, and no figure on this site is ever printed as $0.00 for a service Medicare pays for.
- Live source to verify: CMS ASC payment rates addenda.
Medicare ASC payment rates, explained
Who is paid what when an operation happens in a surgery center
Three separate payments come out of one operation, and this page is one of them. The surgeon is paid a professional fee under the Physician Fee Schedule. The facility is paid a separate amount for the room, the staff, the supplies and the equipment. When the facility is an ambulatory surgical center, that second payment comes from this schedule. When it is a hospital, it comes from hospital outpatient payment instead, which is a different CMS schedule and is not on this site. A facility charge tested against the surgeon’s fee, or a surgeon’s charge tested against this schedule, is tested against the wrong party’s money.
The July 2026 ASC addenda carry 7,380 codes. 4,833 sit in Addendum AA, the covered surgical procedures, and 2,547 in Addendum BB, the covered ancillary services that are paid separately when they go with one of those procedures. 2,692 of them also carry a device portion in Addendum FF, which CMS publishes for the no-cost and credit device adjustments and which is already inside the rate rather than being a second payment.
Why the same code pays differently in two counties
Half of the national amount is adjusted by the wage index of the area the surgery center is in. CMS states the split plainly: “the labor related portion of the payment rate is 50 percent and the remaining non-labor related portion is 50 percent.” (Medicare Claims Processing Manual, Pub. 100-04, ch. 14, s40.2 (Rev. 11793)). The index itself is “the wage index for an ASC is the pre-floor and pre-reclassified hospital wage index for the fiscal year under the IPPS of the CBSA that maps to the CBSA where the ASC is located.” (CY 2025 OPPS/ASC final rule, 89 FR 94362). So the arithmetic is the national amount multiplied by half the wage index plus half of one, rounded to the cent. The table below prices 29881 on Jul 1, 2026 in four counties, through the same code the lookup above runs.
| County | CBSA | CY 2026 wage index | National | Paid to the center |
|---|---|---|---|---|
| NEW YORK, NY | 35614 | 1.2951 | $1,644.87 | $1,887.57 |
| SANTA CLARA, CA | 41940 | 1.8317 | $1,644.87 | $2,328.89 |
| COOK, IL | 16984 | 1.0228 | $1,644.87 | $1,663.62 |
| AGUADA, PR | 10380 | 0.2909 | $1,644.87 | $1,061.68 |
Source: July 2026 ASC addenda, July 2026 ASC Addenda.07.08.26.xlsx, and CMS’s CY 2026 ASC wage index files. 4,755 of the 5,724 priced codes in this release are wage adjusted and 969 are not; the tool names the reason for each.
What the ASC payment indicators mean
Every row of the CMS addenda carries a payment indicator, and it decides whether there is a figure at all. This page publishes no code descriptions, so the indicator is what tells a reader what kind of thing a code is and why it does or does not carry an amount. The definitions below are CMS’s own, read from the DD1 sheet of the July 2026 ASC addenda, with the number of codes in that release carrying each and whether CMS adjusts it by the wage index.
| Indicator | CMS’s definition | Codes | Wage adjusted |
|---|---|---|---|
| A2 | Surgical procedure on ASC list in CY 2007; payment based on OPPS relative payment weight. | 2,011 | Yes |
| N1 | Packaged service/item; no separate payment made. | 1,452 | Yes |
| G2 | Non office-based surgical procedure added in CY 2008 or later; payment based on OPPS relative payment weight. | 969 | Yes |
| J8 | Device-intensive procedure; paid at adjusted rate. | 782 | Yes |
| K2 | Drugs, biologicals, and radiopharmaceuticals paid separately when provided integral to a surgical procedure on ASC list; payment based on OPPS rate. | 630 | No |
| P3 | Office-based surgical procedure added to ASC list in CY 2008 or later with MPFS nonfacility PE RVUs; payment based on MPFS nonfacility PE RVUs. | 403 | Yes |
| Z2 | Radiology or diagnostic service paid separately when provided integral to a surgical procedure on ASC list; payment based on OPPS relative payment weight. | 336 | Yes |
| S2 | Skin substitute supply group; paid separately when provided integral to a surgical procedure on ASC list; payment based on OPPS rate. | 322 | No |
| Z3 | Radiology or diagnostic service paid separately when provided integral to a surgical procedure on ASC list; payment based on MPFS nonfacility PE RVUs. | 84 | Yes |
| D1 | Ancillary dental service/item; no separate payment made. | 77 | Yes |
| P2 | Office-based surgical procedure added to ASC list in CY 2008 or later with MPFS nonfacility PE RVUs; payment based on OPPS relative payment weight. | 72 | Yes |
| R2 | Office-based surgical procedure added to ASC list in CY 2008 or later without MPFS nonfacility PE RVUs; payment based on OPPS relative payment weight. | 51 | Yes |
| D2 | Non office-based dental procedure added in CY 2024 or later. | 47 | Yes |
| K5 | Items, codes, and services for which pricing information and claims data are not available. No payment made. | 47 | Yes |
| L1 | Influenza vaccine; pneumococcal vaccine. Packaged item/service; no separate payment made. | 36 | Yes |
| J7 | OPPS pass-through device paid separately when provided integral to a surgical procedure on ASC list; payment contractor-priced. | 21 | No |
| H2 | Brachytherapy source paid separately when provided integral to a surgical procedure on ASC list; payment based on OPPS rate. | 17 | No |
| L6 | Special payment; New Technology Intraocular Lens (NTIOL) or qualifying non-opioid devices | 13 | No |
| F4 | Corneal tissue acquisition, hepatitis B vaccine; paid at reasonable cost. | 8 | No |
| K7 | Unclassified drugs and biologicals; payment contractor-priced. | 2 | No |
| B5 | Alternative code may be available; no payment made | none | Yes |
| D5 | Deleted/discontinued code; no payment made. | none | Yes |
Source: the DD1 sheet of July 2026 ASC Addenda.07.08.26.xlsx. An indicator with no codes is defined by CMS in this release but carried by nothing in it.
Why the date of service decides the file, down to the day
CMS reissues the ASC addenda every quarter, and once it reissued them in the middle of one. The March 9, 2024 ASC addenda carry the Physician Fee Schedule conversion factor the Consolidated Appropriations Act, 2024 raised part way through the first quarter of that year. On the code set the two releases share, 4,067 amounts differ from January’s: 466 went up, all of them on payment indicators P2, P3, Z3, and 3,601 went down to pay for it. A bill dated 8 March 2024 and the same bill dated 9 March 2024 are therefore different money, and no tool that asks for a year or a quarter can tell them apart.
The two things CMS publishes outside the addendum
CMS restates drug and biological prices after it has published them, on correction pages of its own, and a date of service inside a restatement window is priced at the corrected figure rather than the printed one. The corrections are not small. The January 2026 ASC addenda alone carry 5 restated records. A quarter earlier, CMS restated J9329 from the $551.62 its addendum printed down to $55.16, for dates of service from Jan 1, 2025 to Mar 31, 2025, under CR 14101 and CR 14091. A lookup that reads only the addendum overstates that line by $496.46. This tool applies the restatement that covers the date, labels the figure restated, and names the change request it came from.
CMS also creates and reprices codes retroactively in the narrative of its quarterly transmittals, where an addendum reader never looks. 8 codes in the January 2026 ASC addenda exist only there: C8007, C8008, C8009, C8011, C8012, C8013, C9818, Q5099. CMS’s own words for the first of them are “CMS is establishing six (6) new HCPCS codes (C8007, C8008, C8009, C8011, C8012, and C8013) retroactive to January 1, 2026, to describe the open implantation, revision or replacement, and removal of a hypoglossal nerve neurostimulator that does not include or require insertion of a separate distal respiratory sensor electrode or electrode array and a hypoglossal nerve neurostimulator that does not have an implantable battery or pulse generator.”, in transmittal R13704CP, CR 14445. The Medicare contractors pay those codes and the January addendum does not list them, so a lookup that reads one document answers “not on the schedule” for a service Medicare pays for.
Key terms in an ASC fee schedule lookup
- Addendum AA and Addendum BB
- The two lists CMS publishes each quarter. AA is the covered surgical procedures, BB the covered ancillary services paid separately when they go with one. In the July 2026 ASC addenda that is 4,833 codes and 2,547 codes.
- Payment indicator
- CMS’s one or two character code on every row, deciding how the service is paid and whether a figure exists at all. The July 2026 ASC addenda define 22 of them.
- Wage index
- The pre-floor, pre-reclassified hospital wage index of the CBSA the surgery center maps to. It adjusts half the payment. CMS publishes one per CBSA per calendar year and a county-to-CBSA crosswalk beside it.
- CBSA
- Core Based Statistical Area, the geography CMS pays by. A five-digit code is a metropolitan or micropolitan area; a two-digit code is a state’s rural area.
- Device-intensive procedure
- A procedure where the device is most of the cost. CMS publishes the device portion separately in Addendum FF. It is already inside the rate, and it is carried for the no-cost and credit device adjustments billed with modifier FB or FC.
- Contractor-priced
- CMS publishes no amount and the Medicare contractor that processes the claim sets it. There is no fee schedule figure to quote, and this tool shows none.
How bill reviewers use ASC rates
A medical billing expert reads the code off the facility claim, prices it under the release CMS had in force on the date of service, adjusts it for the county the surgery center is in, and sets that figure beside the billed facility charge. Because each figure traces to an archived CMS file rather than to a link that may be retired, the number can be produced again later unchanged. For the surgeon’s fee on the same operation, use the Medicare rate lookup, which can also find a code you only half remember by word, for HCPCS Level II codes and for a small set of common CPT codes named in S2Reason’s own wording, while this page deliberately carries no names at all. For implants and supplies billed separately, see the DMEPOS fee schedule lookup, for drugs given during the case the Part B drug payment limits, and for anesthesia the anesthesia conversion factors. New Jersey no-fault claims have their own ASC facility fees in Exhibit 1 of the NJ PIP fee schedule. For the whole workflow from a stack of bills to a signed report, see Desk.
Medicare ASC rates, answered
What is the Medicare ASC fee schedule?
It is the price list CMS uses to pay an ambulatory surgical center for the facility side of an operation. It is a separate schedule from the physician fee schedule and from hospital outpatient payment, and it is the one a surgery center's facility charge is benchmarked against. The July 2026 ASC addenda carry 7,380 HCPCS codes, 4,833 of them covered surgical procedures in Addendum AA and 2,547 covered ancillary services in Addendum BB. 5,724 carry a published amount and 1,656 do not. CMS reissues the addenda every quarter and this archive holds all 28 releases, January 2020 to July 2026.
Is the ASC rate the same as the doctor's fee for the same procedure?
No, and confusing the two is the most expensive mistake on a surgery center bill. Three different parties are paid for one operation. The surgeon is paid under the Physician Fee Schedule. The facility is paid under this schedule when the operation happens in an ambulatory surgical center, or under hospital outpatient payment when it happens in a hospital. A facility charge benchmarked against the physician's fee, or a physician charge benchmarked against this schedule, compares a bill to somebody else's money. This tool shows both figures, one under the other, and labels each.
Why do two surgery centers get different amounts for the same code?
Because half the rate moves with local wages. CMS states that "the labor related portion of the payment rate is 50 percent and the remaining non-labor related portion is 50 percent", and the labor half is multiplied by the wage index of the area the center sits in. The arithmetic is the national amount times 0.5 times the wage index, plus the national amount times 0.5, rounded to the cent. For 29881 in the July 2026 ASC addenda, the national amount is $1,644.87 and the same procedure is worth $1,887.57 in NEW YORK, NY and $1,061.68 in AGUADA, PR. The wage index is the center's own area, not the patient's address.
Why does an ASC code show no dollar amount?
Because for 1,656 of the 7,380 codes in the July 2026 ASC addenda CMS publishes no amount, and that is an answer rather than a gap. Some are packaged into the procedure they go with, so there is no separate payment. Some CMS says are contractor-priced, which means the Medicare contractor that processes the claim sets the figure and the fee schedule carries none. Some are paid at reasonable cost from the center's own cost report. A tool that prints $0.00 for any of those is reporting a rate Medicare never set. This one prints the reason in CMS's own words instead.
Does the ASC fee schedule change during the year?
Yes, and in a way a year filter cannot express. CMS reissues the addenda quarterly, and once it reissued them mid-quarter. The March 9, 2024 ASC addenda carry the conversion factor the Consolidated Appropriations Act, 2024 raised part way through the first quarter, and 4,067 amounts differ from January's on the same code set. 466 went up and 3,601 went down. So 8 March 2024 and 9 March 2024 are different money for the same procedure, and only a date of service can tell them apart.
Why does a code the contractors pay show as not on the ASC schedule?
Usually because CMS created it in a transmittal rather than in an addendum, and this tool applies those. CMS changes and creates codes retroactively in the narrative of its quarterly transmittals, and the addendum for the same quarter does not carry them. 8 codes are in exactly that position in the January 2026 ASC addenda: C8007, C8008, C8009, C8011, C8012, C8013, C9818, Q5099. They appear in no January 2026 addendum, the Medicare contractors' own January 2026 fee schedules do pay them, and a lookup that reads only the addendum answers "not on the schedule" for a service Medicare pays for. This one carries those records with their dates and names the transmittal that created them.
Why can this lookup not search by procedure description?
Because it publishes no code descriptions at all, on purpose. For a CPT code the short descriptor is text the American Medical Association licenses, and these files are served publicly to anyone, so the build reads the column, checks it and does not ship it. The cost is real: you have to arrive with the code. What the page publishes instead is CMS's own material, including the definition of all 22 payment indicators in the table above. If you have a half-remembered code, the Medicare rate lookup can find it by word for HCPCS Level II codes, which carry CMS's own names, and for a small set of common CPT codes named in S2Reason's own wording; then price the facility side here.
How do bill reviewers use ASC rates in an expert report?
They read the code off the facility claim, price it under the CMS release in force on the date of service, adjust it for the county the surgery center sits in, and set that figure beside the billed facility charge. Because every amount traces to an archived CMS file rather than to a link, the figure can be produced again later unchanged. Medicare-allowed is a floor-style benchmark: a reasonableness review normally pairs it with a percentage multiplier or with usual and customary data rather than using it as the conclusion on its own.