Medicare expands office surgery payments, raising federal costs and shifting procedures out of hospi

What it does

This bill allows physicians to perform certain high-cost surgical procedures in their offices and receive Medicare payment at rates closer to what ambulatory surgical centers receive, rather than the lower office-based rates. The procedures covered are those that use expensive supplies (over $500) and are already approved for ambulatory surgical centers. Patients' out-of-pocket costs are capped at the hospital deductible amount, with the government making up the difference to the provider.

Why we flagged it

The bill's core mechanism is a payment-rate adjustment: it reclassifies certain office-based surgical procedures to receive ambulatory surgical center-equivalent reimbursement rather than lower office-based rates. This is a targeted Medicare payment policy, not a broad reform.

What the text implies

• The bill creates a new category of 'office-based facilities' that must meet Secretary-specified standards and enter into binding agreements, effectively creating a new Medicare provider type with regulatory oversight not fully detailed in the statute.
• Annual Secretary review of which procedures qualify (with mandatory inclusion if criteria met, permissive removal) creates ongoing regulatory expansion risk; procedures may be added without explicit congressional action.
• Payment to office-based facilities is set at 90% of ASC rates for facility services, but the bill does not clearly specify how physician professional fees are paid, creating potential ambiguity in total reimbursement.
• The copayment cap (limited to inpatient hospital deductible) with government make-up payments to providers may incentivize shift of procedures from hospitals/ASCs to offices, concentrating high-cost surgery in less-regulated settings.
• Device-intensive procedures receive special calculation under CFR 416.172(h)(2)(ii), but the bill does not define which procedures qualify, delegating significant payment determination to regulation.

Section numbers refer to the bill text the analysis read — linked under Primary records below.

Who it affects

Patients benefit from capped out-of-pocket costs (limited to hospital deductible) and expanded access to office-based procedures, but Medicare spending increases substantially as office-based procedures receive near-ASC reimbursement rates. The bill shifts costs from patients to the federal program, which may affect future beneficiary premiums or general taxpayers.

Who stands to gain

• Physicians and office-based surgical practices (higher reimbursement for office procedures)
• Suppliers of high-cost surgical supplies (procedures using $500+ supplies are prioritized)
• Ambulatory surgical centers (procedures treated as 'commonly furnished' in ASCs, potentially stabili

Named in the bill

Centers for Medicare & Medicaid Services (CMS), Physicians and office-based facilities, Ambulatory surgical centers, Medicare beneficiaries, High-cost surgical supply manufacturers, State agencies (compliance oversight)

Where it stands

4 cosponsors: 2 Democrats, 2 Republicans.

• Mar 9, 2026 — Introduced · Congress.gov: “Introduced in House”
• Mar 9, 2026 — Referred to House Committee on Ways and Means and House Committee on Energy and Commerce · Congress.gov: “Referred to the Committee on Energy and Commerce, and in addition to the Committee on Ways and Means, for a…”

Dates and quoted wording are Congress.gov's action record; the timeline shows status changes, not every procedural step.

Money around this bill

34 lobbying clients named this bill on 35 disclosure filings across 1 quarter, Jun 2026 to Jun 2026. Those filings disclosed $70,000 in lobbying spend. A filing names 1 bills on average, so that figure is what each filing reported, not a share belonging to this bill.

More lobbying clients named this bill than 98% of bills with at least one filing.

Gus Bilirakis, the sponsor, reported $937,250 in PAC receipts in the 2026 cycle.

• American College of Radiation Oncology — $40,000 on 1 filing
• Society for Vascular Surgery — $20,000 on 1 filing
• Azura Vascular Care (fka Fresenius Vascular)(dialysis Vascular Access Coalition) — $10,000 on 1 filing
• Boston Scientific (office-based Facility Assn Obfa) (fka Uspa) — $0 on 1 filing
• Lifeline Vascular Care (fka Access) (dialysis Vascular Access Coalition) — $0 on 1 filing

Lobbying Disclosure Act filings through Jul 20, 2026. A filing shows who paid to lobby on a bill it names, not what changed.