Medicare opens door to office-based surgery—at 90% ASC rates
H.R. 7863 — Promoting Fairness for Medicare Providers Act of 2026 · Filed by Gus Bilirakis (R-FL) · 4 cosponsors · Introduced Mar 9, 2026 · Referred to committee
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What it does
This bill allows certain high-cost surgical procedures to be performed in physician offices instead of ambulatory surgical centers, and sets Medicare payment rates for these office-based procedures at 90% of what would be paid in an ASC. Patients' out-of-pocket costs are capped at the inpatient hospital deductible. The bill benefits physician-owned surgical facilities and medical device/supply manufacturers by creating a new reimbursement pathway; Medicare and patients may face higher total costs if office-based procedures are less efficient or if the 90% rate does not reflect true cost differences.
Why we flagged it
The bill creates a new Medicare reimbursement category for high-supply-cost surgical procedures in physician offices, effectively carving out a favorable payment pathway for a specific provider type and procedure set. This is a targeted payment policy, not a broad public health or safety measure.
What the text implies
- The 90% ASC-equivalent payment may not reflect actual cost differences between office-based and ASC settings, potentially creating arbitrage opportunities for physician-owned facilities and inflating total Medicare spending.
- Device and supply manufacturers benefit from increased utilization of high-cost procedures in office settings, where they may face less regulatory scrutiny than in hospital or ASC environments.
The full analysis lists 5 implications of this text.
Who stands to gain
physician-owned surgical facilities; medical device manufacturers; surgical supply companies