This guide is for the CEO, administrator or marketing lead of an orthopedic group that owns or partners in an ambulatory surgery center and wants more joint cases in it. It covers what changed in 2026, what the payment gap means for your pitch, and how to build the patient and referral pipeline that fills ASC slots.
When I reviewed the pages that rank for this topic, most were device-maker marketing pages, trade-news lists or single-practice service pages. Very few were written for the person who has to decide where the marketing budget goes.
What changed in 2026, and what comes next
In its final rule for 2026, CMS began phasing out the inpatient-only list over three years, starting with the removal of 285 mostly musculoskeletal procedures. It also added 560 codes to the ASC covered procedures list: 289 under revised criteria and 271 that came off the inpatient-only list. (CMS fact sheet, November 21, 2025)
For an orthopedic group, the practical effect is that more of the cases your surgeons already do are now eligible for the setting you control, and the list will keep growing through the phase-out.
The payment gap is your strongest argument
For 2026, Medicare pays about $13,116 for a total knee or total hip replacement in a hospital outpatient department. In an ASC, it pays about $9,393 for a total knee and $9,614 for a total hip. (AAHKS summary of the 2026 OPPS and ASC final rules)
That difference matters to three audiences at once:
- Payers and self-insured employers, who pay less for the same procedure in your ASC.
- Patients with high deductibles, whose share is often lower in an ASC.
- Your own group, which keeps the facility economics rather than handing them to a hospital.
Marketing that leads with “same surgeon, lower cost, you go home the same day if you qualify” is speaking to all three. Marketing that only says “state-of-the-art surgery center” is speaking to none of them.
Who your ASC joint patient is, and how they search
Not every joint patient is an ASC candidate. Your surgeons decide that on clinical grounds, and your marketing should say so plainly. A page that explains who qualifies, and who will still be treated in the hospital, filters the right patients in and saves your schedulers a lot of calls.
Patients researching this tend to search in plain language: “outpatient knee replacement”, “same-day hip replacement”, “knee replacement surgery center near me”, or simply “knee replacement cost”. That last group is large. They are comparing settings and prices whether or not you publish yours. I keep patient-side pages on knee replacement cost and robotic vs traditional knee replacement cost for exactly that reader.
What those patients need from your site:
- A page per procedure that explains the ASC option, who qualifies and what recovery looks like at home.
- The surgeon, with their own joint volume, not just the facility.
- A clear answer on cost for insured, Medicare and self-pay patients, or at least what drives it.
- One next step that a person answers the same day.
Referrals still decide most joint volume
The patients who end up in your ASC usually come through a primary care physician, a physical therapist or your own clinic, not straight from an ad.
One study of a new orthopedic practice surveyed its first 300 new patients. Traditional and online advertising took 92% of the marketing budget and brought in 18.7% of those patients. A marketing liaison, at 8% of the budget, brought in 42.7%, mostly through physician referrals. (Cureus, 2021)
That was one start-up practice, not a joint program, so treat it as a direction rather than a benchmark. The direction is clear, though: the referrer relationship is often the cheapest source of joint cases, and it is the one that tends to get the least structured attention. If referrals have been slipping, I wrote about why orthopedic physician referrals decline.
For an ASC joint program, that means:
- A short referrer brief: which patients qualify for the ASC, how fast you see them, and how you report back.
- Surgeon and facility pages that a referring physician can send a patient to without hesitation.
- A referrer report from your practice management data, showing who sent joint patients this quarter and who went quiet.
Measure cost per ASC case, not cost per lead
A form fill is not a case. The number that matters to a CEO is what it cost to put one more joint replacement in the ASC, by source.
When I audited one orthopedic practice’s Google Ads account, 92% of the spend in the baseline month was going to a nationwide campaign that had produced zero appointments, and the website’s appointment buttons led to a page with no form. Neither problem showed up in the monthly marketing report. Both showed up the moment we traced a click to an appointment.
The chain you need, end to end:
- Source: ad, organic search, referrer, Google profile, existing patient.
- Inquiry: call or form, tagged with that source.
- Consult: did the inquiry become a visit with a surgeon?
- Case: did the consult become an ASC joint replacement?
- Cost: marketing and liaison spend for that source, divided by cases.
Until steps 1 to 4 are connected, budget decisions about the ASC are guesses. For the wider picture, see my notes on orthopedic patient acquisition cost.
A 90-day plan with a stop point
- Days 1 to 15, baseline. Current ASC joint cases per month, by surgeon and by source. Check that every appointment path on the website works, from phone and desktop.
- Days 16 to 45, build. One page per joint procedure for the ASC option, surgeon pages with volume, a referrer brief, and source tracking on every call and form.
- Days 46 to 90, run. Liaison visits to the top 20 referrers, plus search on the procedure pages. Review cost per ASC case every two weeks.
Stop point: decide it before you start. For example, if by day 90 the tracked pipeline has not added ASC joint cases above your baseline, change the channel mix before adding budget.
What this means for your group
Some facts, side by side.
CMS is moving joint and other musculoskeletal procedures out of the inpatient-only list over three years and added 560 codes to the ASC list for 2026.
Medicare pays roughly $3,700 less for a total knee in an ASC than in a hospital outpatient department, and that saving is visible to every payer and employer you negotiate with.
In one study that measured it, the marketing liaison brought in more than twice the patients of the advertising budget, at a fraction of the cost.
And in the account I audited, nobody could see which dollar produced which appointment until the tracking was fixed.
What those add up to for your ASC is your decision. The groups that can show cost per ASC case by source are the ones that will know where to put the next dollar.
If you want a second opinion on your ASC joint pipeline, from the website appointment path to the referrer report, book a 20-minute call. I will review your site and your market before we talk.
Frequently asked questions
What did CMS change for ASCs in 2026? CMS began phasing out the inpatient-only list over three years, removing 285 mostly musculoskeletal procedures for 2026, and added 560 codes to the ASC covered procedures list.
How much does Medicare pay for a total knee replacement in an ASC? About $9,393 in 2026, against about $13,116 in a hospital outpatient department, according to the AAHKS summary of the final rules.
What is the best marketing channel for ASC joint replacement? Referral relationships often produce the most joint cases for the money, supported by procedure and surgeon pages that patients and referrers can trust.
How should an orthopedic group measure ASC marketing? By cost per ASC case by source, which requires tracking each call and form from source to consult to surgery.
Should we publish ASC prices? Patients are already comparing settings and costs. Even a clear explanation of what drives the cost for insured, Medicare and self-pay patients answers the question better than silence.
