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Ambulatory surgical center payment indicators

Here are the final ambulatory surgical center (ASC) payment indicators (PIs) for services provided for January 1-December 31, 2025. Use these in conjunction with our fee lookup tool.

Indicator Definition
A2 Surgical procedure on ASC list in CY 2007; payment based on Outpatient Perspective Payment System (OPPS) relative payment weight.
B5 Alternative code may be available; no payment made.
D1 Ancillary dental service/item: no separate payment made.
D2 Non-office based dental procedure added in CY2024 and later.
D5 Deleted/discontinued code; no payment made.
F4

Corneal tissue acquisition, hepatitis B vaccine; paid at reasonable cost.

Note: If an invoice is not included for corneal tissue acquisition, the claim may be denied.
G2 Non-office based surgical procedure added in CY 2008 or later; payment based on OPPS relative payment weight.
H2 Brachytherapy source paid separately when provided integral to a surgical procedure on ASC list; payment based on OPPS rate.
J7 OPPS pass-through device paid separately when provided integral to a surgical procedure on ASC list; payment contractor priced.
J8 Device-intensive procedure; paid at adjusted rate.
K2 Drugs and biologicals paid separately when provided integral to a surgical procedure on ASC list; payment based on OPPS rate.
K5 Items, codes, and services for which pricing information and claims data are not available. No payment made.
K7 Unclassified drugs and biologicals; payment contractor priced.
L1 Influenza vaccine; pneumococcal vaccine. Packaged item/service; no separate payment made.   
L6 Special payment; New Technology Intraocular Lens (NTIOL) or qualifying non-opioid devices
N1 Packaged service/item; no separate payment made.
P2 Office-based surgical procedure added to ASC list in CY 2008 or later with Medicare Physician Fee Schedule (MPFS) non-facility Practice Expense (PE) Relative Value Units (RVUs); payment based on OPPS relative payment weight.
P3 Office-based surgical procedure added to ASC list in CY 2008 or later with MPFS non-facility PE RVUs; payment based on MPFS non-facility PE RVUs.
R2 Office-based surgical procedure added to ASC list in CY 2008 or later without MPFS non-facility PE RVUs; payment based on OPPS relative payment weight.
Z2 Radiology or diagnostic service paid separately when provided integral to a surgical procedure on ASC list; payment based on OPPS relative payment weight.
Z3 Radiology or diagnostic service paid separately when provided integral to a surgical procedure on ASC list; payment based on MPFS non-facility PE RVUs.


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