Ambulatory Surgery Billing That Pays What You Earn
Ambulatory surgery center billing operates under a distinct payment system from physician professional billing — ASC facility claims use HCPCS and CPT codes mapped to CMS's ASC payment groups, with separately payable implant billing, supply billing, and add-on procedure coding. The ASC quality reporting program, payer-specific ASC facility contracts, and the distinction between packaged and separately payable items create significant billing complexity. 360Solutions provides ASC billing specialists who maximize ASC facility revenue, manage implant billing, and ensure correct coordination between facility and professional claims.
Where Ambulatory Surgery Practices Lose Revenue
These are the coding and billing pitfalls that cost ambulatory surgery practices the most — and where our specialised billers add the most value.
ASC Payment Group Classification
CMS assigns each procedure to an ASC payment group — from packaged to device-intensive — with vastly different reimbursement rates. Billing a procedure under the wrong CPT code assignment changes the payment group and significantly reduces facility revenue. Correct code-to-group mapping is essential.
Implant & Device Billing
Implants and devices used in ASC procedures may be separately payable (device-intensive procedures) or packaged into the ASC payment group. Billing implant costs for packaged procedures results in claim overpayment recoupment. We maintain current device-intensive procedure lists by payer.
Coordination with Surgeon Billing
The ASC facility claim and the surgeon's professional claim must use consistent procedure codes, dates, and patient information. Inconsistencies between the two claims trigger payer edits. We coordinate directly with the surgeon's billing team to ensure claim consistency.
Prior Auth & Same-Day Cancellation
ASC procedures require prior auth that must be validated before the patient arrives. Day-of cancellations for auth failures have financial and scheduling consequences. We track active auths for every scheduled case and alert the ASC 48 hours before any case with a pending or expiring auth.
High-Risk CPT Groups
Code ranges payers audit most aggressively in Ambulatory Surgery.
Common Denial Patterns
Knowing these before submission is the difference between a 60% and a 96% first-pass rate.
Implant HCPCS billed for a procedure in a packaged (non-device-intensive) payment group
Facility claim CPT code differs from surgeon's professional claim CPT code
Prior auth not obtained or expired before case date — day-of cancellation revenue loss
ASC claim submitted without documentation of patient discharge within 23-hour window
Multiple procedures billed at full rate without application of ASC multiple procedure discount
Send us your last 90 days of remittance data — we'll identify your top 3 fixable denial sources at no cost.
Request Free Audit →How 360Solutions Works for Ambulatory Surgery Practices
Free 2-Week Billing Audit
We review your last 90 days: denial breakdown by category, AR aging by payer, charge lag, collection rate, and any recurring coding issues specific to your specialty. No commitment required.
Specialty Coder Assignment
You are paired with a coder trained specifically in ambulatory surgery coding. They learn your providers, your documentation patterns, and your payer mix before touching a claim.
Parallel Billing Transition
We run alongside your current billing for 10–14 days with zero cash flow disruption. Claims keep moving during the transition. Your account manager provides daily status updates.
Live KPI Dashboard
Real-time visibility into billed, paid, denied, AR aging, and collection rate — segmented by provider and payer. No black box, no month-end surprises.
Weekly Account Manager Call
Every week your dedicated account manager walks through last week's KPIs, denial trends, and any action items. Critical issues are escalated the same day — not at the next scheduled call.
Questions From Ambulatory Surgery Practices
Start With a Free,
No-Obligation Audit
Two weeks, no contract. A certified ambulatory surgery billing specialist reviews your claims, denial patterns, and AR — and shows you exactly what is recoverable.