There are over 5,800 Centers for Medicare & Medicaid Services (CMS)-certified ambulatory surgery centers (ASCs) in the United States, which are located in every state, each of which has its own laws and rules that govern ambulatory surgery ( Every year in the U.S., the number of ambulatory procedural and surgical suites grows by almost 1%. Between 2017 and 2018, this number grew to 2.6% given changes to the Medicare payment policy, thus dramatically increasing the capacity to provide ambulatory surgical and procedural services ( Presently, 68% of surgical procedures performed in the U.S. are performed on an outpatient basis ( It is estimated that ASC procedure volume will grow by at least 6% in 2021 and that orthopedic, spine, and cardiac procedures will increase the fastest through the mid-2020s (

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