Medicare ambulatory surgery center (ASC) facility payments for trabeculectomy, goniotomy, and cataract surgery with endoscopic cyclophotocoagulation (ECP) will decrease in 2027, according to the Outpatient Ophthalmic Surgery Society (OOSS). Cataract surgery with stent placement will receive a higher payment. 

The Centers for Medicare & Medicaid Services (CMS) issued the final hospital outpatient and ASC payment rule November 4, effective January 1, 2027. OOSS’s comparison shows the following rates by Current Procedural Terminology (CPT) code: 

Source: Outpatient Ophthalmic Surgery Society. “2027 Final ASC Payment Rule Disappoints: Cuts to Cataract and Other Ophthalmic Services.” November 4, 2026. Percentage changes calculated from the payment rates reported by the society. 

Elizabeth Cifers, a practice management consultant and Retinal Physician columnist, advised glaucoma practices to review procedure volume and ensure that documentation supports medical necessity and payer requirements. “For example, if the payer has criteria for any of these surgeries, ensure the chart documentation clearly documents those criteria; otherwise, the practice risks losing payment for the surgery,” she said. 

CMS finalized a 2.3% annual ASC update for facilities meeting quality-reporting requirements. Individual procedure rates can nevertheless fall because of relative payment weights and budget-neutrality adjustments. OOSS criticized the reductions and said it would seek higher ophthalmic payments for 2028. 

Facility rates are separate from surgeons’ professional fees. According to CMS’s Physician Fee Schedule fact sheet, conversion factors will decrease by 1.83% for qualifying alternative payment model participants and 2.31% for other clinicians. Those percentages alone do not establish the change for an individual glaucoma procedure. GP