42 CFR §416.65
Verified against eCFR.gov as of June 20, 2026View official text on eCFR.gov ↗
Effective for services furnished before January 1, 2008, covered surgical procedures are those procedures that meet the standards described in paragraphs (a) and (b) of this section and are included in the list published in accordance with paragraph (c) of this section.
- (a)General standards. Covered surgical procedures are those surgical and other medical procedures that—
- (1)Are commonly performed on an inpatient basis in hospitals, but may be safely performed in an ASC;
- (2)Are not of a type that are commonly performed, or that may be safely performed, in physicians' offices;
- (3)Are limited to those requiring a dedicated operating room (or suite), and generally requiring a post-operative recovery room or short-term (not overnight) convalescent room; and
- (4)Are not otherwise excluded under § 411.15 of this chapter.
- (b)Specific standards.
- (c)Publication of covered procedures. CMS will publish in the Federal Register a list of covered surgical procedures and revisions as appropriate.