A landmark 2019 CMS ruling opened the door for ASCsto receive Medicare reimbursement for certain angioplasty and stenting procedures, and a new study suggests these procedures are just as safe in ASCs as they are in hospital outpatient departments.
Katerina Dangas, MD, of Boston-based Beth Israel Deaconess Medical Center, presented these findings at the Society for Cardiovascular Angiography and Interventions 2025 Scientific Sessions, as reported by the Cardiovascular Research Foundation’s TCTMD.
The study analyzed outcomes for 408,060 Medicare patients who underwent outpatient percutaneous coronary intervention (PCI) between 2020 and 2022. Of those, fewer than 2% were treated in ASCs, but results suggest the safety profile is similar to that of hospital outpatient settings.
Here are seven notes:
1. At 30 days post-procedure, both ASC and hospital patients had low rates of serious complications: less than 1% for all-cause mortality, stroke, and pericardial effusion.
2. Dr. Dangas emphasized that adjusted comparisons showed no increase in adverse events for patients undergoing PCI at ASCs in terms of mortality, hospital admissions, myocardial infarction, stroke or pericardial effusion.
3. The ASC group had a slightly higher rate of repeat PCI procedures, though the absolute numbers were small and not sufficient to draw conclusions about underlying causes.
4. Overall health conditions were similar between ASC and hospital patients, though hospitals treated more patients with prior acute MIs, while ASCs saw more patients with peripheral vascular disease.
5. Atherectomy procedures were less common in ASCs than hospitals (2.4% vs. 6.8%), and multivessel PCIs were about twice as frequent in hospitals, suggesting hospitals may still handle more complex cases.
6. Hospital outpatient groups had slightly higher 30-day rates of hospitalization and acute MI, which researchers say may reflect differences in patient selection or procedural staging.
7. Between 2018 and 2022, PCI procedures performed in ASCs rose sharply from 0.01 to 0.87 cases per 10,000 person-years, signaling growing acceptance of the model.
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