As CMS updates its list of approved procedures and anesthesia techniques continue to develop, more and more orthopedic cases are moving into ASCs. Several factors contribute to this shift. First, for example, CMS added kyphoplasties and vertebroplasties to their list of approved procedures for ASCs. Second, single-level spine surgery is in a transitional period, allowing spine surgeons and pain management physicians in ASCs to perform vertebroplasties and kyphoplasties with insurer permission. Third, simple fractures remain commonplace in ASCs and more cases of complex fracture management are moving into the outpatient setting. Fourth, advances in regional anesthesia are driving more complex fracture management into ASCs. Fifth, certain hospitals have attempted to move orthopedic cases to ASCs to make room for more complex cases in the hospital operating rooms.

A great deal of orthopedic surgery, notwithstanding this movement, may stay in hospitals due to certain economic factors such as hospital employment, which may provide a counterweight to such movement.