Kansas City manager Matt Quatraro said prior to Tuesday's game at Tampa Bay that Royals ace Cole Ragans is expected to undergo elbow surgery.

Ragans, who served as the team's Opening Day starter each of the last three seasons, has not pitched in the big leagues since May 6 due to an impingement in his left elbow. He had one rehab outing for Triple-A Omaha on May 24, but he was moved to the 60-day injured list when his elbow did not respond well thereafter.

Now Ragans, 28, will remain on the 60-day IL for the foreseeable future.

"We anticipate it being a surgical procedure," Quatraro told reporters, per the Kansas City Star. "We don't know, as of right now, what it means. He's got to see another doctor as well, but we anticipate it being surgical."

Ragans posted a 1-4 record with a 4.84 ERA in eight starts for the Royals. He enjoyed three magnificent games -- including a six-inning, one-hit showing on April 14 at Detroit -- but endured two outings where he surrendered more runs than innings pitched.

For his career, Ragans boasts a 22-24 record and a 3.76 ERA in 91 appearances (74 starts). He has averaged 10.86 strikeouts per nine innings: 506 whiffs in 419 1/3 innings.