What Is an Ambulatory Surgery Center? Overview and FAQ

An ambulatory surgical center (ASC) is a facility that conducts outpatient surgeries, giving patients an alternative to hospital-based services. These facilities are heavily regulated to ensure high-quality care, safety, and optimal patient outcomes — often at a lower cost than inpatient services.

As a facility leader, you may still find yourself asking the question, What is an ambulatory surgery center’s role within the always-evolving healthcare market? In this FAQ, we’ll provide an overview of ASCs and how they differ from other types of healthcare facilities.

What Is Considered an Ambulatory Surgery Center? Definition

According to the American Hospital Association (AHA), the general definition of ambulatory surgery center is a healthcare facility that provides same-day surgical care, including diagnostic and preventive procedures.

However, variations among state licensing requirements can also influence how ASCs are defined. For example, surgical procedures must account for more than 50% of care activities in order for a facility in Illinois to be classified as an ASC. In contrast, Washington more broadly defines ASCs as facilities where patients receive specialized surgical services and are discharged within 24 hours.

What Is an Ambulatory Surgical Center‘s Purpose?

In response to ongoing frustrations about limited operating room availability and scheduling delays, two physicians opened up the first ASC in 1970. Today, more than 6,000 ASCs are in operation across the U.S. — and these centers serve to increase care accessibility by providing a quicker and cheaper alternative to inpatient surgery.

What Are Some Common Surgeries Performed at an ASC?

The surgeries conducted in ASCs are typically less invasive than those conducted in inpatient settings. Some common ambulatory surgery examples include:

• Bone fracture repairs
• Knee and hip replacements
• Eye surgeries (e.g. cataract removal)
• Oral surgeries (e.g., wisdom tooth removal)
• Plastic surgeries
• Hernia repairs
• Biopsies

Because of the nature of these procedures, patients can typically go home on the same day of their surgery. In rare cases, patients may be monitored for up to 72 hours. However, length of stay depends largely on state regulations, and not all ASCs offer overnight services.

What Additional Services Do ASCs Provide?

In addition to surgeries, ASCs also offer a range of diagnostic and preventative procedures, such as colonoscopies and endoscopies. ASCs also have multidisciplinary teams of surgeons, anesthesiologists, and nurses responsible for managing a patient’s pain and recovery needs. In cases where patients do need to stay overnight, they’re typically offered meals.

What Is an Ambulatory Surgical Center vs. Outpatient Hospital?

Ambulatory surgical centers and outpatient hospitals both provide same-day medical services. However, ASCs focus mostly on surgeries, whereas outpatient hospitals provide a much wider range of services. Other key differences can be found in:

• Facility ownership. ASCs typically are independently owned by physicians, optometrists, or dentists, while outpatient hospitals are part of a larger hospital system.

• Costs. ASCs are documented to have lower overhead costs than outpatient hospitals.

• Patient populations. ASCs generally serve healthier patient populations, while outpatient hospitals may treat patients with more complex conditions.

How Are Ambulatory Surgical Centers Regulated?

At the federal level, all ambulatory surgical centers participating in Medicare and Medicaid programs must meet regulations outlined by the Centers for Medicare and Medicaid Services (CMS). There are also several accrediting bodies, such as The Joint Commission, that work to ensure that ASCs are meeting minimum safety and care standards.

At the local level, every state has its own laws governing the operation and licensing of an ASC. Healthcare leaders can get more information about their state’s requirements through their local health department.

Are Ambulatory Surgery Centers Safe?

Some people may have concerns about undergoing surgeries in outpatient settings. However, ASCs are held to strict regulatory standards, making them a safe and reliable alternative to inpatient hospitals.

Studies have even shown that patients undergoing surgeries at ASCs have lower rates of 30-day revisits and complications compared to those undergoing hospital-based surgeries. This reflects the rigorous patient selection process used by physicians working in ASCs, ensuring that patients requiring a higher level of care are appropriately referred to hospitals.

Why Are ASCs Cheaper Than Hospitals?

ASCs offer a more cost-effective alternative to hospital-based surgeries since they function on a much smaller scale. These centers focus on efficiency and fast turnarounds, which reduces the overhead costs associated with extended stays. There are also less costs associated with equipment maintenance, since ASCs provide a very specific range of services.

Medicare typically reimburses ASCs at a lower rate than hospitals for the same procedures. On average, ASCs receive about 58% of the reimbursement rates that hospitals do, which reflects their lower operating costs.

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