Build Your Own Surgery Center

Do you want to build your own surgery center?  Congratulations!  This portion of the blog will assist you into the transition smoothly.   Take some time before you pick up the phone and start calling contractors, interior designers, and asc consultants (like me); just review in your mind what type of surgery center you want.  Do you want an office based surgery center or an ambulatory surgery center?  Do you want accreditation or do you want certification (Medicare).  Do you need to obtain licensure first before you can proceed with accreditation or certification?  Let’s take a moment to define the types of surgery centers:

Office based surgery center usually defined as an organization with 1 to 4 physicians’ all with the same specialty and the center utilizes no more than 2 operating or procedure rooms. 

Ambulatory surgery center usually defined as an organization equipped to provide multiple specialties and multiple operating/procedure rooms, you can have on medical staff an infinite amount of surgeons. 

Will your surgery center be utilized by only you or do you want to bring in partners.  This question will help guide you to the type of surgery center you want.  If your partners are physician’s perhaps all of you are the same specialty or maybe not.  Will you have any non-physician ownerships?  If I have a majority of non-physician ownerships how will the surgery center become operable?  Ask yourself these questions.  This will help you narrow it down to what you want to do and build. 

Interview your current biller and ask if they know the procedural codes & facility fees i.e OR and PACU time schedule rates and codes, supplies and medications.  This is very important to know as it will help you project will you be financially viable to run and operate your surgery center.  Palmetto GBA does offer the codes on their website and reimbursement fee schedule.  If your current biller does not know the codes for surgery I highly recommend you getting a consultation with a biller who does.  You can call or email me and I will refer you to a biller.  You need to know this information even before you hire someone like me.  The reason why I want you to decide what you want before you make certain phone calls is that you always want to be in a position of confidence and equipped with solid information.  If you don’t know what you want your project can lead into what someone else wants to build if you know what I mean.  This will also help you determine what kind of center you want.  You will need to come to a decision on whether you want surgery center accreditation, Medicare certification or perhaps if state licensure qualifies.  Refer back to my “Accreditation 101” category for clarification.  After you get an assessment of the financial numbers from an authorized biller; the following is another set of questions to ask yourself:   

Is the space that I currently occupy big enough for office based?  Or is my current space big enough to occupy my surgery center and private practice?

If I want to become Medicare certified I will have to separate the private practice from the surgery center.  The 2 must operate separate from each other. 

Do I need to lease a bigger space?

Do I want to buy a building? (This one usually no but we have had clients who did).

Do I want my private practice and surgery center to be in the same building or neighborhood? 

Do I need to move my private practice? 

Ponder over these questions because the sooner you can narrow it down to what you want the easier things will flow.  This is when you can start to do one or more of the following:


  1. Call me or email. Once I find out what you want we can go over details of how much space you need to do what you want!   
  2. Call a realtor specializing in medical buildings.
  3. If you are currently in a medical building and they have some available spaces talk to the management company.  The key word here is “medical building.”  I will go over that in another post.
  4. If you have an attorney and an accountant let them know what you are doing.  You will need them when it comes time to sign a leasing agreement or discussions regarding tenant improvements (TI’s).  The accountant will come into play later, the accrediting organizations what to ensure that you can      financially run a surgery center.  During some point the surveyors will ask you to produce a profit and loss statement and/or how you are funding the center.

I think this is enough to digest right now.  You have some questions to ask yourself. 

Here’s to your success,


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