Outpatient surgery is typically performed in one of two settings: office-based surgery (OBS) or ambulatory surgery centers (ASCs). OBS procedures take place in a dedicated surgical suite within a physician’s office, providing a familiar and convenient environment for patients. In contrast, ASCs are freestanding facilities purpose-built to deliver outpatient surgical care, offering specialized infrastructure, staffing, and regulatory oversight.

OBS accreditation verifies that surgical procedures performed within a physician’s office are conducted safely, using appropriate:

• Clinical protocols
• Infection prevention practices
• Anesthesia and medication controls
• Emergency preparedness measures
• Staff qualifications and oversight

Accreditation is performed by recognized accrediting organizations using structured surveys.

Ambulatory Surgery Centers (ASCs) in the United States may be accredited by several CMS-approved accrediting organizations. These organizations are authorized to survey ASCs for compliance with national patient safety, quality, and regulatory standards.

The primary accrediting bodies for ASCs include:

• The Joint Commission (TJC)
  The most widely recognized accrediting organization in healthcare, known for its rigorous standards related to patient safety, infection control, quality improvement, and organizational leadership. It is commonly selected by hospital-affiliated and multi-specialty ASCs.
• AAAHC (Accreditation Association for Ambulatory Health Care)
  A leading accreditor focused exclusively on outpatient healthcare settings. AAAHC is often chosen by independent and physician-owned ASCs due to its practical, operations-driven approach.
• AAAASF (American Association for Accreditation of Ambulatory Surgery Facilities)
  An accrediting body with a strong emphasis on surgical safety, anesthesia standards, and peer-based surveying. It is frequently used by procedure-specific ASCs, including those specializing in plastic surgery, pain management, and gastroenterology.

An Ambulatory Surgery Center (ASC) is a freestanding healthcare facility that provides same-day surgical procedures to patients who do not require overnight hospitalization. To qualify as an ASC, the facility must be separately licensed, meet CMS Conditions for Coverage, and operate independently from a hospital, even if it is hospital-owned.

ASCs can be owned by several types of entities, either individually or in partnership:

• Physicians (single or multi-physician ownership)
• Hospitals or health systems
• Joint ventures between physicians and hospitals
• Management companies or corporate healthcare organizations
• Private equity–backed healthcare groups (in some cases)

Ownership structures must comply with state laws, CMS regulations, and federal fraud and abuse laws

The cost to build an ASC typically ranges from $2 million to $10 million or more, depending on the size of the facility, number of operating rooms, location, construction type (new build vs. renovation), and medical equipment required.

ASC construction costs are influenced by:

• Number of operating and procedure rooms
• Geographic location and labor costs
• New construction vs. tenant improvement
• Medical equipment and technology
• Architectural, engineering, and compliance requirements

Build costs may include basic infrastructure but often exclude major surgical equipment, accreditation fees, licensing, and startup operating expenses, which should be budgeted separately.