12 Questions to Ask Before Choosing an ASC

1. Is this facility Medicare-certified and accredited?

Medicare certification is the baseline. Accreditation by AAAHC, AAAASF, or The Joint Commission goes further. Ask which body accredits them and when their last survey was. A facility that can't answer this question clearly is worth pausing on.

2. How many procedures of this type does this facility perform per year?

Volume matters — both for the facility and for your specific surgeon. Higher-volume facilities tend to have more experienced teams, more efficient processes, and better-calibrated protocols for managing the occasional complication. Ask for a real number, not a vague answer.

3. What is your unplanned hospital transfer rate?

ASCs must track and report transfers to the hospital. A facility that has a protocol for this and can speak to their rate clearly is better organized than one that fumbles the question. The rate should be low for routine elective procedures — typically under 1%.

4. What happens if something goes wrong after I'm discharged?

Who do I call? Is there a 24-hour line? What hospital is your transfer agreement with? Knowing the answer to this before surgery (not after) matters. A facility with a clear, practiced answer to this question is reassuring.

5. How many times have you performed this specific procedure?

This is different from asking about general experience. A surgeon with 20 years of orthopaedic practice but who rarely performs your specific procedure is not the same as one who does it weekly. Be specific about the procedure.

6. Will you be the one performing the entire procedure?

In some surgical settings, residents or fellows perform portions of procedures. At ASCs this is less common, but it's a reasonable question — especially for more complex cases. Knowing who will be operating helps you make an informed consent decision.

7. What are the most common complications with this procedure, and how often do they occur?

A surgeon who gives you a thoughtful, specific answer to this question is a surgeon who has thought carefully about risk. A surgeon who dismisses the question or gives a vague reassurance is not necessarily better — they may just be less forthcoming.

8. Are you, the surgeon, and the anesthesiologist all in-network with my insurance?

All three. Separately. The ASC being in-network doesn't mean your surgeon is, and neither means the anesthesiology group is. Anesthesia surprise bills are one of the most common sources of unexpected out-of-pocket costs after outpatient surgery.

9. Has prior authorization been submitted and approved?

Don't assume this has happened. Ask your surgeon's office directly, get the authorization number, and confirm the approval covers the specific facility and procedure code. Do this before confirming your surgery date.

10. Can you give me an estimate of my out-of-pocket costs?

Facilities are increasingly required to provide cost estimates. Ask for the facility fee estimate and factor in separate surgeon and anesthesia costs. No estimate will be exact, but a reasonable range is better than going in blind.

11. What anesthesia will I receive, and what are the alternatives?

Understanding your anesthesia options — and having a say in them — is part of informed consent. Some patients have strong preferences about being fully unconscious versus sedated. Ask early enough to have the conversation with the anesthesiologist before the day of surgery.

12. What are the pre-op requirements and what should I expect for recovery?

Specific questions: Are there medications I need to stop? What are the fasting instructions? How long will I be restricted from driving? When can I return to work? When can I bear weight or use the limb? Getting specific answers sets realistic expectations and helps you plan.