History of ASCs

Forty years ago, virtually all surgery was performed in hospitals. Waits of weeks or months for an appointment were not uncommon, and patients typically spent several days in the hospital and several weeks out of work in recovery.

The first facility was opened in Phoenix, Arizona, in 1970 by two physicians who saw an opportunity to establish a high-quality, cost-effective alternative to inpatient hospital care for surgical services. Faced with frustrations like scheduling delays, limited operating room availability, slow operating room turnover times, and challenges in obtaining new equipment due to hospital budgets and policies, physicians were looking for a better way―and developed it in ASCs.


8 individuals earn the CASC credential, the first-ever ASC-specific credential, establishing the ASC administrator as a separate and distinct career from other health care management and clinical positions.


More than 5,300 ASCs in the United States perform 23 million surgeries annually. Medicare grants approval for ASCs to perform more than 3,500 procedures.


Reached 5,400 ASCs.


Medicare expands the ASC list to cover more than 2,000 procedures.


Medicare approves payment to ASCs for approximately 200 procedures, which are placed in one of four payment groups with payment rates of between $231 and $336, based upon a cost survey of 40 ASCs.


Medicare modified the ASC list to use specific CPT codes and expanded the list to include 1,535 procedures.


A mile marker is reached—the number of ASCs in the United States reaches 1,000. Using the information from a 1986 cost survey of ASCs, Medicare implements a new payment system for ASCs, which remains the basis for ASC payments today.
Today, Medicare beneficiaries can have more than 3,500 different procedures performed in an ASC. Medicare beneficiaries receive approximately 30% of the care provided in ASCs.


Reed's and Ford’s idea becomes reality on February 12 when Surgicenter, the nation’s first freestanding ambulatory surgery facility, opens for business. Five physicians perform five procedures at the facility that day. Four of those procedures require general anesthesia.

Early 1970s

A small number of other ASCs open throughout the United States.


The American Medical Association adopts a resolution endorsing the concept of outpatient surgery under general and local anesthesia for selected procedures and selected patients.


The American Society of Anesthesiologists (ASA) establishes some of the first standards for the industry when it releases “Guidelines for Ambulatory Surgical Facilities,” a list of nine criteria approved by the ASA House of Delegates.


Rapid growth. A total of 42 surgery centers were in operation in the United States by 1975 and an additional 25 facilities opened in 1976.


The industry continues to grow with the number of ASCs reaching triple digits.


Health care professionals and government officials begin calling for affordable, accessible outpatient surgery alternatives that can continue to deliver top-quality patient care.


Facilities dedicated to providing ambulatory surgical care open in conjunction with hospitals in California and Washington, DC


Wallace Reed, MD, and John Ford, MD, commit their idea for a freestanding ambulatory surgery facility to paper for the first time and develop objectives for the facility. They begin collecting endorsements from the governmental bodies and members of the health care community they need to obtain financing for the project.