ASC anesthesia services: an independent review of coverage and cost for surgery centers
By Andrew Woodmancey, Managing Director · Published · Updated October 23, 2026
Your surgery center is weighing a change in how anesthesia is covered. Maybe your group wants a stipend, a new group has made an offer, or your owners are looking at their own anesthesia company. Each choice changes your costs and your schedule. Anesthesia Operations Consultants (AOC) reviews ASC anesthesia services from your center's own data. We compare the options with the math shown, so your owners and your anesthesia group can check every number.
The pressure on surgery centers is growing. VMG Health found that the share of ASCs expecting to pay anesthesia stipends rose from 28% in 2024 to 44% in 2025, as reported by Becker's ASC (July 2026). The picture is not uniform. In the Ambulatory Surgery Center Association's third-quarter 2026 survey of 307 centers, 82% contracted for anesthesia services, 31% offered anesthesia providers financial assistance, and 76% reported adequate access to anesthesia providers.
The four models we compare
An independent group that bills on its own
The group collects from patients and payers and asks the center for nothing.
A group paid an ASC anesthesia stipend
The group bills and also receives support from the center: per case, per day, a guaranteed hourly rate or a collections guarantee.
The company model for ASC anesthesia
The center's owners form an anesthesia company that bills for anesthesia and contracts or employs the clinicians. In 2012 the HHS Office of Inspector General said one such proposal "could potentially generate prohibited remuneration" under federal law (Advisory Opinion 12-06). Have healthcare counsel review any version of it.
Employed CRNAs
The center employs nurse anesthetists directly. Under Medicare's rules for ASCs, a CRNA works under the supervision of the operating physician unless your state has opted out (42 CFR 416.42). State law and your own bylaws still apply; see our 2026 list of opt-out states.
This page is general information, not legal advice.
How we review ASC anesthesia services
- Your data. We work from your block schedule, case counts by room and service line, case mix, payer mix, a staffing roster and your current anesthesia agreement. We need no patient-identified information.
- The math. For each model, we set the cost of coverage against expected collections. The gap is the support the center would pay. Every assumption is written down.
- Staffing. We check CRNA staffing at your center: care-team ratios, coverage hours and turnover. See what 1:2, 1:3 and 1:4 ratios cost.
- The report. You get one model that the center and the group can both test, line by line.
More detail is on our coverage and staffing review and stipend and contract review pages.
How AOC is paid
AOC charges a fixed fee, agreed before we start. We place no clinicians, do no billing and take no share of savings. A management company that sells coverage earns more when it sells more coverage. An advisor paid a fixed fee earns the same whatever you decide. That is our structure. You can judge it.
Questions surgery center leaders ask
What does the review need from us?
Your block schedule, case counts by room and service line, payer mix, a staffing roster (FTE and employment type, not names) and your current anesthesia agreement, including any stipend. No patient-identified information. If your group holds the billing data, we ask for it with your permission.
How long does it take?
Weeks, scoped to your renewal date. The pace depends mostly on how quickly the data arrives. We give you a dated plan at the start.
Do you work with our current group?
Yes. Our default is that you keep the group you have. We show our workings to the center and to the group, so the talks start from the same numbers.
Book 15 minutes with Andrew Woodmancey, AOC's Managing Director, to scope a fixed-fee review for your center, or request a benchmark review.
Sources
- Becker's ASC, "The era of free anesthesia coverage is over," July 10, 2026 (reports the VMG Health figures): beckersasc.com
- ASC Focus (Ambulatory Surgery Center Association), "ASCA survey shows continued improvement in access to anesthesia services," October 2026: ascfocus.org
- HHS Office of Inspector General, Advisory Opinion 12-06, issued May 25, 2012: oig.hhs.gov
- 42 CFR 416.42, Medicare Conditions for Coverage for ASCs, surgical services: ecfr.gov
