Methodology

For the rankings, U.S. News partnered with Arcadia to evaluate 4,421 ambulatory surgery centers (ASCs) across four different specialty areas:

• Colonoscopy and endoscopy
• Ophthalmology
• Orthopedics and spine
• Urology

More than 25% of ASCs were multispecialty providers, including most ASCs that provided urological care.

To assess ASC performance, U.S. News and Arcadia analyzed data from Medicare fee-for-service claims between 2022 and 2024 for different outcome areas:

• ED visit rate, excluding those immediately followed by acute care admissions (ED visit rate)
• Admission rate to acute care facilities through the ED (admission rate)
• Total allowed payment attributable to episode-related complications (cost of complications)
• All-cause mortality rate (mortality rate)
• Average length of stay in days, if any, in institutional post-acute or long-term care (post-acute length of stay)

All five outcomes were used in colonoscopy and endoscopy, orthopedics and spine, and urology. Only the cost of complications and mortality rate were used in ophthalmology.

In this year's rankings, U.S. News and Arcadia added shoulder replacements to the list of procedures included in the orthopedics and spine specialty ratings.

The 10 states with the greatest number of high-performing ASCs were:

• California (105 ASCs)
• Florida (81 ASCs)
• Texas (59 ASCs)
• Maryland (48 ASCs)
• Pennsylvania (43 ASCs)
• New Jersey (40 ASCs)
• Georgia (40 ASCs)
• New York (33 ASCs)
• Arizona (29 ASCs)
• North Carolina (27 ASCs)

"As more complex procedures move out of the hospital and into community-based surgery centers, patients need a reliable way to evaluate their options," said Ben Harder, chief of health analysis and managing editor of U.S. News. "U.S. News' ratings are designed to give consumers peace of mind by highlighting the centers that consistently provide the highest level of care, from the moment a patient checks in to their successful recovery at home."