Office-Based Surgery Frequently Asked Questions for Consumers

1. Why must certain physician practices be accredited?

A law passed in 2007 requires that physicians, physician assistants and specialist assistants, who perform or assist in Office-Based Surgery ("OBS"), must practice in an accredited setting. "OBS" is defined as invasive or surgical procedures, using more than minimal sedation.

As of July 14, 2009, any physician performing "office-based surgery" ("OBS") must do so either in a Article 28 licensed hospital, ambulatory surgery center, diagnostic and treatment center; or in a private physician's office that is accredited. Article 28 facilities must post their operating certificates in an accessible location. Accredited "OBS" offices must also post their accreditation certificates.

2. Who accredits "OBS" physician practices?

Offices may be accredited by any one of the following three organizations designated by the Commissioner of Health:

3. What are examples of procedures that might be covered by this law?

  • All invasive procedures done under moderate sedation, deep sedation or general anesthesia
    • Gastrointestinal procedures:
      • Endoscopy
      • Colonoscopy
    • Plastic surgery:
      • Nasal reconstruction
      • Breast reduction/augmentation
      • Liposuction of greater than 500 ml
    • Some obstetric and gynecologic procedures

4. What are examples of procedures that are not covered by this law?

  • Most, but not all, botulinum toxin (Botox) injections and minor dermatologic procedures can be performed in offices that do not require accreditation because they generally do not require more than minimal sedation.
  • Generally, Magnetic Resonance Imaging (MRI) procedures are not subject to this law. However, MRIs that are performed with contrast are invasive, and these procedures must be performed in an accredited office if done under moderate or deeper levels of sedation.
  • It is important to note that many offices perform invasive procedures using local anesthesia and/or mild sedation where the patient remains awake, aware, responds normally to verbal command, is breathing, and where other body functions are unaffected. In this case, no accreditation is required. However, if the physician's practice performs other surgical or invasive procedures using more than minimal sedation, the practice must be accredited.

5. How can I find out if my physician's office is accredited?

  • A list of accredited practices, including the practice name, address and county, is posted on the Department of Health’s "OBS" Web page at
  • You can call the practice and ask directly if they are accredited, by which agency, and under what name. Once you get this information, you can visit the accrediting agency's Web site to search for the practice's name or contact the agency directly.
  • Please note that a physician may practice at more than one location, each of which must be separately accredited if "OBS" is practiced there.

6. What if I don't find the physician practice name I am looking for on the Web site?

If you do not find the name of the practice you are looking for on the DOH website or on the accrediting agencies websites, then the physician's practice is most likely not accredited. But not all physician practices that perform procedures must be accredited. Practices performing invasive/surgical procedures using only local anesthesia and/or mild sedation do not need to become accredited.

7. I need to have a procedure and my doctor's office is not accredited. What should I do?

You always have the choice as to whether to have surgery or an invasive procedure done at a physician practice/location or at a NYS licensed Article 28 facility. Whether or not the practice needs to be accredited is based on whether moderate or deeper sedation is administered to patients during the procedure.

  • Discuss with your physician what sedation options you have for this procedure. It is your decision as to the level of sedation you want. If you and your physician agree that your procedure will be done with minimal or no sedation, and the practice does not perform any other procedures using moderate or deeper sedation/anesthesia, then the practice would not have to be accredited.
  • If you want more than minimal sedation, you and your physician may decide that the procedure will be done at another practice site, which is accredited.
  • If the physician does not have an accredited practice site and you decide you want moderate or deep sedation, you can ask your physician if he/she can do the procedure in a hospital or ambulatory surgery center.
  • You may choose a different physician to perform your procedure in either an accredited "OBS" practice or in an Article 28 facility with an operating certificate.

8. Where can I go if I want to make a complaint about care in a private physician's office?

9. What happens to a physician, physician assistant or specialist assistant that performs office-based surgery in an unaccredited location?

Any violation of the Office-Based Surgery law falls within the definition of professional misconduct. Any of those providers may be subject to disciplinary action by OPMC.