Both ambulatory surgical centers and hospital outpatient departments have the same kinds of surgical teams, equipment and licensing requirements. However, they each have their differences, as well.

An ambulatory surgical center is a freestanding health care facility that specializes in providing surgical and diagnostic procedures that do not require an overnight stay. As a result, patients are typically discharged on the same day. Some ASCs can also be owned by or in a joint venture with a hospital or health system.

On the other hand, a hospital outpatient department is part of a larger hospital system and offers a wider range of surgical services and access to broader hospital resources for less healthy patients and those with comorbidities (multiple conditions being treated).

Ambulatory surgical centers specialize in certain surgeries – such as appendectomies, colonoscopies, hip replacements, cataract surgeries and endoscopies – that can be safely performed on appropriate patients without the need to stay overnight for observation at a hospital.

If you require a surgical procedure, such as a knee replacement or cataract surgery, an ambulatory surgical center may be faster and less expensive than in a hospital setting. Because ambulatory surgical centers specialize in outpatient surgeries, they typically have shorter wait times and, therefore, may offer a more streamlined experience. Your health status will help determine whether you are a good candidate to receive care in an ambulatory surgical center.

Whether you need a referral to visit an ambulatory surgical center largely depends on your health insurance plan. Many insurance plans, especially HMOs or ones that require pre-authorization for specialized services, require a referral from a primary care physician or a specialist to cover the procedure at an ambulatory surgical center.

Since requirements vary, it’s important to check with your insurance provider to understand your plan’s specific requirements.

It’s important to talk with your doctor first to help you decide whether you are best suited for undergoing a procedure at an ambulatory surgical center or hospital based on your health status.

If you opt to have a procedure performed at an ambulatory surgical center, take into consideration the facility’s U. S. News quality rating for that specialty, including complication rates, as well as accreditation status, experience and qualifications of the medical staff. In addition, be sure to read other patients’ reviews of their experience (if available) and confirm that the facility accepts your insurance.

Insurance coverage for a procedure at an ambulatory surgical center varies. Whether or not your procedure is covered by your insurance depends on your specific health plan, including whether the facility is within your plan’s network and if the procedure is considered medically necessary.

While most insurance plans – such as Medicare and Medicaid – typically cover procedures at an ambulatory surgical center, the amount of coverage and out-of-pocket costs vary based on several factors, such as deductibles, copayments and coinsurance rates.

It’s best to contact your insurance provider prior to scheduling the procedure to better understand your coverage details, obtain any pre-authorizations and referrals and estimate your expected out-of-pocket expenses.

If paying with an original Medicare plan, you can compare national average prices for ambulatory surgical centers and hospital outpatients departments online using theMedicare.gov’s Procedure Price Lookup tool.

The total out-of-pocket cost of a procedure at an ambulatory surgical center is generally lower than the same procedure at a hospital outpatient facility. This is largely because ambulatory surgical centers specialize in outpatient care and have lower overhead cost than hospitals, allowing them to provide the same outpatient services at a reduced price.

Patients undergoing eligible procedures generally benefit from these cost savings through lower copayments and coinsurance amounts.

Rotator cuff surgery is often performed as outpatient procedures and typically does not require overnight stay in the hospital thanks to minimally invasive surgical techniques, including arthroscopic repair and mini-open repair. However, it’s important to discuss with your orthopedic surgeon about whether the procedure should be performed as an outpatient or inpatient treatment. The final decision will depend on several factors, including your individual health status, the severity of your rotator cuff injury and the complexity of your procedure.