American College Of Surgeons - Inspiring Quality: Highest Standards, Better Outcomes

ACS Releases Seventh Report on Physicians as Assistants at Surgery


WASHINGTON, DC (November 7, 2013): The American College of Surgeons (ACS), in collaboration with 15 other specialty surgical organizations, has jointly published and released the seventh edition of Physicians as Assistants at Surgery, a report that provides guidance on how often an operation might require the use of a physician as an assistant. This report reflects the most recent clinical practices and is often relied upon by the Centers for Medicare & Medicaid Services and third-party payors.

Using the American Medical Association’s Current Procedural Terminology (CPT TM) codes from the 2012 and 2013 codebooks, each participating organization reviewed codes applicable to their specialty that are classified by CPT as “Surgery.” CPT is the most frequently used physician medical nomenclature for reporting medical services and procedures to private and public health insurance payors. Participants indicated if the operation requires the use of a physician as an assistant at surgery: (1) almost always; (2) almost never; or (3) some of the time. 

The newly released report adds 107 codes that were introduced by CPT since the last report was issued in 2011. In addition, the report revises 74 codes that had been previously included. Historically, the report is conducted approximately every other year. However, to more accurately reflect new and updated CPT codes and to help improve the quality of care for the surgical patient, updates to the Physicians as Assistants at Surgery report now will be conducted annually and a full review of all surgical CPT codes will be released every five years.

“The frequency of updating the report is becoming increasingly important,” says Mark Savarise, MD, FACS, ACS alternate advisor at the AMA CPT Editorial Panel. “Medicare and third-party payors are attracted to the report because it provides a comprehensive clinical review of surgical procedures to bring an informed opinion from surgeons in the field about the frequency with which a physician’s services as an assistant at surgery are needed.”

The College maintains that a physician as an assistant used during an operation should be a trained individual who can participate in and actively assist the surgeon in completing the operation safely. When a surgeon is not available to serve as an assistant, a qualified surgical resident or other qualified health care professional, such as a registered nurse or physician's assistant with experience in assisting during a procedure, may be used, according to the ACS position as published in its Statements on Principles.

In addition to the American College of Surgeons, the organizations that participated in the study are:

  • American Academy of Ophthalmology
  • American Academy of Orthopaedic Surgeons
  • American Academy of Otolaryngology – Head and Neck Surgery
  • American Association of Neurological Surgeons
  • American Pediatric Surgical Association
  • American Society of Colon and Rectal Surgeons
  • American Society of Plastic Surgeons
  • American Society of Transplant Surgeons
  • American Urological Association
  • Congress of Neurological Surgeons
  • Society for Surgical Oncology
  • Society for Vascular Surgery
  • Society of American Gastrointestinal Endoscopic Surgeons
  • The American Congress of Obstetricians and Gynecologists
  • The Society of Thoracic Surgeons

Download the entire Physicians as Assistants at Surgery study.

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About the American College of Surgeons
The American College of Surgeons is a scientific and educational organization of surgeons that was founded in 1913 to raise the standards of surgical practice and improve the quality of care for all surgical patients. The College is dedicated to the ethical and competent practice of surgery. Its achievements have significantly influenced the course of scientific surgery in America and have established it as an important advocate for all surgical patients. The College has more than 79,000 members and is the largest organization of surgeons in the world. For more information, visit


Chantay P. Moye

Devin Rose