Office-Based Surgery Frequently Asked Questions

Office-based surgery is any surgical or invasive procedure performed by a licensed physician in a location other than a hospital or ambulatory surgery center. These procedures are typically performed in a suite located within the physician's office. 

Yes, over 50,000 cases have been safely performed in the OBS setting:

  • In 2016 Kaiser Permanente published a study on 21,501 cataract cases performed in the office setting, with outcomes that were
    consistent with hospitals or ASCs
  • iOR has been gathering data, with data from over 30,000 real-world cases that also match or beat safety outcomes in other settings.  See iOR safety data here.
  • iOR Partners includes data from 255 cases showing the benefits of OBS for retina surgery, where time to intervention is particularly critical for patient outcomes.

Common ophthalmic OBS procedures include cataract surgery, retina procedures, glaucoma procedures, refractive lens exchange, ICL, various oculoplastics and other lens-based procedures.

Other specialties that commonly perform procedures in an OBS include gastroenterology, otolaryngology, dermatology, cardiology, and maxillofacial surgery.

98% of cases performed in iOR suites are done with oral and topical sedation only, typically with 5-10mg of Valium. If you need or prefer anesthesia similar to that at the ASC, we can accommodate that level of sedation. However, most of our surgeon partners have determined that oral or sublingual sedation is adequate, patient-preferred, and a safer way to perform cataract surgery.  Learn more about anesthesia for OBS here.

Yes, all 50 states allow for OBS. The rules for OBS suites don’t vary much by state and we are familiar with the rules and regulations in all 50 states. We have implemented iOR suites in over 30 states.

Typically, CON laws have no effect on office-based surgery. The CON rules apply to an ASC and since OBS is an extension of your practice you’re already able to perform surgery in your office. If you’re performing LASIK than you are performing surgery in your practice.

The LASIK suite can usually be converted to a surgical suite in most offices. 

Office-Based Surgery Reimbursement

Yes, there is a current method to get reimbursed for office-based surgery. iOR has been successful in collecting reimbursements from all major payers including Medicare. 

iOR Reimbursement Mix:

  • 26% Commercial Payers
  • 34% Medicare Advantage
  • 39% Medicare


On average iOR has collected $600+ in enhanced
professional fees on Medicare cases and $1200+ on Medicare Advantage and commercial cases. These fees are above and beyond the current professional fee received at an ASC.

iOR® has been successful in collecting reimbursements on claims from payors in all 50 states, including 7 Medicare MACs. We are actively pursuing a more streamlined reimbursement process with Medicare.

Those with financial interests in ASCs have touted that Medicare has "rejected payment for ophthalmic office-based surgery".  However, this statement is misleading.  

You can receive Medicare reimbursement for OBS. You’re simply paid in a different way. Instead of a Traditional Primary-National reimbursement of the facility fee, OBS surgeons receive a Secondary-Local reimbursement of their professional fee based on local Medicare Administrative Contractor (MAC) codes. Learn more.

iOR Suites

An iOR Suite can be built with as little as 700 square feet (sq. ft.) for one OR or 1000 sq. ft. for two ORs.  Instrument processing, sterile supply, and pre/post take approximately 200 sq. ft.

Space requirements and costs may vary depending on your equipment choices among other variables.  Buildout costs are nearly identical to building out clinic space.

From space planning and development to onboarding and staff training, we need at least 90-120 days from signing of your agreement to first day of surgery.

Yes. This is a major advantage of working with iOR. We have national account status with all the major ophthalmic vendors.

Almost every OBS suite utilizes the current clinic staff as the Ophthalmic Procedure Tech, Circulator, Sterilizer, and Pre/Post Op.  iOR Partners trains all surgical staff to current standard competencies.

Yes, either by The Joint Commission or AAAASF accreditation. 

We work with each client to understand their specific needs and develop a customized office-based surgery program.

Agreements include a one-time development fee to offset prelaunch expenses including staff training, travel and setup, and a monthly fee for the duration of the agreement.