State by State

Below is information on Office-Based Surgery (OBS) rules, regulations and accreditation requirements by state. This is information only. Rules change often. Please confirm with your state regulators the current status and requirements for an office-based surgical suite. Last Updated April 2021.

Most OBS regulation requirements are based on the level of anesthesia and the level of surgery. For example some states exclude Level I anesthesia (local) and Level I surgical procedures. Our focus is on hand-and wrist orthopedic surgeries, and endoscopic carpal tunnel release specifically; these procedures lend themselves to WALANT and most all would qualify as Level I anesthesia and Level I surgery. If some of your procedures require a higher level of anesthesia then you would need to follow your state’s regulations in the 15 states that exclude local anesthesia.

Some states have no information on OBS. Some are very detailed.

Alabama OBS Guidelines          AL

Alaska OBS Guidelines            AK

Arizona OBS Guidelines           AZ

Arkansas OBS Guidelines         AR REGULATION 35

California OBS Guidelines      CA

Colorado OBS Guidelines        CO

Connecticut OBS Guidelines   CT

Delaware OBS Guidelines       DE

District of Columbia OBS Guidelines  DC

Florida OBS Guidelines           FL

Georgia OBS Guidelines          GA

Hawaii OBS Guidelines           Hi

Idaho OBS Guidelines ID

Illinois OBS Guidelines           IL

Indiana OBS Guidelines          IN

Iowa OBS Guidelines  IA

Kansas OBS Guidelines           KS

Kentucky OBS Guidelines       KS

Louisiana OBS Guidelines       LA

Maine OBS Guidelines ME

Maryland OBS Guidelines       MD

Massachusetts OBS Guidelines            MA

Michigan OBS Guidelines        MI

Minnesota OBS Guidelines      MN

Mississippi OBS Guidelines     MS

Missouri OBS Guidelines         MO

Montana OBS Guidelines        MT

Nebraska OBS Guidelines       NE

Nevada OBS Guidelines          NV

New Hampshire OBS Guidelines         NH

New Jersey OBS Guidelines    NJ

New Mexico OBS Guidelines  NM

New York OBS Guidelines      NY ARTICLE 28

North Carolina OBS Guidelines           NC

North Dakota OBS Guidelines ND

Ohio OBS Guidelines  OH

Oklahoma OBS Guidelines OK

Oregon OBS Guidelines           OR

Pennsylvania OBS Guidelines PA

Puerto Rico PR

Rhode Island OBS Guidelines RI

South Carolina OBS Guidelines           SC

South Dakota OBS Guidelines SD

Tennessee OBS Guidelines      TN

Texas OBS Guidelines TX

Utah OBS Guidelines   UT

Vermont OBS Guidelines        VT

Virginia OBS Guidelines          VA

Washington OBS Guidelines    WA

West Virginia OBS Guidelines WV

Wisconsin OBS Guidelines      WI

Wyoming OBS Guidelines       WY

The information above was gathered from internet searches and the two summary documents below. One is from the Federation of State Medical Boards, the other is from the American Society of Plastic Surgeons (ASPS). They were updated in 2018 and 2014 respectively (so be sure to do your due diligence). Contact me if you have any specific questions.