Methodology

For the rankings, U.S. News partnered with CareJourney by Arcadia to evaluate 4,357 ambulatory surgery centers (ASCs) across four different specialty areas:

• Colonoscopy and endoscopy
• Ophthalmology
• Orthopedics and spine
• Urology

More than 25% of ASCs were multispecialty providers, including most ASCs that provided urological care.

To assess ASC performance, U.S. News and CareJourney analyzed data from Medicare fee-for-service claims between 2021 and 2023 for different outcome areas:

ED visit rate, excluding those immediately followed by acute care admissions (ED visit rate)

• Admission rate to acute care facilities through the ED (admission rate)
• Total allowed payment attributable to episode-related complications (cost of complications)
• All-cause mortality rate (mortality rate)
• Average length of stay in days, if any, in institutional post-acute or long-term care (post-acute length of stay)

The best ASCs in the US

Overall, 733 ASCs — fewer than 17% of those evaluated — received a "high performing" rating.

Among the high-performing ASCs, patients:

• Had lower severity-weighted relation complications (on average, 36% for colonoscopy and endoscopy, 54% for ophthalmology, 37% for orthopedics and spine, and 36% for urology)
• Were less likely to have an ED visit after their procedures (on average, 35% for colonoscopy and orthopedics, 30% for orthopedics and spine, and 31% for urology)
• Were less likely to have an inpatient admission after their procedures (on average, 48% for colonoscopy and orthopedics, 40% for orthopedics and spine, and 40% for urology)

The 10 states with the greatest number of high-performing ASCs were:

• California (95 ASCs)
• Florida (64 ASCs)
• Texas (54 ASCs)
• Pennsylvania (36 ASCs)
• Maryland (34 ASCs)
• Georgia (29 ASCs)
• New York (25 ASCs)
• Arizona (23 ASCs)
• Ohio (23 ASCs)
• New Jersey (22 ASCs)
• Washington (22 ASCs)

For each specialty, the states, listed in alphabetical order, that had the greatest number of high-performing ASCs were:

• Colonoscopy and endoscopy: California, Florida, and Texas
• Ophthalmology: California, Florida, and Texas
• Orthopedics and spine: California, Florida, Maryland, and Texas
• Urology: California, Florida, Georgia, and Maryland

"U.S. News' 2025 Best Ambulatory Surgery Centers ratings highlight the top performing surgery centers in the procedures evaluated, giving consumers the confidence to make informed, data-driven decisions when choosing an ASC," said Chelsey Wen, senior health data analyst at U.S. News. "Facilities ranked 'best' by U.S. News demonstrate on average up to 35% fewer emergency department visits compared to all ASCs evaluated by U.S. News."