Office Surgery Registration Program FAQs


Office Surgery Registration Program

Expand allClose all

Do Pain Management facilities need to register?

The Board of Medicine determined that anesthesia blocks are surgical procedures and would fall under the office surgery rule but the level of sedation would determine the level surgery.

Are there any exemptions from having to register with this program?

Yes, all physicians who perform surgical procedures in a facility licensed pursuant to Chapter 390 or 395, F.S.

Should the office notify the Board of Medicine of changes pertaining to the Office Registration?

Yes, per 64B8-9.0091 the physician must immediately notify the Department, in writing, of any changes to the registration information. Changes can be submitted to the board by completing the Office Surgery Registration Application and submitting it the Department.

What if I have a new physician enter my office surgery practice?

Every Florida licensed physician who holds an active Florida license and performs Level II surgical procedures in Florida with a maximum planned duration of five (5) minutes or longer or any Level III office surgery, as fully defined in 64B8-9.009, shall notify the Department. It is the physician’s responsibility to ensure that every office in which he or she performs Levels II or III surgical procedures as described above is registered, regardless of whether other physicians are practicing in the same office or whether the office is non-physician owned.The Department must immediately be notified in writing, via the Office Surgery Registration form and all required documentations, of all changes to the registration information.

What documentation is needed to prove level of training required?

Documentation to demonstrate satisfactory completion of training such as:

Board certification or Board qualification by a Board approved by the American Board of Medical Specialties or any other board approved by the Board of Medicine or documentation of comparable background, training and experience or documentation of staff privileges at a licensed hospital to perform the same procedure in that hospital as that being performed in the office setting, Documentation to demonstrate knowledge of the principles of general anesthesia (ACLS or BLS certification)
Transfer agreement from a local hospital or staff privileges with a delineation of procedures from a local hospital (within 30 minutes).

If I have staff privileges, do I need a transfer agreement?

No, as long as the staff privileges are at a licensed hospital within reasonable proximity (30 minutes travel distance) and are you are able to perform the same procedures as those performed in the office setting.

What documents are needed to register with this program?

Office Surgery Registration Form with an original signature for registering Surgeon Copy of current accreditation certificate and survey, if applicable. Documentation to demonstrate satisfactory completion of training such as:
Board certification or Board qualification by a Board approved by the American Board of Medical Specialties or any other board approved by the Board of Medicine or  Documentation to demonstrate knowledge of the principles of general anesthesia (ACLS or BLS certification) Additional documentation required for registration to perform levels II & III Office Surgery with this program. Name and license number of any Surgeon, Physician Assistant (PA), Certified Registered Nurse Anesthetist (CRNA), Advanced Registered Nurse Practitioner (ARNP), or Registered Nurse (RN) at facility Copies of any protocols necessary for the supervision of any PA, CRNA or ARNP. Copy of current ACLS Card for Surgeon and at least one assistant Name and license number of M.D. or D.O. Anesthesiologist, if applicable

What are the different levels of surgery?

Level I office surgery is surgery that in which: Surgical procedures where pre-operative medications are not required or used other than minimal pre-operative tranquilization of the patient; anesthesia is local, topical, or none; where no drug-induced alteration of consciousness other than minimal pre-operative tranquilization of the patient is permitted, and the chances of complications requiring hospitalization are remote. Such procedures shall include, but not be limited to:
1. Minor procedures such as excision of skin lesions, moles, warts, cysts, lipomas and repair of lacerations or surgery limited to the skin and subcutaneous tissue performed under topical or local anesthesia not involving drug-induced alteration of consciousness other than minimal pre-operative tranquilization of the patient.
2. Liposuction involving the removal of less than 4000cc supernatant fat is permitted.
3. Incision and drainage of superficial abscesses, limited endoscopies such as proctoscopies, skin biopsies, arthrocentesis, thoracentesis, paracentesis, dilation of urethra, cysto-scopic procedures, and closed reduction of simple fractures or small joint dislocations (i.e. finger and toe joints).

Level II Office Surgery is surgery that in which: peri-operative medication and sedation are used by any means altering the level of consciousness, thus making intra and post-operative monitoring necessary.

Such procedures shall include, but not be limited to: hemorrhoidectomy, hernia repair, reduction of simple fractures, large joint dislocations, breast biopsies, colonoscopy, and liposuction involving the removal of up to 4000cc supernatant fat. Peri-operative medication and sedation are used intravenously, intramuscularly, or rectally, thus making intra and post-operative monitoring necessary. Surgery in which the patient is placed in a state which allows the patient to tolerate unpleasant procedures while maintaining adequate cardio respiratory function and the ability to respond purposefully to verbal command and/or tactile stimulation. (Patients whose only response is reflex withdrawal from a painful stimulus are sedated to a greater degree than encompassed by this definition.) Such procedures shall include, but not be limited to: hemorrhoidectomy, hernia repair, reduction of simple fractures, large joint dislocations, breast biopsies, colonoscopy, and liposuction involving the removal of up to 4000cc supernatant fat
Level III Office Surgery is surgery that in which: Involves, or reasonably should require, the use of a general anesthesia or major conduction anesthesia and pre-operative sedation. This includes, but is not limited to, the use of:

a. Intravenous sedation beyond that defined for Level II office surgery;
b. General Anesthesia: loss of consciousness and loss of vital reflexes with probable requirement of external support of pulmonary or cardiac functions; or
c. Major conduction anesthesia.

Only patients classified under the American Society of Anesthesiologist’s (ASA) risk classification criteria as Class I or, II, are appropriate candidates for Level III office surgery.

Who needs to register with the Office Surgery Registration Program?

Every office performing surgery as defined in Sections 458.309(3) and 459.005(2), (A physician who performs liposuction procedures in which more than 1,000 cubic centimeters of supernatant fat is removed (Effective January 3, 2013), level 2 procedures lasting more than 5 minutes, and all level 3 surgical procedures in an office setting must register the office with the department unless that office is licensed as a facility under chapter 395, 458.309(3) F.A.C.) F.S. must register and maintain a valid registration with the Department of Health.