Government Entities

Bureau of Labor Statistics

Occupational Employment and Wage Statistics for Surgical Assistants from the Bureau
In 2013, ASA began discussions with the Bureau of Labor Statistics. Four years later, the BLS created a separate occupational code for surgical assistants. Other groups and individuals contributed to this success but ASA initiated the discussions.

State Specific Sites for Licensure/Registration

District of Columbia


Professional Organizations

Accreditation Review Council on Education in Surgical Technology and Surgical Assisting

American Society for Healthcare Risk Management

In 2016, ASA exhibited at the Association of Healthcare Risk Managers (ASHRM) and presented a mock surgery the following year. In 2018, ASA conducted a survey at the 2018 ASHRM Annual Conference in preparation for a proposal presented at the 2019 ASHRM Annual Conference. This is a critically important audience for surgical assistants to maintain.

Commission on Allied Health Education Programs

National Surgical Assistant Association

The Joint Commission

In 2016, ASA began seeking avenues to communicate with The Joint Commission. After sustained efforts, ASA began to find the appropriate representatives to discuss the challenges to patient safety that occur when practitioners are working outside of their scope of practice. In 2017, ASA scheduled a Joint Commission Surveyor to present the keynote address at the annual fall meeting in Richmond and in 2018, an ASA representative attended a Health Care Association Forum sponsored by the Joint Commission. The opening keynote speaker at the Spring 2019 ASA/NSAA Joint Conference was Andrew Bland, MD, Medical Director, Division of HealthCare Quality Evaluation. ASA is now undertaking a survey to provide feedback to The Joint Commission about surgical assistant practices.


HealthTrust DHP Credentialing Packet  

In 2017, ASA began conversations with HealthTrust, in conjunction with The Joint Commission effort. HealthTrust credentials surgical assistants in nearly HCA hospitals and will be expanding their credentialing services to other healthcare organizations in 2018. A representative spoke at the ASA 2018 meeting in Phoenix.

National Plan and Provider Enumeration System (NPPES)

How to Apply for a NPI Number

National Uniform Claims Committee

American College of Surgeons

Assistants at Surgery CPT Codes

This study reviews all procedures listed in the “Surgery” section of the 2023 American Medical Association’s Current Procedural Terminology (CPT) coding manual to determine whether the operation requires the use of a an assistant at surgery: (1) almost always; (2) almost never; or (3) some of the time. 

2018 American College of Surgeons Recommendations on When to Use an Assistant in Surgery:

  •  Indication of which surgeon will be responsible for the supervision and performance of the SA or PA.
  •  Review and approval of the application by the hospital board.
  •  Registered nurses with specialized training also may function as first assistants. If such a situation should occur, the size of the operating room team should not be reduced; the nurse assistant should not simultaneously function as the scrub nurse and instrument nurse when serving as the first assistant. Nurse assistant practice privileges should be granted based upon the hospital board’s review and approval of credentials. Registered nurses who act as first assistants must not have responsibility beyond the level defined in their state nursing practice act.

Surgeons are encouraged to participate in the training of allied health personnel. Such individuals perform their duties under the supervision of the surgeon.


American Medical Association

Code of Medical Ethics Opinion 2.3.6 - Certified Surgical Assistants

Surgical co-management refers to the practice of allotting specific responsibilities of patient care to designated clinicians. Such arrangements should be made only to ensure the highest quality of care.

When engaging in this practice, physicians should:

  •  Allocate responsibilities among physicians and other clinicians according to each individual's expertise and qualifications.
  •  Work with the patient and family to designate one physician to be responsible for ensuring that care is delivered in a coordinated and appropriate manner.
  •  Participate in the provision of care by communicating with the coordinating physician and encouraging other members of the care team to do the same.
  •  Obtain patient consent for the surgical co-management arrangement of care, including disclosing significant aspects of the arrangement such as qualifications of clinicians, services each clinician will provide, and billing arrangement.
  •  Obtain informed consent for medical services in keeping with ethics guidance, including provision of all relevant medical facts.
  •  Employ appropriate safeguards to protect patient confidentiality.
  •  Ensure that surgical co-management arrangements are in keeping with ethical and legal restrictions.
  •  Engage another caregiver based on that caregiver’s skill and ability to meet the patient’s needs, not in the expectation of reciprocal referrals or other self-serving reasons, in keeping with ethics guidance on consultation and referrals.
  •  Refrain from participating in unethical or illegal financial agreements, such as fee-splitting.

Surgeons are encouraged to participate in the training of allied health personnel. Such individuals perform their duties under the supervision of the surgeon.