Skip to main content Skip to footer
American Family Children's Hospital

For Referring Providers

Our Madison Surgery Center physicians place a heavy emphasis on communicating with referring physicians.Outpatient surgery and procedures are the sole focus of the physicians and staff at Madison Surgery Center, allowing our surgeons more time to spend with their patients. We pride ourselves on utilizing our surgeons time well with efficient room turnovers. We also provide a comfortable staff lounge for use throughout the day. Our goal is to provide outstanding services to our customers, both patients and surgeons.


Consent for Surgery Form


Consent for Surgery (pdf)


Types of Surgeries


Madison Surgery Center is a multi-specialty ambulatory surgery center and we currently service dermatology, general surgery, gynecology, otolaryngology, ophthalmology, orthopedic, plastics, podiatry, urology and vascular surgery. We provide services for physicians and patients with the expectation that the patient will be discharged the same day.


Patient Guidelines

  • Patients must not have significant health problems which could jeopardize their care here.
  • Patients must not have latex allergies (anaphylaxis).
  • Routinely scheduled patients should not take or eat anything by mouth (NPO) after midnight the night before the procedure.
  • Add-on patients requiring general anesthesia, sedatives or narcotics must not take or eat any solids by mouth (NPO) for eight hours and must not drink any clear liquids for three to four hours before the procedure.

Medicare Patients


Procedures for all Medicare patients must have a CPT code that is on the Medicare-approved list for freestanding ambulatory surgical centers.


Scheduling OR Time at Madison Surgery Center

  • Physicians who have been granted privileges may contact the scheduling staff at (608) 287-2587 between 8:30 am and 5 pm or email
  • If you would like to request OR block time, please submit your request in writing to the attention of the Medical Director or Clinical Services Director: Madison Surgery Center, 1 S. Park St. Third Floor, Madison, WI 53715

Requesting Physician Interest Instructions and Credentials


If you are a licensed provider, please submit:

  • A written request for surgical procedures and/or credentials to the attention of the Medical Director, Madison Surgery Center, 1 S. Park St. Third Floor, Madison, WI 53715
  • Your current Curriculum Vitae with photocopies of your current Wisconsin State License and your Department of Drug Enforcement Authorization License.
  • A summary of surgeries you would like to perform and when you would like OR time (Monday through Friday, 7:30 am to 4 pm).