ACS Surgical Workforce Mapping Tool

The ACS Surgical Workforce Mapping Tool, developed in collaboration with the Program on Health Workforce Research and Policy at the Cecil G. Sheps Center for Health Services Research, UNC-Chapel Hill, provides a comprehensive, data-driven view of where surgeons practice across the United States—and where gaps in access to surgical care exist. By visualizing surgeon distribution across counties, regions, and population centers, this resource helps illuminate disparities that impact patient access, particularly in rural and underserved communities.

Designed for policymakers, surgeon advocates, and researchers, the tool supports informed decision-making and strengthens efforts to address workforce challenges, including the need for increased federal investment in surgical training.

Ways You Can Use This Data

Use the data to add geographic and specialty-specific context to policy briefings, presentations, research, and advocacy materials. The maps can:

• Help illustrate workforce patterns
• Compare areas or surgical specialties
• Identify locations for further analysis
• Support discussions about training, recruitment, retention, and access to surgical care

How to Use the Mapping Tool

• Hover over a region to see its population, practitioner count, and rate per 100,000
• Use the Surgery Group dropdown to switch between specialties; expand “Included taxonomy codes” to see the specific NPPES codes in each group
• Toggle County / HRR / CBSA to change the geography level
• Use Zoom to State to focus on a single state; non-intersecting geographies become transparent
• Check Facility Overlay boxes to show CMS Provider of Services hospital and ambulatory surgical center locations as colored dots

Legend

HRR = Hospital referral region

CBSA = Core-based statistical area

About the Data

Data Sources

• Individual and facility records: National Plan and Provider Enumeration System (NPPES), April 2025. Includes 330,111 individual clinicians across 61 NPPES taxonomy codes in 14 surgery related groups (12 surgical specialties plus Anesthesiology and CRNAs), plus two aggregate views: All Surgeons and Combined Anesthesia Clinicians. Only primary taxonomy codes are considered for classifying each clinician, except that any clinician listing the student/trainee taxonomy code (390200000X, used by residents and fellows) in any taxonomy field is excluded from the data.
• Facility overlays: Centers for Medicare & Medicaid Services (CMS) Provider of Services (POS) Current Files, Q2 2025—4,532 hospitals and 6,468 ambulatory surgical centers in the 50 states and the District of Columbia (facilities in US territories are excluded). The hospital layer includes all CMS-certified acute care hospitals, including some hospitals that are lacking surgical facilities, like many critical access hospitals.
• Population: US Census Bureau County Population Estimates (CO-EST2024) for counties and CBSAs; HRR population approximated from Census 2020 block group data.

Rates

• Rates are weighted counts of clinicians per 100,000 population.
• “Weighted count” is weighted to account for practitioners with multiple practice locations: practitioners at a single location receive weight 1.0; those with secondary addresses receive 0.6 for their primary location and 0.4 divided equally among secondary locations.
• The values for “Individuals” and “Individuals (primary location)” show the unweighted count of unique clinicians in the US or a selected state, respectively. For the state level view, only primary practice location is considered in placing clinicians. “Individuals (any location)” displays the count of unique clinicians practicing within a given county/HRR/CBSA; this includes non-primary practice locations.
• HRR rates use 2020 Census population; county and CBSA rates use 2024 population estimates, so rates may not be comparable across geography levels.

Geography

• County boundaries: US Census Bureau Cartographic Boundary Files (2023, 1:5,000,000). 3,144 counties across 50 states and the District of Columbia.
• Hospital Referral Regions (HRRs): Dartmouth Atlas of Health Care. 306 regions representing regional health care markets for tertiary medical care. HRR boundaries are derived from Medicare referral patterns and may not align precisely with state borders or coastlines.
• Core-Based Statistical Areas (CBSAs): US Census Bureau (2023 definition). 925 metropolitan and micropolitan statistical areas. Non-CBSA counties are shown with county-level rates.
• Congressional Districts: US Census Bureau Cartographic Boundary Files (2024, 1:5,000,000), 119th Congress. 435 House districts plus the District of Columbia delegate district.

Classification

• Choropleth maps use quantile classification with 6 classes. Each class contains approximately the same number of geographies.
• White areas indicate zero practitioners of the selected type; transparent areas have no data for that geography level.
• At the HRR level, areas outside any HRR boundary are transparent (no HRR is defined for those areas).
• At the CBSA level, areas outside any CBSA are filled with county-level rates.