The First Hill Surgery Center is the largest independent surgery center in the Pacific Northwest, and is operated as a joint venture between The Polyclinic and Swedish Medical Center and managed by The Polyclinic. The FHSC features 12 fully-equipped state-of-the-art operating rooms and recovery rooms with comprehensive imaging, laboratory and pharmacy services. The 36,000-square-foot facility provides access for surgeons across the Puget Sound region.

The First Hill Surgery Center is led by Dr. Steven Counter, Medical Director and Cynthia Bess, Executive Director. To learn more about the facility or scheduling surgery, please review the information below or contact 206-320-7750.

Scheduling Surgery

To schedule a case with the First Hill Surgery Center, please complete this form and fax it to 206.320.6755.

To request block time, please complete this form and submit it to FHSC Surgery Scheduling. Requests will be reviewed and determined based on facility availability, consideration of patient type, equipment availability, and the order in which requests are received.

Credentialing for FHSC

Eligible Medical Staff must have Swedish Privileges (active or courtesy) and be trained in EPIC before requesting FHSC privileges. Fellows, Physicians Assistants, surgical assistants and RN-FA will also be credentialed with a sponsoring physician as part of the FHSC staff. Privileging is done via Core privileging format and is renewed on a 2-year cycle. To inquire about receiving FHSC privileges, please contact FHSC Executive Director Cynthia Bess.

Procedure Consent Forms

The First Hill Surgery Center has procedure-specific consent forms that patients must sign before surgery is performed at FHSC. Please download the form you need and share it with your patient before the surgery date. Consent forms should be faxed to the First Hill Surgery Center at 206.720.7755 prior to the procedure.

Anesthesia Guidelines

First Hill Surgery Center uses US Anesthesia Partners (USAP) to provide anesthesia services for our surgeries. Please review the FHSC Anesthesia Review before scheduling a patient for surgery. If you have questions or special requests, contact USAP at 888-279-3668.

Policy on Residents and Fellows

Medical students and residents may participate in surgeries under the direction and discretion of the attending physician. As such, the patient needs to be made aware of their presence during the surgery. Students and residents may not write orders or dictate operative notes or make notes in the patient’s chart. An affiliation agreement (i.e. Univ of Washington, Swedish, MEDEX) must be in place prior to the student or resident’s arrival.

Fellows will be credentialed as part of the medical staff as individual providers with sponsoring physician support. As such, the attending physician must be in the FHSC when the patient and fellow are in the operating room.

Further details are available in the medical staff bylaws governing residents and fellows. Also available is the Board of Governors resolution. Please contact FHSC Medical Director, Steven Counter, MD, for more information.


How do I get privileges?

Please see “Credentialing for FHSC”

How do I schedule a patient?

Please see “Scheduling Surgery”

What patients are eligible for surgery?

In general, ASA category 1 and 2, BMI 35 and without sleep apnea are good candidates for outpatient surgery. In some cases, patients with sleep apnea using CPAP who are not undergoing airway surgery (e.g. tonsillectomy) will also be good candidates.

Children older than 12 months may be approved for certain procedures and those older than 3 years are approved for most surgeries.

You will need to complete this evaluation form for patients with cardiac implantable electronic devices prior to surgery.

Please see “Anesthesia Guidelines” for more information

Where can I find information about billing at the First Hill Surgery Center?

For information about billing, fees, and rates, please contact executive director, Cynthia Bess.

Is there a price list for cosmetic procedures? What about elective surgery?

Cosmetic procedure quotes and elective surgery rates (room rates, anesthesia rates) are available by contacting our financial counselors at 206-320-7799.

What type of cases are being done at First Hill Surgery Center?

In general, outpatient surgeries requiring less than an hour of recovery room time are typically done at FHSC. These are the surgeries currently being performed at the First Hill Surgery Center:

  • Breast surgery: excisional biopsy and lymph node dissection, port a cath placement, mastectomy
  • Colon & Rectal Surgery: anal dysplasia treatment, drainage of abscess, hemorrhoid, lateral internal sphincterotomy
  • ENT: ear tubes, tonsil and adenoidectomy, parathyroidectomy, unilateral thyroid lobectomy, FESS with or without Stealth
  • General surgery: laparoscopic and open hernia repairs, laparoscopic cholecystectomy, melanoma surgery, lymph node and sentinel node biopsy, mass excision, laparoscopic appendectomy
  • Gynecology: D&C, uterine biopsy and ablation, oophorectomy, sterilization procedures, laparoscopic adnexal and uterine surgery
  • Hand surgery: carpal tunnel release, trigger finger, Dupytren's release, fracture repair including ORIF
  • Ophthalmology: cataract and glaucoma surgery, corneal surgery
  • Orthopedic surgery: total hip and total knee replacement, knee and shoulder arthroscopy, tumor excision, ACL reconstruction, ORIF including clavicle repairs
  • Pediatric surgery: ear tubes, tonsil and adenoidectomy
  • Plastic surgery: breast augmentation/mammoplasty/reduction, expander placement/removal; breast reconstruction including latissimus flap
  • Podiatry: foot and ankle arthrodesis, bunionectomy
  • Urology: cystoscopy, urethroscopy, stone removal, stent placement, testicular and scrotal lesion removal

    What if I have a special request for equipment or want to do a procedure that isn't currently being done?

    FHSC has an operating council of practicing surgeons that meet regularly to assess the utilization (block time) and stewardship (equipment usage) of surgeons. During this time new procedures and equipment needs will be discussed and a recommendation made regarding adoption of requested changes. If new equipment is needed, please complete the new equipment form and submit.

    Can I do "add-on" cases? What about "emergencies?"

    Add-on cases (unscheduled when the day begins) are often able to be accommodated. The current need for pre-authorization requires timely notification and planning on behalf of the surgeon. NPO status per anesthesia guidelines must also be met.

    Emergency surgery is not done at FHSC. This includes the possibility of needing to return to the operating room for a complication. If deemed necessary, a return to the operating room is performed after emergency transfer to Swedish Hospital.

    What paperwork needs to be done before I can get my patient scheduled?

    FHSC is paper-free. We've developed order sets (located in EPIC using "JV SFH" as the search term) and preoperative protocols for the nursing staff to assure efficient care of your patient. We will be able to incorporate your instructions in discharge materials, especially if you have already developed an EPIC "dot phrase" that you currently use.

    I'm working with medical students/residents/fellows, can they work at FHSC?

    Please see “Policy on Residents and Fellows”