Pre-Operative Clearance
A focused medical evaluation before surgery — history, physical exam, EKG and labs when indicated, and a signed pre-op evaluation letter sent to your surgeon.
What Pre-Op Clearance Is
Before an elective procedure, most surgeons and surgical centers ask for written clearance from a primary care physician. The goal is to confirm that your medical conditions are stable, identify anything that could raise your risk under anesthesia, and address it before the day of surgery rather than after.
Dr. Mui completes these evaluations routinely, including for patients traveling out of state or abroad for their procedure.
What “Cleared” Actually Means
Clearance isn’t a pass/fail stamp, and no physician can promise that surgery will go well. What the evaluation actually produces is a risk assessment — an informed estimate of how likely you are to have a heart, lung, or bleeding complication around the time of your procedure, and what can be done to lower it.
In practice that lands in one of three places:
- Low risk. Healthy, or with well-controlled conditions, having a routine elective procedure. This is most patients, and the letter is straightforward.
- Moderate risk. Something is worth flagging — blood pressure that isn’t at goal, diabetes that needs a plan for the day of surgery, untreated sleep apnea, or limited exercise tolerance. The letter names the risk and what reduces it, and surgery usually still goes ahead.
- High risk. Active cardiac symptoms, a recent cardiac event, or significant lung disease. These cases warrant a cardiology opinion, and sometimes a change in the timing or the anesthetic plan, before proceeding.
One of the most useful questions in that assessment is simple: can you climb two flights of stairs without stopping? Patients who can do that reliably tend to do well, and often need less testing than they expect.
The letter your surgeon receives states that assessment plainly. The decision to operate stays between you and your surgeon — our job is to make sure it’s an informed one.
What’s Included
- Full history and physical exam focused on cardiac, pulmonary, and bleeding risk
- Review of your medical conditions — blood pressure, diabetes, sleep apnea, thyroid, and anything else that affects anesthesia
- Medication review, including which blood thinners, supplements, and GLP-1 medications to hold and for how long
- EKG with interpretation when indicated by your age, history, or your surgeon’s requirements
- Pre-operative labs — CBC, metabolic panel, coagulation studies, pregnancy testing, and anything your surgeon specifies
- A signed pre-op evaluation letter on office letterhead, sent directly to your surgeon or surgical facility
Procedures We Evaluate For
- Cosmetic and plastic surgery — Lipo360, BBL, tummy tuck, breast procedures
- Surgery abroad — clearance packets for procedures scheduled in another country
- Orthopedic surgery — joint replacement, arthroscopy, hardware removal
- Gynecologic and urologic procedures
- General surgery — hernia repair, gallbladder, and other outpatient operations
- Dental and oral surgery under sedation
- Endoscopy and colonoscopy when the facility requires clearance
How It Works
- Book a visit. Pre-op clearance requires an in-person appointment, since it includes a physical exam.
- Complete the pre-op intake form. Filling it out ahead of your visit expedites the process.
- Bring your surgeon’s requirements. Any forms, a list of the labs they want, and the date and type of your procedure.
- Come in for the evaluation. History, exam, and an EKG or labs if they’re needed.
- We send the letter. If no additional testing is required, your pre-op evaluation letter usually goes out the same day. If labs are pending, it goes out as soon as the results are back — typically two to three business days.
When to Schedule
Most surgeons want clearance dated within 30 days of the procedure, and many labs and EKGs have the same window. Booking about three to four weeks before surgery is the sweet spot — recent enough to satisfy the requirement, with time left over if something needs to be corrected or repeated.
If your surgery is sooner than that, call or text 617-675-4085 and we’ll do our best to fit you in.
Self-Pay Visit Pricing
$250 for new patients • $175 returning patients • Free with membership
EKG with interpretation is $50, and labs start at $5. Click here for more pricing information.
Frequently Asked Questions
No. New patients are welcome for pre-op clearance. If you’d like Dr. Mui to be your primary care physician going forward, we’re happy to set that up at the same visit.
Yes. Bring the form with you, or email it ahead of the visit. If your surgeon has a required lab panel, send that list too so everything can be drawn at one appointment.
The evaluation is the same. Bring whatever paperwork the facility sent you, ideally translated, and let us know your travel dates. Pre-op evaluation letters are provided in English on office letterhead with Dr. Mui’s signature and stamp.
No — clearance depends on what the evaluation finds. Most patients are cleared without any issue. Occasionally something turns up that needs to be treated first, or that warrants a cardiology opinion before proceeding. If that happens, we’ll explain it clearly, help arrange the next step, and communicate directly with your surgeon.
Pre-op clearance requires an in-person visit. A physical exam is part of what the surgeon is relying on, and an EKG has to be done in the office.