Overview of Services Powder River Surgery Center is a multi-specialty surgery center providing services in the fields of ophthalmology, ortho-spine, orthopedic, pain management, podiatry, ENT, GI, General Surgery, and urology. We have 2 operating rooms and 1 procedure room and average approximately 250 cases/month. Recognized Standards Powder River Surgery Center complies with all Accreditation Association for Ambulatory Health Care, Inc., The State of Wyoming Department of Health, CMS, Board of Nursing, Board of Medicine, and Board of Pharmacy guidelines.