Although not ideal for all situations, provider volume is particularly suited for measuring surgical quality in certain contexts. Specifically, we believe that for uncommon operations with a strong volumes-outcome effect, provider volume may be the most informative performance measure. Because of the relative ease of determining provider volume, it will continue to be used in value-based purchasing and public reporting efforts. With increasing momentum from outside the profession of surgery, it is particularly important for surgeons to participate in making decisions regarding situations where volume may be an appropriate measure of quality.