In the face of increasing overhead and declining reimbursement for hand surgery services, ancillary services provide additional opportunities for revenue capture outside the standard stream of office visits and surgical billing. These additional revenue streams may allow hand surgeons to practice with less stress, improve efficiency, and create more financial security overall. Hand surgery practices are quite diverse. There are solo practitioners, hand surgery group practice, hand surgery within a specialty group (most often orthopedic surgery), multispecialty clinics, and those who are incorporated within a health system. Each of these types of practices may provide different suites of ancillary services.