Two matched groups of patients who underwent endoscopic anterior cruciate ligament reconstruction using the middle one third of the patellar tendon were retrospectively reviewed to compare hospitalization charges. Group 1 had the procedure performed in the outpatient surgical center owned by our hospital, and group 2 underwent the surgical procedure in the main operating suite of Rush-Presbyterian-St. Luke's Medical Center. The charges of the surgical procedure and their relation to postoperative hospitalization were reviewed. An average charge difference of $7,390 (range, $3,679 to $12,202) was obtained in the outpatient surgical center. A number of surgical and anesthetic techniques are discussed that allow major reductions in charges for anterior cruciate ligament reconstruction and allow outpatient surgery to be performed routinely.