with surgery services and the identification of populations by zip code areas using Medicare patient origin data. (B) Identification of surgeons Identification of all actively practicing general surgeons. (C) Surgeon to population ratios Development of general surgeon-to-population ratios for each surgery service area. (D) Thresholds (i) In general Determination of threshold general surgeon-to-population ratios for the number of general surgeons necessary to treat a population for each of the following levels: (I) Optimal supply of general surgeons. (II) Adequate supply of general surgeons. (III) Shortage of general surgeons. (IV) Critical shortage of general surgeons. (ii) Considerations In determining the thresholds under clause (i), the Secretary shall not assume that the current supply of general surgeons nationwide is the optimal or adequate level and shall consider additional factors such as wait times, health outcomes, ground transportation time to the nearest health care center with a general surgeon, critical access hospitals with surgical capabilities but lacking a general surgeon, and patient experience. (3) Report Not later than 1 year after the date of the enactment of this subpart, the Secretary shall submit to Congress a report on the study conducted under this subsection. (4) Consultation In conducting the study under paragraph (1), the Secretary shall consult with relevant stakeholders, including medical societies, organizations representing surgical facilities, organizations with expertise in general surgery, and organizations representing patients. (5) Publication of data The Secretary shall periodically collect and publish in the Federal Register— (A) data comparing the availability and need of general surgery services in urban, suburban, or rural areas in the United States