Proposed changes to state rules for new surgery centers could jeopardize the Wayne State University Physician Group's plans for a new outpatient surgery center in Troy . New standards recommended by the state Certificate of Need Commission would restrict the definition of "surgery" to only those procedures that are performed in an operating room, eliminating procedures commonly cited on applications such as endoscopy or mole removal. The narrower definition reduces the number of procedures that can be counted toward surgical volume. That makes the standard "almost impossible" for the university's physician group and other non-hospital applicants without existing centers, said Colin Ford, director of state government affairs with the Michigan State Medical Society.