OBJECTIVES: This study quantifies the benefits of surgeon’s volume on outcomes in lung surgery: lobectomies and wedge resections. The goal of this analysis is to analyze the effect of technique-specific experience (VATS) on cost, utilization and adverse events. METHODS: This study utilizes the Premier hospital database which contains clinical and utilization information on patients receiving care in over 600 US hospitals.  Eligible patients were those of any age undergoing lobectomy or wedge resection using VATS for cancer treatment. Volume measures use additional data for patients undergoing lobectomy or wedge resection using open thoracotomy. Our measure of volume represents the aggregate experience level of the surgeon per six month window. Multivariable logistic regression analyses were estimated for the binary outcome - adverse events. Ordinary Least Squares (OLS) regression was used for continuous outcomes: hospital costs, surgery time, length of stay, and number of adverse events. In addition, the following explanatory variables were included: patient demographics, diagnosis, comorbid conditions, patient severity index and hospital characteristics. RESULTS: Of 7137 patients in the database with elective, inpatient resections for lung cancer, a total of  2698 patients underwent lobectomy (n=716) or wedge resection (n=1982) using VATS. More than 70% of these procedures were performed by thoracic surgeons (n=1896). A positive volume-outcome relationship appeared as follows: The relationship is stronger for cost and utilization outcomes versus adverse events,  for thoracic surgeons versus other surgeons, and  for VATS lobectomy procedures versus VATS wedge resection procedures. Finally, we find that while there was a reduction in cost and resource utilization associated with greater experience with VATS, these outcomes were not strongly linked with greater experience with open procedures. CONCLUSIONS: There is a reduction in cost and resource utilization associated with greater experience with VATS. Greater experience with open procedures does not correlate with better VATS outcomes.