The military recognizes distinctions between combat and garrison surgical care and developed the Knowledge, Skills, and Abilities (KSA) methodology to link current procedural terminology (CPT) codes to a combat readiness score. A KSA score of 4100 or greater indicates surgeons ready to deliver vascular surgery care in wartime clinical settings. Our previous analysis of KSA data demonstrated that embedding specialty-trained coding teams consisting of a surgeon, coder, and auditor significantly improved procedural CPT code capture and yielded a 13% increase in vascular surgeon mean KSA scores. The primary goal of this analysis was to determine the effect of the addition of external workload (outside of military facilities) on KSA scores and, therefore, surgeon readiness. KSA scores are calculated using high and low acuity surgical procedures. High acuity procedures are considered most relevant for combat surgery and are uncapped when scoring, whereas low acuity procedure volume is capped. This prevents the ability to achieve “readiness” with lower acuity, less combat relevant surgeries. This study analyzed the factors leading to surgeons reaching a readiness score with the primary outcome being to identify the top 3 factors leading to surgeon readiness score. 41 military vascular surgeons serve on active duty within the Air Force, Army, and Navy. Fiscal year 2023 data for the KSA methodology was done for all surgeons within the services. The mean KSA Score per vascular surgeon within the MTFs was 2104.7 (SD = 404.3). The addition of external workload yielded a mean KSA Score of 4826 (SD = 389.5), or a 129.2% (range 99.7%-167.0%) raw increase in KSA score. When considered as a percent of the goal KSA score of 4100, the addition of external workload contributed 66% of the goal KSA score. Military leadership has a vested interest in ensuring vascular surgeon readiness, requiring a repeatable, objective metric performed continuously (active duty) and prior to deployment (active duty and reserve). The KSA methodology identifies gaps in surgeon military practice to focus resources and time. The addition of surgeons’ external workload to the KSA methodology contributes an additional 66% of the score towards threshold goal. This has several important implications. Military-civilian partnerships and agreements are necessary to maintain vascular surgeon skills. The current and future vascular surgeon readiness relies on coding improvements with MTFs and filling gaps in practice with external surgical practice.