Background As Acute Care Surgery and shift-based models increase in popularity, there is evidence of better outcomes for many types of emergency general surgery patients. We explored the difference in outcomes for patients with acute biliary disorders, treated by either Acute Care Surgery (ACS) model or traditional call model (TRAD) during the same period. Methods Retrospective review of patients undergoing laparoscopic cholecystectomy for acute biliary disease 2017-2018. Demographics, clinical presentation, operative details, and outcomes were compared. Results Demographics, clinical presentation, and complication rates were similar between groups. Time from surgical consult to operating room (Δ = −15.34 hours [−24.57, −6.12], P = .001), length of stay (Δ = −1.4 days [−2.45, −.35], P = .009), and total charges were significantly decreased in ACS group compared to TRAD (Δ$2797.76 [−4883.12, −712.41], P = .009). Conclusions Acute biliary disease can be managed successfully in an ACS shift-based model with reduced overall hospital charges and equivalent outcomes.