Disclaimer: This article is for informational purposes only and does not constitute medical advice.
- An estimated 10–20% of surgeries performed in the United States may be unnecessary, translating to millions of avoidable procedures every year.
- Unnecessary surgeries cost the U.S. healthcare system between $25 billion and $50 billion annually and expose patients to serious complications, including chronic pain, infections, and even death.
- A 2025 Lown Institute report found that Medicare paid $1.9 billion for over 200,000 unnecessary back surgeries in just three years — roughly one every eight minutes.
- Studies show that second opinions change the diagnosis or treatment plan in 50–88% of cases, and up to 40% of patients told they need surgery may be redirected to non-surgical alternatives.
- Seeking a second opinion before any elective surgery is a patient right supported by physicians, insurers, and medical organizations — and it could save your health, your finances, and your life.
Every year, millions of Americans undergo surgery. For many, these operations are life-saving. But for a troubling number of patients, the surgery they receive is medically unnecessary — a procedure performed on a body that might have healed on its own, or been managed with less invasive approaches.
According to peer-reviewed studies and federal health data, an estimated 10 to 20 percent of all surgical procedures performed in America may be unnecessary — roughly 7.5 million avoidable procedures each year, costing tens of billions of dollars and exposing patients to risks ranging from surgical complications to long-term disability and death.
The hopeful part: a significant number of these operations could be prevented by getting a second opinion before surgery. In this guide, we’ll explore the data behind unnecessary surgery, examine which procedures are most commonly overperformed, and explain how a second opinion can protect you.
What Is Unnecessary Surgery? Definition and Scope
Unnecessary surgery is any surgical procedure performed when the expected benefits do not clearly outweigh the risks, or when equally effective non-surgical treatments are available. In clinical terms, it refers to operations where the medical evidence does not support surgical intervention as the best course of action for the patient’s specific condition.
The concept is not always straightforward. What qualifies as “unnecessary” depends on clinical guidelines, patient characteristics, and available alternatives. However, major medical organizations — including the American Board of Internal Medicine’s Choosing Wisely campaign — have identified over 550 tests, treatments, and procedures that are commonly overused or performed without sufficient clinical justification.
Unnecessary surgery generally falls into four categories: procedures with no proven benefit over conservative treatment (e.g., arthroscopic knee surgery for osteoarthritis); premature surgical intervention before exhausting non-surgical options like physical therapy; diagnostic uncertainty where an incorrect diagnosis drives an incorrect treatment plan; and overtreatment of low-risk conditions that have a high probability of resolving without surgery (e.g., small thyroid nodules).
According to a widely cited survey published in PLOS ONE, physicians themselves reported that approximately 11.1% of all procedures they perform are unnecessary — roughly one in every ten operations. When you consider the more than 50 million inpatient surgeries and procedures performed in the U.S. annually, even a conservative estimate means millions of patients are undergoing operations they do not need.
Unnecessary Surgery Statistics: How Big Is the Problem?
The data on unnecessary surgery in America paints a troubling picture. Multiple studies, government reports, and healthcare watchdog analyses converge on a clear conclusion: surgical overuse is a systemic problem with enormous human and financial consequences.
The Numbers at a Glance
| Metric | Statistic | Source |
|---|---|---|
| Percentage of surgeries that may be unnecessary | 10–20% | Multiple peer-reviewed studies |
| Estimated unnecessary procedures per year | ~7.5 million | Aggregate federal & clinical data |
| Annual cost of unnecessary surgery | $25–$50 billion | Healthcare economics analyses |
| Total U.S. healthcare waste annually | $760–$935 billion | Shrank et al., JAMA (2019) |
| Medicare spending on unnecessary back surgeries (3 years) | $1.9 billion | Lown Institute (2025) |
| Unnecessary back surgeries on Medicare patients (3 years) | 200,000+ | Lown Institute Hospitals Index (2025) |
| Estimated deaths from unnecessary surgery complications (annual) | ~1,000 | Healthcare safety analyses |
A landmark 2019 study published in JAMA by Shrank, Rogstad, and Parekh estimated that up to 25% of total U.S. healthcare spending — between $760 billion and $935 billion annually — is waste. Overtreatment, including unnecessary surgery, accounts for $75.7 billion to $101.2 billion per year of that total.
In October 2025, the Lown Institute released a major report revealing that U.S. hospitals performed more than 200,000 unnecessary back surgeries on Medicare beneficiaries over a three-year period, costing taxpayers $1.9 billion — roughly one unnecessary back surgery every eight minutes. The top 10% of physicians by overuse volume accounted for 60% of all unnecessary spinal procedures.
Which Surgeries Are Most Commonly Performed Unnecessarily?
Certain procedures have been consistently identified by researchers and government reports as having particularly high rates of unnecessary performance. Understanding which surgeries are most commonly overperformed can help patients seek second opinions when appropriate.
Spinal Fusion and Back Surgery
Back surgery is one of the most overperformed operations in the United States. The 2025 Lown Institute Hospitals Index found an average spinal fusion and laminectomy overuse rate of 13% across U.S. hospitals, with some facilities exceeding 50%. A study of 544 patients seeking second opinions found that 60% had been recommended for unnecessary spine surgery. Research shows that about 70% of herniated disc patients recover within six weeks without surgery, and physical therapy is cited as comparably effective to surgery for many back conditions. Learn more in our guide on getting a second opinion for spinal surgery.
Knee Replacement and Knee Arthroscopy
According to research published by Reuters, approximately one-third of all knee replacements in the United States may be inappropriate. With roughly 790,000 knee replacements performed annually, that means more than 260,000 patients per year may be undergoing the procedure without clear medical justification. Knee arthroscopy for osteoarthritis has been found ineffective in over 25% of cases, and shared decision-making tools have been shown to reduce elective knee surgery rates by about 26%. For more details, see our comprehensive guide on second opinions for knee replacement surgery.
Coronary Stents and Cardiac Procedures
The Lown Institute Hospitals Index found that from 2019 to 2021, U.S. hospitals performed over 229,000 unnecessary coronary stents. Of approximately one million stents placed, 22% met overuse criteria. For stable heart disease patients, up to 30% of cardiac stent procedures may be unnecessary, and an estimated 18% of coronary bypass surgeries may not clearly benefit patients over medical therapy alone.
Cesarean Sections
About 35% of cesarean deliveries in the United States are considered medically unnecessary, with rates varying dramatically across hospitals — from 7% to as high as 70%. The extra cost of C-sections over vaginal deliveries adds an estimated $5 billion per year to U.S. healthcare spending.
Hysterectomy
An estimated 20,000 to 30,000 hysterectomies per year are considered unnecessary. Research has found that approximately 23% of hysterectomies performed for benign conditions show no evidence of the suspected disease upon pathological examination. Less invasive alternatives, including medication management and uterine-preserving procedures, can be effective for many patients.
Other Commonly Overperformed Surgeries
| Surgery | Estimated Unnecessary Rate | Effective Alternative |
|---|---|---|
| Thyroid surgery (small nodules) | Up to 60% | Active surveillance, monitoring |
| Tonsillectomy (children) | Over 50% | Watchful waiting (symptoms often resolve) |
| Appendectomy | ~20% | Antibiotic therapy in selected cases |
| Gallbladder removal | ~15% | Further diagnostic workup |
| Meniscal tear surgery | ~30% | Physical therapy (equally effective in 70% of cases) |
Why Do Unnecessary Surgeries Happen? Understanding the Root Causes
Unnecessary surgeries rarely happen because surgeons are deliberately harming patients. The causes are systemic, driven by financial incentives, diagnostic uncertainty, and cultural factors.
Financial Incentives and Fee-for-Service Payment
The fee-for-service payment model creates a financial incentive to perform more procedures. Research shows that fee-for-service surgeons operate at rates approximately 50% higher than salaried surgeons. Physicians who own ambulatory surgery centers perform about 2.5 times more minor surgeries than those without ownership stakes. While most surgeons act in good faith, the payment structure rewards volume, not outcomes.
Diagnostic Errors and Incomplete Evaluation
Many unnecessary surgeries stem from diagnostic mistakes or incomplete workups. If a diagnosis is wrong or incomplete, the treatment plan — including a recommendation for surgery — will be wrong too. According to the Mayo Clinic study, 21% of patients who sought a second opinion received a completely different diagnosis from their initial one. In many of these cases, the revised diagnosis led to an entirely different treatment plan that did not involve surgery. Learn to recognize the warning signs of a potential misdiagnosis.
Insufficient Trial of Conservative Treatment
Surgeons sometimes recommend surgery without ensuring patients have adequately tried non-surgical options. About 70% of herniated disc patients recover within six weeks without surgery, and physical therapy is as effective as surgery for 70% of meniscal tear patients.
Patient Demand and Geographic Variation
Patients sometimes push for surgical solutions — a Choosing Wisely survey found that 47% of physicians reported that patients request an unnecessary procedure at least weekly. Additionally, the likelihood of receiving surgery varies enormously by location. The Lown Institute’s 2025 report found that spinal fusion overuse ranged from under 1% to over 50% across U.S. hospitals. Even among U.S. News Honor Roll hospitals, overuse rates varied from 0.5% to over 22% for vertebroplasty.
The Human and Financial Cost of Unnecessary Surgery
Every unnecessary surgery carries real consequences — for the patient, their family, and the healthcare system. The costs extend far beyond the hospital bill.
Physical Risks and Complications
Up to 15% of surgical patients experience serious complications, including infections, blood clots, nerve damage, and adverse reactions to anesthesia. For unnecessary procedures, these risks are entirely avoidable. The data is particularly alarming for certain operations:
- Spinal fusion complications occur in up to 18% of patients.
- About 12% of patients who undergo unnecessary spine surgery develop chronic pain worse than their pre-surgical condition.
- 30% of patients with unneeded back surgery require a revision surgery within five years.
- Patients over 75 face a 25% higher complication rate from elective surgery.
- One in seven patients is readmitted within 30 days after major surgery.
An estimated 1,000 preventable deaths per year in the United States are attributed to complications from surgeries later deemed unnecessary.
Emotional and Financial Toll
Surgery is not just a physical event — it is a psychological one. Research shows that 10.9% of patients experience significant psychological stress the day before surgery, and 13.9% continue experiencing it three months afterward. For patients who later learn their surgery was unnecessary, the toll can include feelings of betrayal, anxiety, and post-traumatic stress.
The financial impact is equally devastating. The average hospital stay costs $2,883 per day, and a single knee replacement can cost $20,000 or more. Patients bear copays, deductibles, lost wages during recovery, and ongoing costs for managing complications. It is no coincidence that 58.5% of Americans who file for bankruptcy cite medical expenses as a contributing factor. Understanding the real cost of medical misdiagnosis in America underscores why prevention through second opinions is so critical.
How Second Opinions Prevent Unnecessary Surgery
A second medical opinion is one of the most effective tools patients have to protect themselves from unnecessary surgery. The research is clear: when patients seek a second opinion before surgery, a substantial percentage receive a different recommendation — one that often avoids or delays the operation entirely.
What the Research Shows
The evidence supporting second opinions is robust and consistent across multiple studies:
- Mayo Clinic (2017): A study of 286 patients published in the Journal of Evaluation in Clinical Practice found that 88% received a new or refined diagnosis upon second opinion. Only 12% had their original diagnosis confirmed. A full 21% received a completely different diagnosis, fundamentally altering their treatment trajectory.
- Cleveland Clinic Virtual Second Opinions: Analysis showed that 67% of virtual second opinions resulted in a change to the patient’s diagnosis or treatment plan. Diagnoses changed in 14.8% of cases, and treatment plans changed in 37.4%.
- Musculoskeletal Second Opinions (2024): A study published in PMC analyzing 544 cases found that treatment plans changed in 53% of cases, diagnoses changed in 22.5%, and — critically — surgery was avoided in 40.1% of cases where the primary provider had recommended it.
- Spine Surgery Second Opinions: Research has shown that 61% of second readings of spine MRIs disagreed with the original interpretation, with 75% of those disagreements recommending more conservative care.
These are not marginal effects. Second opinions prevent unnecessary surgery in a significant percentage of cases — protecting patients from avoidable risk and saving the healthcare system billions of dollars.
Cost Savings from Second Opinions
The financial case for second opinions is compelling. The 2024 musculoskeletal study estimated average savings of $8,147 per second opinion, with savings per surgical diversion case averaging $28,715. Separate analysis found average savings of $8,705 per virtual second opinion across all specialties. For cases where the initial treatment plan exceeded $10,000, average savings reached $100,911.
When you compare the modest cost of a second consultation — which is often covered by insurance — to the tens of thousands of dollars an unnecessary surgery costs, the return on investment is extraordinary. Learn more about whether your insurance covers second opinions.
How to Get a Second Opinion Before Surgery: A Step-by-Step Guide
Getting a second opinion is your right as a patient. Here is how to do it effectively:
Step 1: Gather Your Medical Records
Request copies of all relevant medical records, including imaging studies, lab results, and pathology reports. Under HIPAA, you have the right to access your own records. Our guide on how to request your medical records walks you through the process.
Step 2: Choose the Right Doctor
Seek a second opinion from a specialist independent of your first surgeon — ideally at a different hospital or health system. For guidance, see our article on how to choose the right doctor for a second opinion.
Step 3: Consider a Virtual Second Opinion
Many leading medical centers now offer virtual second opinion programs, including Cleveland Clinic, Mayo Clinic, and Johns Hopkins. Many employer health plans include these as a benefit. Explore your options with our online medical second opinion guide.
Step 4: Ask the Right Questions
When you meet with the second physician, come prepared with specific questions:
- Do you agree with the diagnosis? What else could it be?
- Is surgery the best option, or are there effective non-surgical alternatives?
- What happens if I do nothing or delay surgery?
- What are the specific risks and expected outcomes of this procedure?
- How many of these procedures do you perform annually, and what are your complication rates?
- Would you recommend this surgery for a member of your own family?
Step 5: Compare and Decide
If opinions disagree, consider a third opinion to break the tie. Ultimately, the decision is yours — and a well-informed patient is better positioned to make the right choice.
Red Flags That May Indicate You Need a Second Opinion
Certain red flags should prompt you to seek a second opinion before proceeding with surgery:
- Rushed timeline: A surgeon pushes for immediate scheduling without explaining urgency, especially for an elective procedure.
- No conservative alternatives discussed: Your surgeon does not mention or adequately explain non-surgical options such as physical therapy, medication, or injections.
- Vague diagnosis: The underlying diagnosis is unclear, contested, or based on imaging findings that may not correlate with your symptoms.
- Surgery for a condition with high spontaneous resolution: Conditions like herniated discs, meniscal tears, and small thyroid nodules frequently improve without surgical intervention.
- Surgeon resistance to second opinions: Any surgeon who discourages you from getting a second opinion may not be acting in your best interest. Ethical, competent surgeons welcome second opinions.
- Financial red flags: You’re being treated at a physician-owned surgery center where the doctor has a direct financial stake in performing the operation.
- Your gut feeling says something is wrong: Patient instinct matters. If something feels off about the recommendation, trust that feeling and seek another perspective.
The Role of Choosing Wisely and Medical Organizations
Major medical organizations are working to address surgical overuse. The Choosing Wisely campaign, launched by the ABIM Foundation, has catalogued over 550 tests, treatments, and procedures that should be questioned. Shared decision-making tools have reduced elective surgery rates by up to 26%, and pre-surgery peer review programs have cut unnecessary spinal fusions by 24% at some centers.
Despite these efforts, only about 2% of physicians face disciplinary action for unnecessary surgery, and fee-for-service incentives continue to drive overuse. This is why individual patient advocacy — starting with a second opinion — remains the most powerful tool available.
Unnecessary Surgery: A Global Concern
While this article focuses on the United States, unnecessary surgery affects patients globally. In the United Kingdom, the NHS “Getting It Right First Time” (GIRFT) program has identified significant variation in surgery rates across NHS trusts, particularly for hip and knee replacements and spinal procedures. In Australia, the Choosing Wisely Australia initiative has documented substantial rates of low-value surgical care, with particular concerns around spinal surgery and cardiac procedures. Across all three countries, the evidence supports the same conclusion: second opinions reduce unnecessary surgery and improve patient outcomes.
Frequently Asked Questions About Unnecessary Surgery
What percentage of surgeries in the United States are unnecessary?
According to a survey published in PLOS ONE, physicians reported that about 11.1% of the procedures they perform are unnecessary. For specific procedures, rates are much higher — up to one-third of knee replacements and 60% of thyroid surgeries for small nodules may be unnecessary, costing the healthcare system between $25 billion and $50 billion annually.
How does a second opinion help prevent unnecessary surgery?
A second opinion provides an independent expert evaluation of your diagnosis and treatment plan. Research consistently shows that second opinions change the diagnosis or treatment plan in 50 to 88 percent of cases. In a 2024 study of musculoskeletal conditions, surgery was avoided in 40.1% of cases where the primary provider had initially recommended it. The second physician may identify a misdiagnosis, recommend less invasive treatments, or confirm that conservative approaches like physical therapy should be tried first. This independent review serves as a critical safety check before committing to an irreversible surgical procedure.
Which surgeries are most commonly performed unnecessarily?
The procedures most frequently identified as overperformed include spinal fusion and back surgery (13% average overuse rate nationally, with some hospitals exceeding 50%), knee replacement (approximately one-third may be inappropriate), coronary stents (22% met overuse criteria in a major analysis), cesarean sections (about 35% considered medically unnecessary), hysterectomy (20,000–30,000 unnecessary cases annually), and knee arthroscopy for osteoarthritis (over 25% deemed ineffective). Tonsillectomies in children and thyroid surgery for small nodules also have notably high rates of unnecessary performance.
Does insurance cover the cost of getting a second opinion before surgery?
Most health insurance plans in the United States cover second opinions, and some plans — particularly Medicare and many employer-sponsored plans — actively encourage or even require them before approving certain surgeries. Medicare covers second surgical opinions at the same rate as other specialist visits. Many insurers now also cover virtual or telemedicine second opinions from major medical centers. The cost of a second opinion is typically a fraction of the cost of an unnecessary surgery, making it one of the most cost-effective steps a patient can take. Check with your specific insurance provider for details about your coverage, or read our guide on insurance coverage for second opinions.
Can a surgeon refuse to let me get a second opinion?
No. Getting a second opinion is your legal right as a patient. Under U.S. federal regulations and medical ethics guidelines, patients have the right to seek additional perspectives before consenting to any procedure. If a surgeon discourages you from getting a second opinion or refuses to share your medical records, that itself is a significant red flag. Ethical, confident surgeons routinely support their patients’ decisions to seek second opinions.
Unnecessary surgery is a widespread problem in America that costs billions of dollars, causes thousands of preventable complications, and takes lives that should never have been at risk. The most powerful tool patients have to protect themselves is a second opinion. If you or a loved one has been told you need surgery — especially an elective procedure — exercise your right to seek another expert perspective. It could change your diagnosis, spare you from an operation you don’t need, and save your health, your finances, and your life.
This article was last reviewed and updated in November 2026. For personalized medical advice, please consult a qualified healthcare provider. The statistics cited in this article are drawn from peer-reviewed studies, government reports, and established healthcare research organizations. Individual circumstances vary, and the decision to proceed with or decline surgery should always be made in consultation with your medical team.