During the COVID-19 pandemic, strains on the healthcare system led states to postpone many elective surgeries. But what factors make a surgery elective or nonelective?

“Elective surgery” is the term used for a procedure that can be safely delayed without great risk to a patient’s health, such as cataract surgery. A nonelective (or emergency) surgery is a procedure that must be performed immediately for lifesaving or damage-preventing reasons, such as in repairing a brain aneurysm. While both types of surgery are medically important for a person’s health, there are key differences between the two.

This article provides an overview of what makes a surgery elective or nonelective and outlines the situations in which they may be used.

What to Know About Elective Surgery

Simply put, any surgery that is not an emergency is considered to be elective surgery. This means that the procedure can be scheduled in advance or postponed without compromising the patient’s health and safety.

How Does It Work?

Contrary to popular belief, the term “elective” does not mean that the surgery is optional or unimportant; it simply means that the procedure is not quite as time-sensitive as nonelective surgery.

In fact, most elective surgeries are considered to be essential and medically necessary, whether it’s for a major condition (such as a hip replacement) or a more minor one (such as cataract surgery).

Other examples of elective surgeries are:

  • Diagnostic surgery, like an endoscopy
  • Joint replacement
  • Kidney stone removal
  • Mole removal
  • Carpal tunnel release
  • Tonsillectomy
  • Ear tube surgery
  • Cleft lip repair

Researchers estimate that about 90% of surgeries performed in the United States are considered to be elective.

Elective Surgery Delivery

After your healthcare provider refers you to a surgeon or suggests that you have surgery, your diagnosis and overall health will be assessed to confirm the need for elective surgery.

What Is Elective Surgery?

Elective surgery is a type of procedure that can be planned ahead of time by you and your healthcare provider. Elective surgeries are typically performed to help treat a health condition, improve quality of life, or repair an injury.

All surgeries are performed by making an incision in the body. Depending on your diagnosis, the surgery may be:

  • Open or traditional, which uses a larger or full-length incisionMinimally invasive (laparoscopic), an approach using several small incisionsRobotic, a technique using robotic tools guided by the surgeon

Your elective surgery may be performed as inpatient surgery, which means that a hospital overnight stay is required, or outpatient surgery, meaning you can typically go home the same day.

Prices & Where to Get It

Health insurance plans do pay for elective surgery if it’s deemed to be medically necessary. But keep in mind that the insurer’s definition of “medically necessary” may not align with your surgeon’s.

If you find that your elective surgery is covered by your health insurance, know that it might not be for the total amount. Each health plan is different, but an elective surgical procedure would likely fall under cost-sharing arrangements. This means you may have to end up paying a deductible and/or coinsurance.

What to Know About Nonelective Surgery

When there’s a medical emergency, surgery often needs to be done right away to save a patient’s life or prevent permanent damage. This is a nonelective (or emergency) surgery.

If you don’t have access to health insurance or are planning to pay for the surgery out of pocket, be sure to ask the surgeon or hospital for a breakdown of typical procedure costs. This includes items like anesthesia expenses, hospital care, labs, medications, and more—in addition to the surgeon’s bill and the cost of the surgical suite.

Nonelective surgery is designed to deal quickly with urgent medical issues that can be life-threatening or require emergency care.

As the American College of Surgeons points out, nonelective surgeries often involve greater health risks than elective (scheduled) surgery due to the time-sensitive nature of the procedure.

Examples of nonelective surgeries include procedures to treat:

  • Cardiac emergencies, such as heart attacks or cardiac shock
  • Limb amputation
  • Brain aneurysm
  • Physical trauma, particularly to the head, chest, or abdomen
  • Certain cancers
  • Abdominal or bowel blockage

It’s estimated that nonelective general surgeries represent about 11% of hospital admissions in the United States.

Nonelective Surgery Delivery

The process of having nonelective surgery moves quickly.

What Is a Nonelective Surgery?

Nonelective surgery is often lifesaving surgery to treat an urgent medical need. It’s typically performed without any advance planning.

Once the care team has assessed and stabilized the individual, diagnostic tests, such as an X-ray, CT (computed tomography) scan, or lab work may be ordered to confirm the need for surgery. The person is then prepared for the surgery.

Data suggests that more than 3 million patients in the United States are admitted to the hospital for emergency general surgery (excluding heart and trauma-related surgery) each year.

For people who have access to health insurance, many plans cover a solid portion of surgical costs for procedures that are determined to be medically necessary or lifesaving. The exact amount that an insurer will contribute depends on several factors, such as your health plan, the type of procedure, the amount of care needed, and the length of your hospital stay.

What can be challenging about nonelective surgery is that the individual often doesn’t have a choice about the surgeon or location, as it’s typically necessary to use the closest hospital that’s equipped to perform the surgery.

Data shows that emergency surgery typically has higher costs than elective surgery.

Which Treatment Is Best for You?

Both elective and nonelective surgeries are important, but they serve different purposes.

If the goal of the surgery is to:

  • Relieve mild symptoms, repair a mild injury, or restore function, an elective surgery is likely most appropriate. Because it’s not an emergency, you’ll have the opportunity to discuss the procedure with a healthcare provider before scheduling it.
  • Save your life or prevent life-changing harm or damage, a nonelective surgery will be performed. Depending on the circumstances of the emergency situation, you may not have the chance to thoroughly discuss details and options.

Hospitals typically rank or prioritize surgeries based on the urgency of the patient’s health condition.

Can Elective and Nonelective Surgery Be Used Together?

It’s possible that some people may require both elective and nonelective surgery to care for the same medical condition, such as a serious illness or traumatic injury.

Whether elective or nonelective surgery is best for your individual situation will depend on the reason behind the procedure. A healthcare provider will be able to determine which is most appropriate.

Sometimes, it can take several surgeries to correct an issue. For example, in life-threatening situations, an individual may need to have several nonelective surgeries at first. Later, elective surgery may be recommended to further correct the problem.

Note that each time you undergo surgery, there is a chance for complications. Your surgeon and healthcare provider will be able to answer your questions about potential risks, recovery times, and more.

Summary

Elective surgery is one that can be planned in advance or postponed if needed, while nonelective (emergency) surgery is performed immediately because of an urgent or life-threatening medical condition. Both types of surgery are important and can be medically necessary. Your healthcare provider will be able to discuss the circumstances around whether the surgery needs to be performed now or if it can be scheduled later.

A Word From Verywell

It’s difficult to learn that you need to have surgery—whether it’s elective or nonelective. While all surgeries come with potential risks, know that you’re not alone, as roughly 40 million to 50 million surgeries are performed in the United States each year.

If you have questions, talk to your healthcare provider. The Centers for Disease Control and Prevention (CDC) also offers a helpful patient-safety resource with information about how to prepare yourself for surgery.