A friend of mine went in for what she thought was a routine knee scope. She didn’t ask many questions. Trusted her surgeon, figured it’d be fine. Six weeks later, she was still limping, confused about what was normal, and staring at a $4,200 bill she wasn’t expecting.
She’s not unusual. Most people walk into pre-op consultations and nod along, too overwhelmed or too polite to push back. Here’s the thing: the questions to ask before surgery aren’t optional homework. They’re how you protect yourself.
I know it feels awkward to question your surgeon. Do it anyway. The good ones respect it. The ones who don’t? That tells you something important too.
We organized 22 questions into five categories. Print this list. Bring it to your appointment. Write down every answer. You’ll walk into that OR feeling like you actually know what’s happening, because you will.
Questions About the Procedure Itself
1. What exactly is this surgery, and why do you recommend it for my specific situation?
This is informed consent 101. You have the right to understand, in plain English and not medical jargon, what someone is about to do to your body and why. Your surgeon should connect the recommendation directly to your diagnosis, your imaging, your symptoms. Not a generic explanation they give everyone.
If the answer feels vague, say so. “Can you walk me through that more slowly?” is a perfectly reasonable request.
2. Are there non-surgical alternatives I should try first?
Surgery isn’t always the only path forward. Depending on your condition, physical therapy, medication adjustments, injections, or lifestyle changes might be worth trying first. Sometimes they work. Sometimes they buy you time. Sometimes they confirm that yes, surgery really is the best option.
Red flag: A surgeon who dismisses alternatives without explaining why they won’t work in your case. You want a doctor who’s considered the full picture, not someone running down a checklist.
3. How many times have you performed this specific surgery?
This isn’t rude. It’s practical. Research consistently shows that surgeons who perform a procedure more frequently have lower complication rates. For something like a hip replacement, you want to hear hundreds. For a rarer procedure, even 30-50 can be reassuring if their outcomes are strong.
Ask for their complication rate too. A surgeon who’s confident in their track record won’t flinch at this question.
4. What type of anesthesia will be used, and who will administer it?
General anesthesia puts you fully under. Regional (like a spinal block) numbs a large area while you stay conscious. Local numbs only the surgical site. Each carries different risks, different recovery profiles, and different experiences.
You should also know whether a board-certified anesthesiologist or a certified registered nurse anesthetist (CRNA) will be managing your case, and whether you’ll meet them before the day of surgery. If you’ve had a bad reaction to anesthesia before, this is the time to bring it up.
5. How long will the surgery take?
A straightforward question that helps in two ways. First, it lets your family know what to expect while they sit in that waiting room. Second, it gives you a benchmark, since longer surgeries carry higher risks of blood clots, infection, and anesthesia complications.
Tip: Ask for a time range, not a single number. Surgeries rarely run exactly on schedule, and a good surgeon will acknowledge that upfront.
Understanding the Risks
6. What are the most common risks and complications?
Every surgery carries risk. Infection. Bleeding. Blood clots. Adverse reactions to anesthesia. Your surgeon should walk you through the specific risks for your procedure, including how often they actually happen.
Percentages matter here. “There’s a 2% chance of infection” is useful information. “There are some risks” is not. And if a surgeon tells you “there aren’t really any risks,” find a different surgeon.
7. What happens if I don’t have this surgery?
This is the question that puts everything in perspective. Sometimes skipping surgery means mild inconvenience. Sometimes it means a condition that gets progressively worse, chronic pain, or a genuine threat to your life.
You need the full picture, both short-term consequences and long-term trajectory, to make an honest decision. Don’t let anyone rush you past this one.
8. Are there less invasive options, like laparoscopic or robotic-assisted surgery?
Minimally invasive techniques often mean smaller incisions, less post-op pain, shorter hospital stays, and faster recovery times. Not every procedure has a minimally invasive version, and not every patient is a good candidate. But it’s always worth asking.
The key follow-up: is your surgeon actually trained and experienced in the less invasive approach? A surgeon doing their fifth robotic procedure isn’t necessarily better than one doing their 500th open surgery.
9. Given my age, health conditions, and medications, are there special risks I should know about?
This is where the conversation gets personal. Diabetes, heart disease, obesity, sleep apnea, blood-clotting disorders: all of these change your risk profile. So do medications, especially blood thinners and certain supplements.
What you want to hear: An answer that references YOUR medical history. Not a generic rundown. If your surgeon hasn’t reviewed your full medication list and health history before answering, push them to do it now.
Pre-Surgery Preparation
10. What do I need to do to prepare in the days and weeks before surgery?
Preparation isn’t just “don’t eat after midnight.” Depending on your procedure, you might need to stop certain medications weeks in advance, complete pre-op blood work, adjust your diet, arrange your home for limited mobility, or quit smoking (ideally 4-8 weeks before, since smoking dramatically slows healing).
Ask for a step-by-step timeline. Write it down or ask for it in print. There’s too much to remember from a single conversation.
11. Which medications and supplements should I stop taking, and when?
This one can genuinely save your life. Blood thinners, aspirin, ibuprofen, and even over-the-counter supplements like fish oil, vitamin E, and ginkgo biloba can increase bleeding during surgery. Stopping them too late is dangerous. Stopping the wrong ones is also dangerous.
Get a complete written list: what to stop, when to stop it, and what to keep taking (even on the morning of surgery). Don’t rely on your memory for this. Tape it to your fridge if you have to.
12. Will I need any pre-operative tests, and how far in advance?
Blood work, EKGs, chest X-rays, or other tests may be required depending on your procedure, your age, and your health history. These help your surgical team catch potential problems before you’re on the table.
Two things to clarify: where to get the tests done, and whether your insurance covers them. Pre-op testing that’s out-of-network can be an unwelcome surprise on your bill.
13. Do I need to arrange for someone to drive me home and stay with me?
Yes. The answer is almost always yes. After anesthesia, you won’t be able to drive, and most facilities won’t discharge you without a responsible adult present. For many procedures, you’ll need someone with you for the first 24 hours.
Plan this early. The last thing you want is to be scrambling for a ride the night before surgery. Also ask how long you’ll need help with basics like cooking, getting dressed, or climbing stairs.
What to Bring to Your Pre-Op Consultation
Walking into your consultation prepared makes the conversation more productive and ensures nothing falls through the cracks.
- This printed checklist: with space to write down the answers. You’ll be absorbing a lot of information, and your memory isn’t as reliable as you think under stress.
- A complete list of every medication and supplement you take: include the name, dosage, and frequency. Don’t forget over-the-counter meds, vitamins, herbal supplements, and anything you take “only sometimes.” Your surgeon and anesthesiologist need the full picture.
- Your insurance card and a list of insurance questions: confirm pre-authorization status, in-network providers, estimated out-of-pocket costs, and coverage for anesthesia, facility fees, and post-op rehab.
- All relevant imaging and test results: MRIs, X-rays, CT scans, blood work. Even if your surgeon ordered them, bring copies. Medical records don’t always transfer between systems as smoothly as they should.
- A list of your medical history and past surgeries: include any previous reactions to anesthesia, allergies (medications, latex, adhesives), and chronic conditions. Write it down even if you think they already have it in your chart.
- A trusted friend or family member: a second set of ears catches information you’ll miss. They can also take notes, ask follow-up questions, and help you process everything afterward.
- Questions about logistics: where to park, what entrance to use on surgery day, what to wear, what NOT to bring (jewelry, contacts, valuables), and what time to arrive. Getting these details sorted now means less stress on the day.
Recovery and What Comes After
14. What does the typical recovery timeline look like?
Recovery timelines affect everything: your job, your family, your sanity. And there’s a big difference between “feeling better” and “fully healed.” Your surgeon should give you specific milestones: when you can shower normally, drive, go back to work, exercise, lift more than 10 pounds.
Tip: Ask about best-case AND worst-case timelines. If the typical recovery is 4-6 weeks, ask what could make it 8-10. Knowing the range helps you plan realistically instead of optimistically.
Setting up your recovery space before surgery day makes a real difference. A good wedge pillow keeps you elevated and comfortable, especially after abdominal, back, or shoulder procedures.
15. How much pain should I expect, and how will it be managed?
Nobody loves this conversation, but you need to have it. Understanding the expected pain level helps you prepare mentally and set up a solid management plan before you’re in the middle of it.
Ask specifically about non-opioid options: nerve blocks, anti-inflammatory medications, ice therapy, physical therapy. If opioids are part of the plan, ask how long you’ll be on them and what the tapering schedule looks like. The opioid conversation matters. Don’t skip it.
For non-medication pain management, having reusable ice packs ready at home is worth every penny. They’re cheap, effective, and your surgeon will almost certainly recommend icing the surgical site.
16. What complications should I watch for after surgery, and when should I call the ER?
Fever. Unusual swelling. Pain that’s getting worse instead of better. Redness or drainage at the incision site. Shortness of breath. Chest pain. These are the warning signs that something might be wrong post-op, and you need to know which ones mean “call the office in the morning” versus “go to the emergency room now.”
Ask for these instructions in writing. When you’re groggy, in pain, and it’s 2 AM, you won’t remember what your surgeon said three weeks ago.
17. Will I need physical therapy or rehabilitation?
Joint replacements, spinal procedures, ACL repairs, rotator cuff surgeries: many operations require structured rehab to get the best outcome. Skipping it (or starting too late) can mean the difference between a full recovery and a permanent limitation.
Find out how soon after surgery PT should start, how many sessions you’ll likely need, and whether your surgeon has a preferred provider. Also worth asking: does my insurance cover it, and for how many sessions?
18. What dietary or activity restrictions will I have during recovery?
Post-surgical restrictions exist for a reason. “No lifting over 10 pounds for six weeks” isn’t a suggestion. It’s protecting your healing. Same goes for restrictions on bending, driving, bathing, and diet.
Get specifics with timeframes. When can you shower? Climb stairs? Submerge the incision? Resume exercise? Resume sex? (People always forget to ask that one. Ask it.)
If your surgeon recommends compression socks to reduce blood clot risk during recovery, buy them before surgery day. They’re commonly recommended after lower body and abdominal procedures, and having them ready saves a post-op shopping trip nobody wants to make.
Costs and Insurance Questions
19. What is the estimated total cost, including surgeon fees, facility fees, and anesthesia?
Here’s what catches people off guard: surgical costs come from multiple separate bills. The surgeon. The anesthesiologist. The hospital or surgery center. Lab work. Pathology. Follow-up visits. Each one bills independently, and the totals add up fast.
Ask for a breakdown of the major cost components. If you’re uninsured or underinsured, ask about cash-pay pricing, which is often significantly lower than the “insurance rate.” Many facilities also offer payment plans or financial assistance programs. You just have to ask.
20. Is this surgery covered by my insurance, and has pre-authorization been obtained?
Pre-authorization is the step where your insurance agrees in advance to cover the procedure. Without it, you could be on the hook for the entire bill, even if the surgery is medically necessary. Don’t assume your surgeon’s office has handled this. Confirm it directly.
Also confirm that the surgeon, anesthesiologist, AND facility are all in-network. An out-of-network anesthesiologist at an in-network hospital is one of the most common sources of surprise medical bills.
21. Will there be separate bills from the anesthesiologist, lab, or other providers?
Surprise billing is absurdly common. You might get a bill from a pathologist you never met or a consulting physician who walked into the OR for five minutes. Ask upfront: who might bill me separately?
Tip: After you get the list, call your insurance company directly to verify coverage for each provider. It takes 20 minutes and can save you thousands.
22. What happens financially if the surgery is canceled or rescheduled?
Surgeries get postponed. It happens: you catch a cold, the schedule shifts, your condition changes. You need to understand the facility’s cancellation policy, any fees involved, and whether pre-op tests would need to be repeated if you’re rescheduled beyond a certain window (usually 30 days).
Nobody thinks about this one until it happens to them. Think about it now.
Typical Cost Range and Factors
Surgical costs are notoriously opaque, and the range is enormous depending on the procedure, your location, and your insurance. Here’s a realistic framework so you’re not blindsided.
Common Outpatient Procedures: Arthroscopic knee surgery runs $5,000 to $15,000. Hernia repair: $6,000 to $12,000. Cataract surgery: $3,500 to $7,000 per eye. These are facility + surgeon + anesthesia combined, before insurance.
Major Inpatient Procedures: Hip replacement: $30,000 to $50,000+. Spinal fusion: $50,000 to $100,000+. Heart bypass: $70,000 to $200,000+. These numbers include hospital stay, surgeon, anesthesia, and post-op care.
Anesthesia Fees: Billed separately, typically $1,000 to $3,500+ depending on the length and type of procedure. General anesthesia costs more than regional or local.
Facility Fees: The hospital or surgery center charges its own fee for the operating room, equipment, nursing staff, and supplies. This is often the single largest line item. Ambulatory surgery centers are usually 30-60% less expensive than hospital ORs for the same procedure.
Pre-Op Testing: Blood work, EKGs, imaging, and other tests typically run $200 to $1,500 out of pocket, depending on what’s ordered and whether the lab is in-network.
Post-Op Physical Therapy: $75 to $250 per session, with many procedures requiring 12 to 24 sessions. Insurance coverage varies; some plans cover 20-30 visits per year, others cap at 10.
What Drives the Cost Up: Out-of-network providers, hospital-based (vs. ambulatory) settings, longer operating times, overnight stays, complications, and procedures that require implants or specialized equipment.
What Drives the Cost Down: In-network providers, ambulatory surgery centers, cash-pay pricing (often 40-60% less than insurance rates for uninsured patients), and choosing surgeons with high volume and low complication rates (fewer follow-up procedures means lower total cost).
Your best move: ask for a Good Faith Estimate (required by federal law for uninsured patients) or call your insurance company for a pre-authorization cost estimate. Getting the numbers in writing before surgery day is always better than getting surprised after.
Quick Reference Checklist
Print this checklist and bring it to your appointment. Write the answers in the space next to each question.
Understanding the Procedure
- What is the surgery and why is it recommended for me?
- Are there non-surgical alternatives?
- How many times have you performed this surgery?
- What type of anesthesia will be used, and who administers it?
- How long will the surgery take?
Risks and Alternatives
- What are the most common risks and complications?
- What are the risks of not having surgery?
- Are less invasive options available?
- Are there special risks based on my health history?
Pre-Surgery Preparation
- What do I need to do to prepare before surgery?
- Which medications and supplements should I stop, and when?
- What pre-operative tests are needed?
- Do I need someone to drive me home and stay with me?
Recovery and Aftercare
- What is the typical recovery timeline?
- How will pain be managed?
- What post-op complications should I watch for?
- Will I need physical therapy?
- What restrictions will I have during recovery?
Costs and Insurance
- What is the estimated total cost?
- Is this covered by my insurance, and is pre-authorization done?
- Will there be separate bills from other providers?
- What is the cancellation or rescheduling policy?
Red Flags vs. Green Flags: When to Get a Second Opinion
| Red Flag | Green Flag |
|---|---|
| Your surgeon dismisses alternatives without explanation. “Surgery is the only option” with no discussion of why PT, injections, or medication won’t work in your case. A good surgeon explains the full range and why surgery is the best path for you. | Your surgeon discusses all options first. They explain why non-surgical approaches may or may not work for your specific condition, and they support your right to try conservative treatment first if appropriate. |
| They can’t clearly answer your questions. Vague, rushed, or jargon-heavy answers that leave you more confused than when you walked in. If they can’t explain it to you, that’s a communication problem that won’t get better after surgery. | They explain everything in plain language. They use terms you understand, welcome follow-up questions, and offer written materials. They make sure you leave the appointment feeling informed, not overwhelmed. |
| They discourage a second opinion. Any surgeon who reacts negatively to you getting another perspective is prioritizing their ego over your wellbeing. Good surgeons welcome second opinions because it validates their recommendation. | They encourage a second opinion. Especially for major, elective, or high-risk procedures. They’ll help facilitate records transfer and view it as part of responsible patient care, not a personal insult. |
| The diagnosis doesn’t sit right. Trust your gut. If something about the explanation, the urgency, or the recommendation feels off, that feeling is worth exploring with another provider. | The diagnosis is consistent across providers. When two independent surgeons review your case and reach the same conclusion, you can move forward with confidence. |
| You’re pressured to schedule immediately. Unless it’s a genuine emergency, there’s no reason to rush an elective surgical decision. High-pressure scheduling tactics benefit the surgeon’s calendar, not your outcome. | They give you time to decide. They outline the timeline (when surgery should ideally happen, how long you can safely wait) and let you make an informed decision at your own pace. |
| Their complication rate is unknown or undisclosed. A surgeon who won’t share their outcomes data either doesn’t track it (bad) or doesn’t want you to see it (worse). Volume and outcome transparency matter. | They share their experience and outcomes openly. They can tell you how many times they’ve done this procedure, what their complication rate looks like, and how their outcomes compare to national averages. |
| The facility or anesthesiologist is out-of-network. Surprise billing from an out-of-network provider at an in-network facility is one of the most common, and most expensive, surgical billing traps. | All providers and the facility are confirmed in-network. The office proactively verifies insurance coverage for every provider who will bill you, and they put it in writing before surgery day. |
Money-Saving Tips
- Verify every provider is in-network, not just the surgeon. The anesthesiologist, the facility, the pathologist, the assistant surgeon. One out-of-network provider can cost you thousands. Call your insurance company directly and get confirmation in writing.
- Ask about ambulatory surgery centers. For eligible outpatient procedures, ambulatory surgery centers charge 30-60% less than hospital operating rooms. The care quality is comparable for most procedures, and many surgeons operate at both. Ask if your procedure can be done at a surgery center instead.
- Negotiate before, not after. If you’re uninsured or underinsured, ask for the cash-pay rate before surgery. It’s often 40-60% lower than the insurance-billed rate. Many hospitals also have financial assistance programs and charity care policies, but you have to ask for them.
- Request a Good Faith Estimate. Federal law requires healthcare providers to give uninsured patients a written estimate of expected charges. Even if you have insurance, asking for a detailed cost breakdown in advance gives you the information you need to plan and negotiate.
- Set up a payment plan before the bills arrive. Most hospitals and surgery centers offer interest-free payment plans. Arrange one proactively rather than scrambling after a $10,000 bill shows up. You’ll have more negotiating power before the bill goes to collections.
- Use your HSA or FSA. If you have a Health Savings Account or Flexible Spending Account, surgical costs are eligible expenses. This effectively gives you a tax discount of 22-37% on your out-of-pocket costs, depending on your tax bracket. Max out your contributions in the year of a planned surgery.
- Compare facility costs before scheduling. The same surgeon performing the same procedure can have wildly different facility fees depending on where they operate. Ask your surgeon which facilities they use and compare the costs. A 20-minute phone call can save you $5,000 or more.
- Review every bill carefully. Medical billing errors are shockingly common. Some estimates put the error rate at 30-80% of hospital bills. Check for duplicate charges, services you didn’t receive, and incorrect codes. If something doesn’t look right, call the billing department and dispute it.
Glossary
Informed Consent: The legal and ethical process where your surgeon explains the proposed procedure, its risks, benefits, and alternatives before you agree to move forward. You’ll sign an informed consent form before surgery. Read every word, and ask about anything that wasn’t discussed verbally. You have the right to withdraw consent at any point before the procedure begins.
General Anesthesia: A state of controlled unconsciousness induced by medication, during which you feel nothing and have no awareness of the procedure. It’s administered by an anesthesiologist or CRNA through an IV and/or inhaled gases. General anesthesia carries its own risks (including nausea, sore throat, and rare but serious complications), which is why your anesthesia provider reviews your health history separately.
Minimally Invasive Surgery: Procedures performed through small incisions (often 0.5 to 1.5 cm) using specialized instruments and cameras, rather than a large open incision. Common types include laparoscopic, arthroscopic, and robotic-assisted surgery. Benefits typically include less pain, shorter hospital stays, faster recovery, and smaller scars, though not every patient or procedure is a candidate.
Pre-Authorization (Prior Authorization): Approval from your insurance company confirming they’ll cover a procedure before it happens. Without pre-authorization, your insurer can deny the claim, leaving you responsible for the full bill, even if the surgery was medically necessary. Always confirm pre-authorization is complete before your surgery date.
Co-Insurance: The percentage of a covered healthcare cost you pay after meeting your deductible. For example, if your plan has 20% co-insurance, you pay 20% of the allowed amount and your insurance pays 80%. On a $20,000 surgery, that’s $4,000 out of your pocket, before you hit your out-of-pocket maximum.
Out-of-Pocket Maximum: The most you’ll pay for covered healthcare services in a plan year. Once you hit this number, your insurance covers 100% of covered costs for the rest of the year. For 2026, the ACA maximum is $9,450 for individual plans and $18,900 for family plans. If you’re facing a major surgery, knowing this number tells you your true worst-case financial exposure.
Helpful Tools and Resources
Keeps you elevated and comfortable during recovery. Essential after abdominal, back, shoulder, and chest procedures where lying flat isn't an option.
Most surgeons recommend icing the surgical site to reduce swelling and pain. Having a few gel packs in the freezer before surgery day means you're ready from the moment you get home.
Commonly recommended after surgery to reduce the risk of blood clots during recovery periods with limited mobility. Ask your surgeon about the right compression level for your procedure.
Keeps all your pre-op instructions, medication lists, insurance documents, and post-op care plans in one place. When you're groggy after surgery, having everything organized in a single binder is a lifesaver.
- Medicare.gov Procedure Price Lookup: Compare what Medicare pays for common procedures at different hospitals in your area. Even if you’re not on Medicare, it’s a useful benchmark for understanding what procedures actually cost.
- AHRQ Patient Safety Resources: The Agency for Healthcare Research and Quality offers evidence-based guides on preparing for surgery, understanding your rights, and improving communication with your surgical team.
- Hospital Compare (Medicare.gov): Compare hospital quality ratings, patient experience scores, complication rates, and readmission rates. Use this to evaluate the facility where your surgery is scheduled.
- Choosing Wisely: A resource from medical specialty societies that identifies commonly overused tests and procedures. Helpful for understanding whether a recommended surgery is supported by evidence or might be unnecessary.
- Fair Health Consumer: Look up the typical cost of medical procedures in your zip code. Shows both in-network and out-of-network estimates based on actual claims data.
- CMS No Surprises Act Information: Information on your rights under the No Surprises Act, which protects you from unexpected out-of-network bills in many situations. Know your rights before surgery, not after a surprise bill arrives.
- Patient Advocate Foundation: Free case management and financial assistance resources for patients struggling with medical costs. They can help negotiate bills, navigate insurance denials, and find financial aid programs.
Frequently Asked Questions
How many questions is it okay to ask my surgeon before surgery?
As many as you need. There’s no limit, and any surgeon worth their scrubs will welcome them. An informed patient is a better-prepared patient, and surgeons know this. If your appointment feels rushed, ask the office to schedule a longer pre-operative consultation. You can also send questions through the patient portal ahead of time so your surgeon comes prepared.
When should I start asking these questions?
The moment surgery is recommended. Don’t wait until the week before. Early conversations give you time to understand your options, get a second opinion, sort out insurance pre-authorization, and make practical arrangements for recovery. Ideally, these questions get covered during a dedicated pre-op consultation, not in a five-minute hallway conversation.
What is informed consent, and should I actually read the form?
Informed consent is the legal process where your surgeon explains the procedure, its risks, benefits, and alternatives before you sign off. And yes, read the form. Every word. You have the right to ask about anything on it before you sign, and you should never feel pressured to sign quickly. If something on that form wasn’t discussed with you verbally, stop and ask about it.
Can I bring someone with me to the consultation?
Absolutely. It’s one of the best things you can do. A second listener catches details you’ll miss, helps you remember questions you wanted to ask, and provides emotional support during a stressful conversation. Some offices also allow you to record the appointment. Just ask permission first.
What if my surgeon seems annoyed by my questions?
That’s a red flag, about them, not about you. Skilled surgeons understand that patient education improves outcomes and reduces complications. They want you to ask questions. If you feel dismissed or rushed, take that seriously. It’s important information about whether this is the right provider for you. You’re choosing someone to cut you open. You’re allowed to be thorough.