Recent efforts to limit health care cost increases have focused on prescription drugs. Although millions of surgical procedures are performed in the US each year, limited information is available about perioperative costs incurred by persons undergoing surgery. These types of data are expected to be important to clinicians and decision-makers as financial pressure increases to define, understand, and rationalize medical costs. OBJECTIVES: This pilot study identified the costs associated with inpatient hospitalization after common abdominal or orthopedic surgeries. METHODS: Total costs from admission until discharge were identified using the hospital perspective for persons undergoing total abdominal hysterectomy (TAH), or total joint (hip or knee) replacement (TJR) between August and November 1999. RESULTS: Patients' average age was 53.0 years for all patients, 43.7 years for TAH, and 59.1 years for TJR. More than 70% of participants had private insurance. Average length of stay was 3.6 days overall, 3.2 days for TAH, and 4.3 days for TJR. Mean total costs were $6,596 for all persons (n = 8), $5,495 for TAH (n = 5), and $8,431 for TJR (n = 3). Routine room and operating room costs accounted for 72.5%, 76.3%, and 68.3% of the total, TAH, and TJR costs, respectively. Pharmacy costs accounted for 4.4% of total costs, 5.9% of TAH costs, and 2.8% of TJR costs. CONCLUSIONS: Most of the costs incurred during the perioperative period are related to the surgical procedure and per diem costs. Efforts to restrict pharmacy costs are unlikely to significantly affect total costs.