We investigated the influence of insurance status on the frequency of negative appendectomy. Over 5 years 820 patients underwent surgery with the diagnosis of acute appendicitis. Private and semi-private rated patients had statistically significantly more appendectomies without inflammation in the pathological specimen than ward patients (p < 0.04). This difference arose only from a statistically highly significant difference in patients aged over 40 years (p < 0.001); there was no difference between patients aged under 40 years. Possible reasons for this phenomenon are discussed. The most important finding from our data seems that financial reasons are not at all a major factor influencing the surgeon's decision for operation.