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058; 0.0001), private insurance (OR 1.057; =0.0182), or self-pay (OR 1.570; 0.0001) were more likely to receive a complex surgery. ZIP codes with higher adult poverty (OR 2.614; 0.001) were more likely complex surgery patients, whereas those with higher rates of high school attendance (OR 0.487; =0.0193) and home occupancy (OR 0.704; =0.0047) were less likely to be complex. Selected patient- and community-level factors including being male, Black, Asian, Hispanic, non-Medicare, or within lower education, higher poverty