In Reply We thank Salminen and Grönroos for their interest in our study1 and for the opportunity to engage in continued dialogue over this important topic. The authors voice concern about 2 points in our study: (1) that the increased abscess rate seen in our retrospective cohort may be related to incorrectly included patients with complicated appendicitis and (2) that the higher overall cost of care seen for nonoperatively managed patients does not account for indirect societal costs.