Forty-two hospitals spent more than €627 million on surgeries performed outside normal working hours — a 51% increase — saddling Portugal's SNS with an extra €212 million bill. The largest spenders were Braga, São João (Porto) and Santa Maria (Lisbon), highlighting rising after-hours demand that is putting pressure on hospital budgets and state healthcare resources. The surge points to surgical backlogs and staffing/scheduling pressures with potential implications for the SNS budget and service delivery.