Autopsy Explained: When It's Done, Who Pays, and How Long Results Take

An autopsy can feel frightening, especially when it comes up in the first hours after a death. Knowing the kinds, who decides, and what to expect helps families make choices calmly.

What kinds of autopsy are there?

1. Forensic (medicolegal) autopsy. Ordered by a medical examiner, coroner, or similar official when a death falls under their jurisdiction, for example a sudden, unexpected, unattended, or violent death. In general it doesn’t require the family’s consent. See coroner vs. medical examiner for which deaths and who decides
2. Hospital (clinical) autopsy. Offered by a physician, or requested by the family, to understand an illness or cause of death when there’s no legal reason for an investigation. The University of Vermont Health Network says the legally designated next of kin must give consent, whoever raises the request
3. Private autopsy. Hired by the family from an independent pathologist, usually when no official autopsy is being done but the family wants answers. The College of American Pathologists (CAP) keeps a public fee-for-service list of board-certified pathologists who have said they will do these, and says it doesn’t endorse anyone on it

Is an autopsy required?

Only in some situations, and the rules vary by state. In California, for example, the coroner must perform an autopsy when an infant dies suddenly and unexpectedly, and otherwise has discretion. In Texas, a justice of the peace decides case by case but must order one in certain circumstances, such as when a child under six dies unexpectedly or the district attorney directs it. Neither state requires a pathologist to perform it.

Many deaths don’t get one. In 2018, offices across the country accepted about 605,000 cases for investigation and performed roughly one full autopsy for every three accepted. A death from a known illness under a doctor’s care generally doesn’t involve one unless a hospital or the family asks.

What happens during an autopsy?

CAP describes a complete autopsy as an external and internal examination of the body using surgical techniques, performed by a pathologist, a physician specially trained to recognize the effects of disease. It takes about two to four hours. Small samples of each organ are taken for microscopic examination, and other tests may check for genes, drugs, chemicals, or toxic substances. The body is treated with dignity, and a written report follows.

The exam can be limited to one area, such as the chest if a heart attack is suspected, but CAP notes that limiting the scope may reduce its value. Some organs may be kept for further study, research, or teaching, for a period that depends on the purpose. Families can ask in the consent form that organs be released with the body, though CAP says that may limit the autopsy’s value and isn’t recommended. At the New York City medical examiner’s office, a family can ask for return of retained organs or tissue after the body is released.

Who has to agree, and can the family set limits?

• Hospital and private autopsies: the next of kin must consent in writing, and CAP says the family may make restrictions, limitations, or special requests. UVM Health says the family can stipulate limits, including for religious beliefs
• Forensic autopsies: often no permission is needed. Orange County, Florida, says state law doesn’t require next-of-kin permission for autopsies within its jurisdiction, and the Georgia office says it doesn’t need permission but makes efforts to respect the religious and cultural beliefs of the next of kin. If this matters to your family, say so immediately. See why Islamic burial happens quickly
• Religious concerns: CAP says religious decisions are personal and suggests talking with family and religious or spiritual advisors

Will it delay the funeral or prevent viewing?

CAP says an autopsy should not delay a funeral or affect viewing of the body, and that funeral directors and pathologists have long worked together on this. New York City’s medical examiner says the same. For forensic cases, offices commonly release the body within a day or two: Orange County, Florida, says 24 to 48 hours of examination, and San Diego County says about 48 to 72 hours. Viewing is usually done at the funeral home, not at the medical examiner’s facility.

Who pays?

• Forensic autopsies: offices say no charge to the family for an autopsy within their legal responsibility (San Diego, New York City, Georgia, and others). In California, if the office doesn’t require one, the next of kin can ask for one at their own expense
• Hospital autopsies: CAP says many hospitals, particularly teaching hospitals, don’t charge for autopsies on patients who died in the hospital, but some institutions do because of the labor and expertise involved, and there can be a charge to transport the body to and from an autopsy facility. Ask before you consent
• Private autopsies: the family pays. We found no authoritative national price. One private provider’s published FAQ lists autopsies starting at $3,500, and a university fee schedule reported by a funeral-products site lists $4,000, with the total depending on scope and testing. Ask for an itemized quote, and see CAP’s suggested questions, such as how many fee-for-service autopsies the pathologist did in the past year and how soon you can expect the final report

How long do results take?

• Preliminary findings: UVM Health says these are usually available within 24 to 48 hours for a hospital autopsy, and families can ask to discuss them with a pathologist
• Final report: UVM says it typically takes about 60 working days because of the tests involved, and CAP says several weeks. For private autopsies, one provider’s FAQ says a microscopic exam is typically done within a week and the report finalized within a month
• Medical examiner reports: can take longer. San Diego County says reports are released only after the autopsy, investigative, and toxicology reports and the death certificate are all complete, which can take as long as four to six months, though usually sooner. Georgia’s office says complicated cases can take several months

If the cause isn’t known yet, the death certificate may say “pending” and be amended later. See how long it takes to get a death certificate and how to correct an error on a death certificate.

How do I get the report?

• Hospital autopsy: the final report goes to the physicians involved, and the next of kin can get a copy from the patient’s physician or by asking the autopsy service, ideally when consenting. The report becomes part of the person’s medical record; see how to get a deceased person’s medical records
• Medical examiner autopsy: the next of kin can request a copy, which several offices provide free for the first copy; see our coroner vs. medical examiner guide

Why do families ask for one?

CAP lists reasons including answering questions about the cause of death, finding inherited conditions that could affect other family members, finding an infectious disease that could affect close contacts, uncovering evidence of a work-related illness that might lead to compensation, and providing information for insurance claims or death benefits. It can also ease the stress of not knowing. These are possible benefits, not guarantees. An autopsy can’t answer every question, and results may be inconclusive.

What should I do next?

1. If a medical examiner or coroner has the case, ask whether an autopsy is planned, who will perform it, and when the body can be released
2. If no one is planning one and you want one, ask the physician or hospital right away about a hospital autopsy, since the body will move to a funeral home soon
3. Ask whether there’s a charge, who gets the report, and how long it will take, and put any limits in writing in the consent form
4. If you’re considering a private autopsy, ask for an itemized quote and about timing before the funeral
5. Keep the report with the estate’s records

Autopsy laws and practices vary by state, hospital, and office. This is general information, not medical or legal advice; the physician, hospital pathology department, or medical examiner’s office can tell you what applies in your situation.