High adherence to enhanced recovery program components can significantly cut costs in colorectal surgery.

• Patients with ≥70% adherence had total costs of $17,576 versus $22,343 for those with <70% adherence (p<0.001).
• Key cost-saving components included avoiding nasogastric tubes (-$16,036), early mobilization (-$3,476), and discontinuing maintenance intravenous fluids (-$4,460).

Targeting specific ERP components could enhance outcomes and reduce financial burdens for surgical practices.

• Adherence to crucial components such as early diet and foley removal also contributed to cost reductions.