Cataract surgery is the most commonly performed surgery in the United States—over 4 million procedures per year. A standard procedure costs $3,500–$7,000 per eye at a hospital, but only $2,000–$3,500 at a surgery center. Medicare covers it, but premium lens upgrades are 100% out of pocket. Here’s the full breakdown.
1. Full cost breakdown
| Component | CPT Code | Hospital Charge | ASC Charge | Medicare Rate |
|---|---|---|---|---|
| Surgeon’s fee | 66984 | $1,500–$3,000 | $1,200–$2,000 | ~$650–$750 |
| Facility fee | — | $2,000–$4,000 | $800–$1,500 | HOPD ~$2,100 / ASC ~$1,050 |
| Anesthesia (topical + IV sedation) | 00142 | $500–$1,000 | $300–$600 | ~$200–$350 |
| Standard IOL (monofocal) | V2632 | $150–$500 | $150–$400 | Included |
| Pre-op testing (biometry, OCT) | 76519/92134 | $200–$600 | $150–$400 | ~$50–$100 |
| Post-op drops | — | $50–$300 | $50–$300 | Part D |
2. Lens options and costs
The intraocular lens (IOL) is the most important decision you’ll make. Here’s what each type costs:
| Lens Type | What It Does | Extra Cost (per eye) | Insurance Covers? |
|---|---|---|---|
| Standard monofocal | Clear vision at one distance (usually far) | $0 (included) | Yes |
| Toric | Corrects astigmatism + one distance | $1,500–$3,000 | No |
| Multifocal | Near + far vision (reduces need for glasses) | $2,000–$4,000 | No |
| Extended depth of focus (EDOF) | Range of vision from intermediate to far | $2,500–$3,500 | No |
| Light-adjustable lens (LAL) | Adjustable after surgery with UV light | $3,000–$4,500 | No |
3. Medicare coverage
Medicare Part B covers cataract surgery when cataracts cause significant vision impairment. Here’s what you owe:
| Setting | Medicare Pays | You Pay (20% coinsurance) |
|---|---|---|
| ASC | ~$840 | ~$210 |
| Hospital outpatient (HOPD) | ~$1,680 | ~$420 |
Plus the surgeon’s fee: Medicare pays ~$650–$750, you pay 20% (~$130–$150). Total out of pocket per eye: ~$340–$360 at an ASC, or ~$550–$570 at a hospital. Add the $257 Part B annual deductible if you haven’t met it yet.
If you have Medigap (supplemental), it typically covers the 20% coinsurance, bringing your cost to $0 after the deductible.
Medicare patient saves $420 by choosing an ASC
A 72-year-old Medicare patient in Ohio needed cataract surgery on both eyes. At the hospital outpatient department, her total out-of-pocket would have been ~$1,140 (2 eyes × $570). By having surgery at an ASC across the street, her cost was ~$720 (2 eyes × $360). Savings: $420 for the exact same surgeon and procedure. Her Medigap plan covered the rest.
4. Hospital vs. surgery center
| Factor | Hospital (HOPD) | Surgery Center (ASC) |
|---|---|---|
| Total charge | $3,500–$7,000 | $2,000–$3,500 |
| Medicare facility rate | ~$2,100 | ~$1,050 |
| Your 20% coinsurance | ~$420 | ~$210 |
| Procedure time | 15–30 min | 15–30 min |
| Wait time | Often longer (shared OR schedule) | Typically shorter |
| Quality/safety | Comparable | Comparable |
Over 80% of cataract surgeries are now performed at ASCs. Find one near you: BillKarma Surgery Center Directory. For more on ASC savings, see our surgery center vs. hospital guide.
5. Insurance coverage
Most private insurance plans cover cataract surgery when cataracts impair daily activities. Typical coverage:
- PPO/HMO: Covered after deductible, with 10–30% coinsurance. Out-of-pocket typically $500–$2,000 per eye.
- Medicare: Part B covers surgery + standard lens. You pay 20% coinsurance.
- Medicare Advantage: Coverage varies by plan. Some have flat copays ($100–$500 per eye).
- Medicaid: Covered with minimal or no copay.
- Not covered: Premium IOL upgrades, laser-assisted cataract surgery (femtosecond laser adds $1,000–$2,000), refractive lens exchange for purely refractive purposes.
6. Timing: both eyes strategy
If you need surgery on both eyes, timing matters for your wallet:
- Same calendar year: You meet your deductible once and may hit your out-of-pocket maximum, making the second eye cheaper or free.
- Different calendar years: You pay two deductibles. Only consider this if your cataracts are at very different stages.
- Typical spacing: 1–4 weeks between eyes. This is standard practice for safety.
7. 5 ways to lower your cataract surgery cost
a) Choose an ASC over a hospital
Saves 45–55% on the facility fee. Same surgeon, same equipment, same 20-minute procedure.
b) Stick with a standard lens unless you have a strong reason
Premium IOLs add $1,500–$4,500 per eye out of pocket. Many patients are happy with a monofocal lens and reading glasses. Ask your surgeon for an honest assessment of the benefit for your eyes.
c) Skip laser-assisted surgery unless recommended
Femtosecond laser adds $1,000–$2,000 per eye and is not covered by insurance. Studies show comparable outcomes to traditional phacoemulsification for most patients.
d) Do both eyes in the same calendar year
Meet your deductible once instead of twice. If you’re near your out-of-pocket max, the second eye may be nearly free.
e) Audit your bill
Check for duplicate facility charges, bilateral coding errors, and inflated supply costs. Upload to BillKarma for an instant review.
Frequently asked questions
How much does cataract surgery cost per eye?
$3,500–$7,000 at a hospital, $2,000–$3,500 at an ASC with a standard lens. Premium lenses add $1,500–$4,000 per eye out of pocket.
Does Medicare cover cataract surgery?
Yes. Medicare Part B covers standard cataract surgery including a monofocal IOL. You pay 20% coinsurance (~$210 at an ASC, ~$420 at a hospital) plus the Part B deductible. Premium lens upgrades are not covered.
What is the difference between standard and premium cataract lenses?
Standard monofocal lenses (included in coverage) correct one distance. Premium lenses (toric $1,500–$3,000, multifocal $2,000–$4,000) correct astigmatism or multiple distances. Premium lenses are never covered by insurance.
Is cataract surgery cheaper at a surgery center?
Yes, 45–55% cheaper. Medicare ASC rate is ~$1,050 vs. ~$2,100 at a hospital. Your coinsurance is proportionally lower too. Over 80% of cataract surgeries are now done at ASCs.
Should I have both eyes done at the same time?
Most surgeons do one eye at a time, 1–4 weeks apart. Do both in the same calendar year to meet your deductible only once.