CPT66984

Cataract Surgery Cost

Xcapsl ctrc rmvl w/o ecp

$2,820Hospital outpatient total2026 Medicare, physician + facility
Hospital payments are wage-adjusted by locality, so the ZIP changes the numbers.
Complete Cost Report + Letters
Adds the letters that get a price in writing before you book.
$6.99
  • Everything in the Premium report
  • 15 nearby hospitals instead of five
  • Filled good-faith-estimate request letter
  • Bill-negotiation letter
  • Printable PDF download
🔒 Secure checkout⚡ Instant link✓ One-off, no account✓ No records, no insurance card

National Medicare physician rate (2026)

Medicare (Hospital)
$462.60
Facility physician fee
Private plan est.
$601–$925
~130–200% of Medicare
Cash / self-pay est.
$370–$694
~80–150% of Medicare

What the whole procedure costs

The rate above is the physician’s fee on its own. The facility bills separately, and for most procedures the facility is the larger half of the bill. These are 2026 national Medicare amounts.

Surgery centre, total
$1,718
$463 physician + $1,256 facility
Physician fee alone
$463
Only 16% of the hospital total

Choosing a surgery centre over a hospital saves about $1,102 on the Medicare allowed amount for cataract surgery. Ask whether your procedure can be done at an ambulatory surgery centre.

Medicare pays the hospital a single comprehensive amount for this procedure, covering the facility's share of the encounter including implants and supplies. Medicare allowed amounts are not what an uninsured patient is charged, and not a quote. Private plans typically allow more.

Get the rate for your ZIP

CMS adjusts this CPT by locality. A five-digit ZIP is enough — no account, no insurance card.

What cataract surgery costs at hospitals near you

Everything above is a national average. The hospital you pick in your area moves the bill more than anything else you control.

Locked

Rates for your ZIP, 5 named hospitals with CMS ratings, the add-on codes, and the scheduler script.

One-off payment, no account and no subscription. You get a private link and an email. No medical records and no insurance card, ever.

What these numbers are

Every figure on this page is a 2026 Medicare allowed amount: the physician line comes from the Physician Fee Schedule adjusted by geographic practice-cost indices, and the facility totals come from the CMS hospital outpatient (OPPS) and ambulatory surgery centre rates. None of them is a hospital chargemaster price, your insurer's contracted rate, or a quote. Anesthesia, pathology, imaging reads and follow-up care are billed under their own codes when they apply, and an inpatient stay is paid a different way again.

How CMS prices CPT 66984

CMS descriptionXcapsl ctrc rmvl w/o ecp
Work RVU7.17
Practice expense RVU (office)6.14
Practice expense RVU (hospital)6.14
Malpractice RVU0.54
Conversion factor$33.4009

Work is about 52% of the office total RVU; practice expense is about 44%. Localities with a high PE GPCI move this code more when practice expense is a large share.

Office vs hospital for this code

Office (non-facility) physician rate: $462.60. Hospital (facility) physician rate: $462.60.

Medicare patients typically owe 20% of the allowed amount after the Part B deductible — about $93 for the office physician fee, before any Medigap coverage. That coinsurance does not include a hospital facility fee.

Labeled private-plan and cash ranges on this page are arithmetic multiples of Medicare, not negotiated quotes. Ask the billing office for the CPT code, the site of service, and a good-faith estimate.

What Is Cataract Surgery?

Cataract surgery removes the eye's clouded natural lens through a tiny incision using ultrasound to break it up, then implants a clear artificial lens called an IOL. It is the most common surgery performed on Medicare patients and one of the safest. Done one eye at a time under numbing drops with light sedation, the procedure itself takes about 15 minutes, and most people notice better vision within days.

What Affects the Cost

  • Lens choice is the biggest patient-controlled cost: a standard single-focus lens is covered, while multifocal, extended-depth, or astigmatism-correcting toric lenses cost extra out of pocket, often thousands per eye.
  • Laser-assisted surgery, offered as an upgrade over the standard ultrasound technique, is an additional self-pay charge at many practices.
  • The facility fee differs between hospital outpatient departments and ambulatory surgery centers, where most cataract surgery now happens.
  • Because each eye is a separate surgery weeks apart, all charges effectively occur twice for most patients.
  • Pre-surgical eye measurements and testing beyond the standard set may be billed to you when tied to premium lens upgrades.

How It Is Billed

CPT 66984 covers the surgeon's fee for standard cataract removal with insertion of a conventional IOL, and it carries a global period that includes routine post-operative visits; the facility and anesthesia bill separately. Premium lens and laser upgrades are billed directly to you outside insurance entirely, via a required notice you sign accepting the extra cost. One pair of eyeglasses or contacts after surgery is a covered benefit under Medicare, a quirk unique to cataract surgery.

Insurance & Coverage Notes

Medicare Part B and commercial plans cover cataract surgery with a standard monofocal lens once vision loss affects daily activities; documentation of visual acuity and functional impact supports the claim. The premium lens itself and associated testing are never covered, so the surgeon's upgrade quote is a true out-of-pocket price you can compare across practices. Medicare pays 80 percent of the approved amounts for surgeon and facility, with supplements picking up the rest; Medicare Advantage plans may require prior authorization, which original Medicare does not.

Questions to Ask Before Booking

  • 1.What exactly is included if I choose the standard covered lens, with zero upgrade charges?
  • 2.What is your all-in out-of-pocket price for each premium lens option, per eye?
  • 3.Is laser assistance clinically necessary for my eyes or an optional upgrade?
  • 4.Where will the surgery be done, and what is the facility fee at that location?
  • 5.Does my plan require prior authorization, and is the post-surgery eyeglasses benefit being applied?

Cataract Surgery (CPT 66984): questions

The 2026 national Medicare physician rate for CPT 66984 is $462.60 in an office and $462.60 in a hospital. Enter a ZIP code to apply the geographic adjustment for your locality.

For CPT 66984 the office and hospital physician rates are essentially the same ($462.60). The hospital will still usually add a separate facility fee that this page does not show.

Cataract surgery removes the eye's clouded natural lens through a tiny incision using ultrasound to break it up, then implants a clear artificial lens called an IOL. It is the most common surgery performed on Medicare patients and one of the safest. Done one eye at a time under numbing drops with light sedation, the procedure itself takes about 15 minutes, and most people notice better vision within days. CMS bills it as “Xcapsl ctrc rmvl w/o ecp.”

Not on its own. $462.60 is the physician allowed amount. Medicare also pays the facility, which takes the total to about $2,820 in a hospital outpatient department or about $1,718 at an ambulatory surgery centre. Anesthesia, pathology and imaging interpretation billed under other codes are separate again. Private-plan allowed amounts are often higher than Medicare; your deductible and coinsurance still apply.

For cash-pay surgery shopping, use this CPT as the Medicare floor when you compare written quotes. How cash-price shopping works.

Data source: 2026 Medicare Physician Fee Schedule (CMS PPRRVU26B, released March 2026). Conversion factor: $33.4009. Prices shown are Medicare allowed amounts for the physician service and may not match what you are billed. Private insurance and self-pay ranges, when shown, are labeled estimates (typical multiples of Medicare), not quotes. This site is an independent cost tool, not medical advice.