CPT66984

Cataract Surgery Cost in New York

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.
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New York Medicare physician rate (2026)

+9.0% vs national

Average of 5 localities. Office range $446.99–$532.15.

New York (Hospital)
$504.15
Facility physician fee
Private plan est.
$655–$1,008
~130–200% of Medicare
Cash / self-pay est.
$403–$756
~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.

Your ZIP in New York

New York's multiple localities make a ZIP-level check essential: compare Manhattan, Queens and the outer boroughs, Long Island, the Hudson Valley near Poughkeepsie, and upstate cities like Buffalo, Rochester, Syracuse, and Albany.

What cataract surgery costs at hospitals near you

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

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

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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.

National vs New York

National office$462.60
National hospital (physician)$462.60
New York vs national9% above the national office rate of $462.60

Where New York ranks for this CPT

Rank (lowest physician fee first)#49 of 51
Lowest stateArkansas ($424.94)
Highest stateAlaska ($587.58)

CPT 66984 by New York locality

LocalityOffice
nyc suburbs/long island$532.15
queens$523.23
manhattan$521.72
poughkpsie/n nyc suburbs$496.65
rest of new york$446.99

PE GPCI ranges from 0.950 to 1.189 in New York. That index is why the same CPT is not one price statewide.

Cataract Surgery and how New York is priced

New York has one of the most complex locality maps in the country, with around five payment areas: Manhattan is its own locality, Queens is separately priced, the NYC suburbs and Long Island form another high-cost locality, the Poughkeepsie area has its own, and the rest of the state, including Buffalo, Rochester, Syracuse, and Albany, shares a distinctly lower-priced upstate locality. The spread between Manhattan and upstate adjustments is among the widest within any state. A knee MRI or office visit is approved at meaningfully different amounts in Manhattan, Mineola, and Rochester. Upstate New York prices closer to the Midwest than to the five boroughs.

New York City is a global medical capital with world-famous academic medical centers competing within blocks of each other, while upstate cities each center on their own regional academic hubs. Long Island and the lower Hudson Valley support dense suburban hospital markets of their own. The upstate-downstate divide runs through everything in New York health care, including what providers charge and what patients can access locally.

This procedure: 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 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.

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 in New York: questions

The 2026 Medicare physician office rate for CPT 66984 averages $504.15 across 5 New York localities, from $446.99 in REST OF NEW YORK to $532.15 in NYC SUBURBS/LONG ISLAND. The hospital physician rate averages $504.15. Enter a ZIP for the exact locality.

Yes. CMS splits New York into 5 payment localities. For this CPT the office physician fee spans $85.16 from the lowest to highest locality. New York's multiple localities make a ZIP-level check essential: compare Manhattan, Queens and the outer boroughs, Long Island, the Hudson Valley near Poughkeepsie, and upstate cities like Buffalo, Rochester, Syracuse, and Albany.

After the Part B deductible, coinsurance is usually 20% of the allowed amount: about $101 for the office physician line or $101 for the hospital physician line in New York. Medigap may cover that 20%. This is not the hospital facility fee.

No. $504.15 is only the physician's share. Adding Medicare's facility payment brings the total to about $2,820 in a hospital outpatient department, or about $1,718 at an ambulatory surgery centre. Anesthesia, pathology and other codes billed the same day are extra. New York ranks #49 of 51 states on the physician line (9% above the national office rate of $462.60).

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.