Cataract Surgery Cost in Rhode Island
Xcapsl ctrc rmvl w/o ecp
$2,820Hospital outpatient total2026 Medicare, physician + facility- ✓Your ZIP's wage-adjusted hospital and surgery centre rates
- ✓Five nearby hospitals by name, with CMS star ratings
- ✓The add-on codes that typically land on the bill
- ✓A word-for-word script for asking for a good-faith estimate
- ✓A private link you can reopen and share
- ✓Everything in the Premium report
- ✓15 nearby hospitals instead of five
- ✓Filled good-faith-estimate request letter
- ✓Bill-negotiation letter
- ✓Printable PDF download
Rhode Island Medicare physician rate (2026)
+2.0% vs nationalSingle statewide locality.
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.
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 Rhode Island
Enter a ZIP code for your part of Rhode Island, whether Providence and Pawtucket, Warwick and Cranston, Newport, or the South County shore towns.
What cataract surgery costs at hospitals near you
Everything above is a national average. The hospital you pick in Rhode Island moves the bill more than anything else you control.
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.
National vs Rhode Island
Where Rhode Island ranks for this CPT
Cataract Surgery and how Rhode Island is priced
Rhode Island, the smallest state, is unsurprisingly a single payment locality, with geographic adjustments above the national average in line with southern New England's cost structure. Providence and the shoreline towns publish identical Medicare-approved amounts, and no point in the state is more than an hour from its main hospitals. The compact geography makes locality subdivision pointless. Pricing here reads as a slightly discounted echo of neighboring Boston's market.
Providence dominates Rhode Island care, with the state's teaching hospitals and academic affiliation concentrated there, and consolidation has left a small number of systems running most beds. Many Rhode Islanders, particularly in the northeast corner, use Boston hospitals for complex or specialized procedures, accepting metro Boston pricing when they do. South County residents have fewer local options and often travel to Providence.
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?
Other featured procedures in Rhode Island
Cataract Surgery in other states
Cataract Surgery in Rhode Island: questions
Rhode Island is a single Medicare locality for this fee schedule. The 2026 physician rate for CPT 66984 is $471.97 in an office and $471.97 in a hospital, statewide. A ZIP lookup still confirms the locality mapping.
Not on the physician fee schedule. Rhode Island uses one locality, so the Medicare physician rate is the same from one end of the state to the other. What still changes is site of service (office vs hospital) and any facility fee the hospital bills on its own claim.
After the Part B deductible, coinsurance is usually 20% of the allowed amount: about $94 for the office physician line or $94 for the hospital physician line in Rhode Island. Medigap may cover that 20%. This is not the hospital facility fee.
No. $471.97 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. Rhode Island ranks #39 of 51 states on the physician line (2% above the national office rate of $462.60).