Cataract Surgery Cost in Virginia
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
Virginia Medicare physician rate (2026)
-1.9% 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 Virginia
Check your exact ZIP in Virginia, because Arlington and Alexandria price with Washington while Richmond, Virginia Beach and Hampton Roads, Charlottesville, Roanoke, and the rural southwest do not.
What cataract surgery costs at hospitals near you
Everything above is a national average. The hospital you pick in Virginia 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 Virginia
Where Virginia ranks for this CPT
Cataract Surgery and how Virginia is priced
Virginia's physician fees are set through a small number of Medicare payment localities rather than one statewide rate, and the picture is complicated further by the DC locality reaching across the Potomac to cover close-in Northern Virginia suburbs like Arlington and Alexandria at the region's highest adjustments. The rest of the commonwealth, including Richmond, Hampton Roads, and the rural south and west, prices at lower levels through Virginia's own localities. That makes the Northern Virginia line one of the sharper pricing boundaries on the East Coast. Where exactly you sit relative to it is worth confirming.
Virginia's care landscape is regionally distinct: Northern Virginia operates as part of the Washington market, Richmond hosts an academic medical center and large system headquarters, Hampton Roads supports its own dense hospital market, and university medicine anchors Charlottesville. Southwest Virginia's coalfield counties face some of the state's toughest access problems, with some residents using Tennessee providers. Military health facilities add another layer in the Tidewater region.
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 Virginia
Cataract Surgery in other states
Cataract Surgery in Virginia: questions
Virginia is a single Medicare locality for this fee schedule. The 2026 physician rate for CPT 66984 is $453.81 in an office and $453.81 in a hospital, statewide. A ZIP lookup still confirms the locality mapping.
Not on the physician fee schedule. Virginia 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 $91 for the office physician line or $91 for the hospital physician line in Virginia. Medigap may cover that 20%. This is not the hospital facility fee.
No. $453.81 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. Virginia ranks #26 of 51 states on the physician line (within 2% of the national office rate of $462.60).