Does Medicare cover it?
Does Medicare cover cataract surgery, and what will you pay?
Yes, Part B covers it with a standard lens implant. The estimator below prices one eye with the surgeon’s fee for your area and the facility rate CMS pays in October 2026.
What this service costs you
You pay
$570
| Doctor’s fee | $463 |
| Surgery center fee | $1,256 |
| Medicare-approved amount | $1,718 |
| Part B deductible used | $283 |
| Your 20% or copayment | $287 |
| Medicare pays | $1,148 |
| Deductible left after this | $0 |
Part B: you pay the yearly deductible ($283 in 2026), then 20% of the approved amount.
How this is calculatedMedicare Part B pays for cataract surgery that removes the clouded lens and implants a conventional intraocular lens, and two bills come out of it: one from the surgeon and one from the place where the surgery is done. At national rates in October 2026, the surgeon is approved $463 and an ambulatory surgery center $1,256, so the eye costs $1,718 in total. With Original Medicare alone and the $283 Part B deductible still to pay, your share is $570: the deductible, then 20% of the rest. The same eye in a hospital outpatient department is approved $2,820 and leaves you $790, because the hospital rate is almost twice the surgery center rate. A Medigap Plan G brings the bill down to the deductible alone; Plans C and F, open only to people eligible before 2020, bring it to zero. Premium lenses that also correct astigmatism or near vision cost extra, and Medicare does not pay that difference.
One eye or both in the same year
Both eyes: you pay
$914
| First eye | $570 |
| Second eye | $344 |
Deductible paid once, on the first eye.
Costs computed by Radif Partners · Editorial policy · How the costs are calculated
Two bills for one eye
Cataract surgery under Medicare is never a single price. The surgeon bills Part B under the physician fee schedule, and the facility bills its own rate. The facility rate covers the operating room, the nurses, the anesthesia supplies and the conventional lens itself.
| Line | Surgery center | Hospital outpatient |
|---|---|---|
| Surgeon, national rate | $463 | $463 |
| Facility | $1,256 | $2,358 |
| Approved for the eye | $1,718 | $2,820 |
| You pay, deductible already met | $344 | $564 |
Where you live changes the surgeon's fee
The physician fee schedule is adjusted for 109 local price areas. The same surgery center eye leaves you $355 in Manhattan and $337 in Alabama with the deductible met, against $344 at national rates. Facility rates also vary with each hospital's local wage index, which CMS applies to each facility; the estimator shows the national facility rate and says so. Pick your state and area in the tool to see your surgeon's fee.
What Medigap changes, letter by letter
A Medigap policy pays after Original Medicare. Plan G pays all of your 20% but not the Part B deductible, so a first eye in January costs you $283 and a second eye later that year costs nothing. Plan N also pays the 20%, which leaves $283 for the first eye with the deductible still due; its small copay applies to office visits, not to the surgery. Plans K and L pay half or three quarters of your share. The coverage menu of the estimator above lists every letter.
Medicare Advantage plans
An Advantage plan must cover cataract surgery, but it sets its own copays and often requires prior authorization and an in-network surgeon. Some plans charge a flat copay for outpatient surgery, others a percentage. Enter your plan's figure and what is left under its yearly out-of-pocket limit, both in the Summary of Benefits, and the estimator applies them to the approved amount.
Glasses after cataract surgery
You pay
$39
| Approved (frame + 2 lenses) | $195 |
| Frame allowance in the state | $99 |
| Upgrade above it | $0 |
Before the surgery date
Ask three questions. Which facility will be used, surgery center or hospital outpatient department? Does the surgeon accept assignment, so that the approved amount is the full fee? Is a premium lens being proposed, and at what price? The answers decide most of what you will pay, and the first two can change your share by several hundred dollars with the same doctor.
Keep the paperwork that follows. The Medicare Summary Notice lists each line with its approved amount and the part marked as yours; compare it with the bills from the surgeon and the facility before paying. A bill above your 20% from a provider who accepts assignment is a billing error to raise with the office, not a price to negotiate.