Cataract removal is the most common surgical procedure performed on Medicare beneficiaries, and millions of seniors underestimate what they’ll actually owe. The average cost of cataract surgery with Medicare in 2026 is roughly $380 to $460 per eye out of pocket after the Part B deductible, covering a standard monofocal intraocular lens (IOL). Premium lens upgrades remain the patient’s responsibility and can add $2,000 to $3,500 per eye. Broader pricing context lives in our healthcare costs guide.
How Medicare Pays for Cataract Surgery
Medicare Part B covers medically necessary cataract surgery when the cataract causes functional vision loss, per CMS coverage policies. The procedure must be performed by a Medicare-enrolled ophthalmologist in an approved facility. After meeting the 2026 Part B deductible of $257, beneficiaries pay 20 percent coinsurance on the Medicare-approved amount for both the surgeon fee and the facility fee.
Total Medicare allowed amounts for CPT 66984 (extracapsular cataract removal with IOL insertion) typically run $1,900 to $2,300 per eye when combining the surgeon and facility fees, so a beneficiary’s 20 percent share usually lands between $380 and $460 per eye after meeting the deductible.
Medicare Coverage Breakdown in 2026
Here’s how the numbers typically break out for a monofocal procedure at an ambulatory surgical center:
- Medicare-approved total: approximately $1,950
- Medicare pays (80%): approximately $1,560
- Patient coinsurance (20%): approximately $390
- Part B deductible (first encounter of the year): $257
- First-eye out of pocket: $390 to $650 depending on deductible status
Second-eye surgery the same calendar year usually costs about $390 out of pocket since the deductible has already been met for the first eye.
What Medicare Covers
Medicare Part B covers the surgeon fee, facility fee, anesthesia, standard monofocal IOL, and routine post-operative visits for 90 days. It also covers one pair of basic eyeglasses or contact lenses after surgery — the only time Medicare pays for eyewear, according to Medicare.gov.
Covered items include the pre-op biometry testing (A-scan or optical biometry) used to calculate the IOL power, intraoperative monitoring, and the standard antibiotic and steroid drops dispensed immediately after surgery.
What Medicare Doesn’t Cover
Medicare does not cover premium IOL upgrades (multifocal, extended depth-of-focus, or toric lenses), laser cataract surgery technology fees, refractive testing unrelated to cataract removal, or post-op eyeglass upgrades beyond the basic pair. Patients choosing a premium lens pay $2,000 to $3,500 per eye out of pocket in addition to their standard 20 percent coinsurance, per American Academy of Ophthalmology fee surveys.
Femtosecond laser-assisted cataract surgery (LACS) technology fees of $800 to $1,500 per eye are also patient-paid because Medicare considers the laser platform an elective enhancement.
Medicare Advantage vs. Traditional Medicare
Medicare Advantage (Part C) plans must cover everything traditional Medicare covers, but they may use different cost-sharing structures. Some charge a flat copay ($150 to $400) per cataract procedure instead of 20 percent coinsurance. Others require prior authorization and restrict you to in-network surgeons. Medigap supplemental plans cover the 20 percent coinsurance gap, leaving most traditional Medicare beneficiaries with Medigap Plan G paying $0 to $257 per eye depending on deductible status.
How to Save Money on Cataract Surgery with Medicare
Stick with a standard monofocal IOL unless you have a specific lifestyle reason to upgrade. The $2,000-to-$3,500-per-eye premium lens fee is rarely worth it for patients who don’t mind wearing reading glasses. Choose an ambulatory surgical center (ASC) over a hospital outpatient department — ASCs typically have lower facility fees, though your coinsurance percentage is the same.
If you’re enrolling in Medicare for the first time, Medigap Plan G essentially eliminates the 20 percent coinsurance after the small Part B deductible. Medicare Advantage plans may be cheaper in monthly premiums but can impose prior authorization delays and network restrictions. For more context, see our guides on cataract surgery with Medicare and laser cataract surgery with Medicare.
Factors That Affect Your Final Bill
Deductible status is the biggest variable. A first-of-the-year cataract surgery includes the full Part B deductible ($257) plus the 20 percent coinsurance. Surgery later in the year when the deductible is already met costs only the coinsurance portion. Facility type matters: ASCs usually result in lower total fees than hospital outpatient departments, though the percentage cost-share is identical.
Premium lens selection drives the largest potential upcharge. Complications requiring additional equipment (capsular tension rings, iris hooks) occasionally add smaller amounts. Geographic adjustments under the Medicare Physician Fee Schedule cause some regional variation.
Frequently Asked Questions
Does Medicare cover cataract surgery at 100 percent?
No. Medicare pays 80 percent of the approved amount after the annual Part B deductible of $257. The remaining 20 percent is the patient’s coinsurance unless a Medigap plan covers it.
Will Medicare pay for laser cataract surgery?
Medicare covers the cataract removal itself but not the laser technology fee ($800 to $1,500 per eye), which is billed directly to the patient.
Does Medicare cover cataract surgery in both eyes?
Yes. Both eyes are covered when medically necessary, typically performed one to four weeks apart. Each procedure applies the 20 percent coinsurance.
Are post-surgery eyeglasses covered?
Medicare Part B covers one pair of standard eyeglasses or contact lenses after cataract surgery — the only time Medicare pays for routine eyewear.
Bottom Line
The average cost of cataract surgery with Medicare in 2026 is $380 to $460 per eye for a standard monofocal procedure, rising to $2,400 to $4,000 per eye if you choose a premium lens or laser-assisted technology. A Medigap Plan G policy nearly eliminates out-of-pocket costs. Stick with a standard lens unless you have a specific reason to upgrade, and choose an ambulatory surgical center over a hospital outpatient department when feasible.