Cataract Surgery price: Medicare anchor and facility lever
Anchor for Cataract Surgery - CPT 66984
$467.80
Hospital OPPS facility anchor, this code billed alone: $2,357.81 (APC 5491, Level 1 Intraocular Procedures; national unadjusted, before wage-index adjustment).
Routine cataract surgery with a standard intraocular lens is CPT 66984, and three things decide what the patient sees on the bill: the facility, any premium lens or testing options chosen, and the eyeglasses afterward. The surgeon's anchor includes 90 days of related follow-up care.
CPT code
66984
Extracapsular cataract removal with insertion of intraocular lens prosthesis (1-stage procedure), manual or mechanical technique (for example irrigation and aspiration or phacoemulsification); without endoscopic cyclophotocoagulation
CPT 66984 is routine cataract removal with a standard intraocular lens. A complex cataract procedure is 66982. Premium lens options and additional testing are billed under separate lines and are not in this anchor.
The codes this visit can be billed under
| CPT | PFS office or global | PFS facility (professional) | Global period | Hospital single-service APC | Minimum Medicare copay at hospital |
|---|---|---|---|---|---|
| 66984 (this page) | n/a | $467.80 | 90 days | $2,357.81 (APC 5491) | $471.57 |
| 66982 | n/a | $639.24 | 90 days | $2,357.81 (APC 5491) | $471.57 |
The CY2026 fee schedule lists a 090 global period for 66984. In a hospital it maps to APC 5491 at $2,357.81, with a minimum unadjusted copayment of $471.57. The complex code, 66982, maps to the same APC but carries a higher surgeon anchor of $639.24.
After cataract surgery that implants an intraocular lens, Medicare.gov says Part B covers one pair of eyeglasses with standard frames or one set of contact lenses, at 20 percent of the approved amount after the deductible, and the patient pays any extra for upgraded frames. That post-surgery eyewear is a separate bill from the surgery.
The surgeon's anchor for 66984 is the same in a hospital and a surgery center, $467.80 for Michigan Locality 01, because the fee schedule lists no lower facility rate for this code. Many patients have the second eye done separately; each eye is its own procedure and its own claim, so a written quote should state whether it covers one eye or both.
Inside and outside the 66984 anchor
Covered by the anchor
- Surgeon professional fee for cataract removal with standard lens insertion (PFS anchor below)
- Operating room and standard lens cost inside the facility payment
Billed outside it
- Anesthesia billed separately
- Premium intraocular lens upgrades and related testing billed under separate lines
- Pre-operative visits outside the surgical package and post-operative care transferred to another clinician
- The second eye billed as a separate procedure on a later date
Why prices vary for CPT 66984
For cataract surgery the surgeon professional anchor is the same in a hospital and an ASC. The facility layer is what moves: a hospital comprehensive APC versus an ASC facility fee at a lower rate for the same code. Anesthesia bills separately in both settings. An all-in written quote should list surgeon, facility, and anesthesia lines.
Ask whether surgery will be at a hospital outpatient department or an ASC, and get the facility fee, surgeon fee, and anesthesia fee as separate written lines for CPT 66984.
Questions specific to Cataract surgery
- Is the code 66984 (routine) or 66982 (complex), and how is that decided?
- Are any premium lens or extra testing options proposed, and what does each cost in writing?
- Is the surgery in a hospital or a surgery center, and is anesthesia in the quote?
- Which follow-up visits are included in the 90-day global period?
Cataract Surgery: billing questions
Does Medicare pay for glasses after cataract surgery?
Medicare.gov says Part B covers one pair of eyeglasses with standard frames, or one set of contact lenses, after cataract surgery that implants an intraocular lens. You pay 20 percent after the Part B deductible and any extra for upgraded frames.
What is the difference between 66984 and 66982?
66984 is routine cataract removal with a lens implant; 66982 is the complex version. Both map to the same hospital APC in CY2026, but the surgeon's anchor is higher for 66982.
Are premium lens options part of the anchor?
No. The anchor is for the standard procedure. Premium lens and related testing options are priced separately, so ask for each in writing before the surgery date.
Is anesthesia included in the cataract surgery anchor?
No. The anchor covers the surgeon's professional service under CPT 66984. Anesthesia is billed separately by the anesthesia provider in both hospital and surgery center settings, and the facility bills its own fee.