Cataract Surgery Cost

How much does cataract surgery cost today, approximately? Obviously, nothing hurts the pocket like the cost of (any) surgical procedure, especially if it is not covered by insurance, or if you are not under the umbrella of a health insurance scheme (like Medicare for example).

Before we start, you should be made aware that the numbers that will be mentioned later are just approximate figures that can vary with the passing of time, and location. They are more like a guide (and should be treated as such) that aims to help you better understand how the cost of a cataract surgery is determined, and what are the factors that influence the final figure on the bill.

So, What Are The Factors That Affect The Cost Of Cataract Surgery?

Many variables influence the cost of cataract surgery, including (whether):

  1. The operation is under the cover of a private insurance company, e.g. Medicare, or it will be held completely in a private center.
  2. The type of IOL that will be implanted inside the eye, whether it be: monofocal, toric or presbyopia-correcting IOL.
  3. The type of procedure that you will undergo.
  4. Whether you are going to have the operation for one eye or for both eyes.
  5. The level of experience of the ophthalmic surgeon.
  6. The center or the hospital where the operation will be held.
  7. Whether the costs of pre-operative examination and the post-operative follow up are included in the procedure fee or not.
  8. Whether the cost of post-operative medications and eye drops are included in the procedure fee or not.

Is The Operation Under The Cover Of Medicare, Private Insurance, Or Will It Be Held In A Private Center?

  • According to Medicare policies and regulations – cataract surgery is considered an outpatient procedure, as the patient returns to his home on the same day of the operation, so cataract surgeries are covered under Medicare part B. Medicare pays about 80% of the cost of the typical cataract procedure including a standard monofocal IOL, and you pay for the remaining 20%(minus the annual deductible which is $155 as of February 2010), meaning that if you want to have a premium IOL as torics or presbyopia-correcting IOL, you will have to pay for the difference out of your own pocket.
  • Private insurance companies offer packages more like those of Medicare covering only the cost of a typical cataract surgery using a standard monofocal IOL. If you want a fancier IOL, you will have to pay for the extra cost.
  • If you don’t have any of the previous options and you decide to have the cataract surgery procedure in a private center, get ready to pay around $3300 per eye using a standard monofocal lens; as 50% of doctors have an asking price that is less than or equal to $3000, while 40% have an asking price from $3000 to $4000, and the remaining 10% have an asking price that is higher than $4000 (according to a study conducted by one of the major industry analysts and sponsored by AllAboutVision.com in 2010).

The Type Of IOL That Will Be Implanted Inside The Eye

There are many types of IOLs used in cataract surgeries; this is why the cost of cataract surgery can vary greatly in conjunction with the type used.

  • The monofocals : these are the IOLs used in a standard cataract surgery covered by Medicare. This type of lens can correct only one type of refractive error, such as nearsightedness or farsightedness. If the patient has concomitant astigmatism, he will need to wear prescribed spectacles to correct it. The reason behind considering more advanced IOLs as “medically unnecessary” according to Medicare, is that the cost of a glasses prescription for correcting astigmatism or that of a reading prescription is much cheaper than the cost of the IOL that will correct all visual complaints of the patient, thus minimizing or even eliminating the need for wearing glasses after cataract surgery.
  • The torics: These are IOLs capable of: correcting both the main visual complaint of the patient, whether nearsightedness or farsightedness (in addition to correcting astigmatism, or correcting astigmatism alone if the patient has only astigmatism). Expect to pay around $1000 if you would like to have a toric IOL implanted in your eye during cataract surgery supposing that you have Medicare coverage for the basic cost of the cataract surgery.

According to the report – more than 70% of doctors will ask for a price of around $1000 per eye for implanting a toric IOL, while 20% of doctors will have an asking price from $1000 to $1500. The remaining 10% will have an asking price that is more than $1500.

  • The presbyopia-correcting IOLs: These are the lenses capable of compensating for the loss of the accommodative power of the natural crystalline lens. Many technologies have been implemented in these high end IOLs to allow the patient to see both far as well as near objects clearly (during walking as well as during reading), thus minimizing or even eliminating the need for a reading glasses prescription after cataract surgery. But you will have to pay for the cost of this fancy IOL, as it is not supported by Medicare. According to the same report; you will be charged around $2000 for asking for a premium presbyopia-correcting IOL supposing you have Medicare coverage for the basic costs of the cataract surgery.

About 60% of doctors will have an asking price of around $2000 per eye for implanting a presbyopia-correcting IOL, while 25% of doctors will have an asking price from $2000 to $2500. The remaining 15% will have an asking price that is more than $2500.

These types of IOLs don’t provide superb vision unless the eye is free of astigmatism, so if you have astigmatism, you will need an extra surgical procedure to correct the astigmatism as CRI (corneal relaxation incisions) or LRI (limbal relaxation incisions). These procedures include making incisions (cuts) in the cornea in order to flatten it, thus greatly decreasing or even eliminating the astigmatism.

Get ready to pay around $500 for these extra surgical procedures, and you might end up pulling out of your pocket a total of $2500 for requesting a high end presbyopia-correcting IOL.

The Type Of Procedure That You Will Undergo

An eyePatients complaining of high refractive errors can choose to have their lens removed (although the lens in this case is clear and not cloudy as in patients suffering from cataract) and replaced by an IOL to correct their refractive errors.

This surgery is called refractive lens exchange (RLE) or clear lens exchange (CLE). It is typically the same procedure as the conventional cataract surgery with the only difference that the lens is extracted while being clear and not cataractous. This procedure is totally elective, like Lasik procedures. This is why it is not under the coverage of Medicare although being the same as cataract surgery, as it is considered medically unnecessary. The final cost also varies according to the type of IOL used, whether monofocal or premium IOL.

According to the latest statistics – 50% of doctors have an asking price that is less than or equal to $3000 per eye for performing a RLE with a monofocal IOL, while 40% have an asking price from $3000 to $4000. The remaining 10% have an asking price that is higher than $4000.

On the other hand; 37% of doctors have an asking price that is less than or equal to $4000 per eye for performing a RLE with a presbyopia-correcting IOL, while 44% of doctors have an asking price that is from $4000 to $5000. The remaining 19% have an asking price that is higher than $5000.

So expect to pay around $3000 if you chose monofocal IOL, or around $4500 if you chose a high end presbyopia-correcting IOL.

To conclude; there are many factors that influence cataract surgery cost. You will need to have an in-depth conversation with your Medicare representative or insurance provider so as to reach a complete understanding of the ratio by which Medicare or the insurance provider will share in the cost of your cataract surgery, and how much you might ultimately be charged.

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