Eye Care Costs: Cataract Surgery, Eye Exams, and More
From cataract surgery to retina imaging — what eye care really costs under Medicare.
Eye care is one of the largest categories in Medicare, driven by the aging population and conditions like cataracts and macular degeneration. We analyzed four key eye care procedures that together account for 29.5M Medicare services in 2023.
Key Eye Care Procedures
| Procedure | Code | Medicare Allowed | Hospital Charge | Markup | Services | Providers |
|---|---|---|---|---|---|---|
| Cataract Surgery | 66984 | $229.60 | $972.98 | 4.237717770034843x | 8.7M | 28.9K |
| Comprehensive Eye Exam | 92014 | $125.45 | $220.42 | 1.7570346751693902x | 9.4M | 46.5K |
| Intravitreal Eye Injection | 67028 | $121.19 | $569.60 | 4.700057760541299x | 3.5M | 6.6K |
| Retina Imaging (OCT) | 92134 | $39.48 | $121.77 | 3.084346504559271x | 8.0M | 40.8K |
Cataract Surgery (66984)
Cataract surgery is the most commonly performed surgery in America. The procedure takes about 15 minutes and has a very high success rate. Medicare covers the basic procedure and a standard intraocular lens, but premium lenses (multifocal, toric) come with out-of-pocket costs of $1,000-3,000 per eye.
With 8.7M services and 28.9K providers, it's one of the most widely available procedures in the country.
Eye Injections (67028)
Intravitreal injections — shots directly into the eye — are the primary treatment for wet age-related macular degeneration (AMD) and diabetic eye disease. Patients typically need injections every 4-8 weeks, making this one of the most frequently recurring procedures in ophthalmology.
The procedure cost shown above doesn't include the drug itself (anti-VEGF medications like Eylea or Lucentis can cost $1,000-2,000 per dose), making the total cost of treatment significantly higher.
Retina Imaging — OCT (92134)
Optical coherence tomography (OCT) is a non-invasive imaging test that creates detailed cross-section images of the retina. It's used to monitor macular degeneration, glaucoma, and diabetic eye disease. At $39.48, it's relatively inexpensive but performed in enormous volume.