For covered outpatient cataract surgery under Original Medicare, Medicare generally pays 80% of the approved amount after the Part B deductible. The remaining share depends on the approved charges and your other coverage. This page explains Medicare’s published payment figures. For your own bill, use our per-eye estimate and deductible calculation guide.
Medicare’s published 2026 payments for CPT 66984
| Published component | Ambulatory surgical center | Hospital outpatient department |
|---|---|---|
| Total | $1,717 | $2,819 |
| Doctor fee | $462 | $462 |
| Facility fee | $1,255 | $2,357 |
| Medicare pays | $1,374 | $2,256 |
| Patient pays | $343 | $563 |
Source and date: Medicare.gov Procedure Price Lookup, code 66984, checked October 27, 2026. Open “More cost information” for each setting to see the components. The lookup identifies the figures as national averages based on 2026 payments and copayments. They are not a provider quote.
How to read the figures without mistaking them for your bill
Read the payment, patient share, and total as separate fields. A provider’s advertised cash price, a premium-lens package, and the Medicare-approved amount are different bases for comparison. The published average cannot tell you which services your particular estimate includes.
The displayed whole-dollar amounts are rounded. Do not present a calculation from these rounded numbers as an exact claim payment. Check the itemized estimate and, after care, the processed claim when reconciling an actual bill.
Ask which billing parties are represented before treating any figure as a complete episode-of-care cost. The expanded lookup shows doctor and facility components and warns that additional doctors or charges may be involved. A separate anesthesia estimate or other services can therefore matter.
Why the facility changes Medicare’s payment
The facility component is the main difference in this comparison. The displayed doctor fee is the same, while the hospital outpatient facility amount is larger. This helps explain why two quotes for a similarly described procedure may differ.
This is a budgeting comparison, not a recommendation to select a facility. Ask the surgeon which locations are appropriate for your care. When comparing written estimates, hold the procedure, eye, lens choice, and insurance basis constant; otherwise, the difference may reflect more than the location.
What the averages leave unresolved
Medicare’s cataract coverage page describes the patient’s 20% share for covered facility and doctor services after the Part B deductible. Coverage requirements still apply. Ask the clinic to confirm the planned procedure and any noncovered extras.
The 2026 Part B annual deductible is $283. Your remaining deductible may be lower. Do not automatically add the full annual amount to a published patient average: first establish what remains unpaid and which covered charges are subject to it.
Supplemental coverage may change what you personally owe. Medicare Advantage members should obtain the plan’s own estimate rather than use the Original Medicare averages as their copayment. Optional lens features and other noncovered services need their own line items.
For the arithmetic, hypothetical examples, and a billing-office request you can copy, continue to calculate your cataract surgery estimate. That guide separates deductible, coinsurance, and extras instead of repeating the national payment table.
Verify the procedure before using a published figure
- Ask the clinic for the expected procedure code and which eye it describes. Do not select a code yourself from a blog.
- Match that code and the actual facility type in the official lookup.
- Record the lookup date and the components included, rather than copying only the patient-share number.
- Request a written estimate listing every billing party, covered charges, and optional extras separately.
- Confirm remaining deductible, assignment or network requirements, and other coverage with the relevant provider or insurer.
If the clinic expects a different code, return to the lookup rather than reusing this table. Keep a copy of the written estimate so that an unexplained charge can be discussed with the appropriate billing office.
Editorial update: October 27, 2026. Official payment figures and deductible source checked; scope narrowed to payment interpretation. Independently prepared by a non-clinician. This is not a clinical review, personal coverage determination, or guaranteed quote.