CPT 66984 is the standard cataract operation: the cloudy natural lens is broken up with ultrasound and replaced with an artificial lens. It takes 15 to 30 minutes, is done under local anesthesia with light sedation, and you go home the same day. It is one of the most common operations in the United States.
What the price covers
The hospital's price is the facility fee for the operating room, nursing, the phacoemulsification equipment, the standard single-focus lens and recovery. The ophthalmologist and the anesthesia provider bill separately. Premium lenses (multifocal, toric for astigmatism) are not part of the covered procedure and are charged on top, usually $1,000 to $3,000 per eye, often directly by the surgeon.
Why prices vary
Hospital outpatient departments are consistently more expensive than ambulatory surgery centers for the same operation, sometimes by a factor of two or three. Within hospitals, the spread follows system size and ownership. Medicare pays for most cataract surgery in the US, so hospitals' negotiated rates cluster; the cash prices vary far more.
Questions to ask
- What is the self-pay price for 66984 per eye, and does it include the standard lens?
- What does the surgeon charge, and what does anesthesia charge?
- If I choose a premium lens, what is the extra charge and who bills it?
- Would the same surgeon do it at an ambulatory surgery center for less?