Rising Out-of-Pocket Costs Push Patients Toward Expensive Laser Cataract Surgery

Medicare’s payment for cataract surgery has fallen to about $520 per case, a decline of roughly one-fifth over the past decade, prompting ophthalmologists to seek supplemental revenue. By using laser-assisted techniques to insert premium intraocular lenses or address astigmatism, doctors can bill patients an extra $1,000 to $3,000 per eye, and the lenses themselves can add $1,000 to $4,000 to a patient’s bill. Although laser systems promise more exact incisions, the American Academy of Ophthalmology notes that research does not show fewer complications or better visual results than the conventional scalpel method.

High-cost equipment—sometimes costing up to $500,000—creates a strong economic motive for clinics to adopt the technology, a point highlighted by ophthalmologists such as Oliver Schein and Kevin Miller. Patients like 69-year-old Tammy Chalala and 71-year-old Barbara Cobuzzi have paid nearly $4,000 and $1,500 per eye, respectively, for laser procedures, even as some seek second opinions and opt for traditional surgery. The trend is growing, with laser-assisted cases now representing about 12% of the roughly five million cataract operations performed annually in the United States.