Does Medicare Cover Cataract Surgery? What Cataract Surgery Costs in 2026

Yes. Medicare Part B covers medically necessary cataract surgery with a standard (monofocal) lens implant. In 2026, you pay the $283 Part B deductible once for the year, then 20% of the Medicare-approved amount, unless a supplemental plan covers that share.

Optional lens upgrades cost extra. This guide explains what Medicare pays for, what it does not, and what cataract surgery costs at Eye MDs of Inland. It also covers Medicare Advantage and commercial PPO insurance.

What Medicare Covers for Cataract Surgery

Medicare.gov states that Part B (Medical Insurance) may cover cataract surgery that implants a conventional intraocular lens (IOL), the clear artificial lens that replaces your cloudy natural lens. A conventional lens is usually a monofocal lens, set to give clear vision at one distance.

Covered services generally include the surgeon's fee, the surgery facility fee, and the standard lens itself. Medically necessary exams before and after surgery are also part of covered care.

Medicare also covers one pair of eyeglasses with standard frames, or one set of contact lenses, after each cataract surgery that implants an IOL. That is a helpful benefit, since most people with a standard lens still need reading glasses.

Your 2026 Medicare Costs

Here are the official 2026 Part B figures from Medicare.gov:

Medicare.gov explains that in a hospital outpatient department or an ambulatory surgery center, you pay 20% of the Medicare-approved amount to both the facility and the surgeon after you meet the deductible. Higher-income enrollees may pay a higher premium.

Does a Medigap plan pay the 20%?

Often, yes. A Medigap plan (Medicare Supplement Insurance, a private policy that works alongside Original Medicare) can cover costs Medicare does not pay, such as the 20% coinsurance. Some people also have a secondary plan from a former employer.

The exact amount depends on your specific plan.

Medicare Advantage Works Differently

Medicare Advantage (Part C) plans are private plans that replace Original Medicare for most services. They must cover cataract surgery, but the rules and costs can differ.

According to Medicare.gov, a Medicare Advantage plan may require you to use doctors in the plan's network. You may need a referral to see a specialist, and you may need approval in advance, called prior authorization, before certain services are covered.

Medicare Advantage plans have a yearly limit on what you pay for covered services. People enrolled in Medicare Advantage cannot buy a Medigap plan.

What Medicare Does Not Cover

Medicare pays for removing the cataract and restoring vision with a standard lens. It does not pay for the extra features of lenses designed to reduce your need for glasses.

This comes from two federal rulings by the Centers for Medicare & Medicaid Services (CMS), the agency that runs Medicare:

• CMS Ruling 05-01 (issued May 3, 2005) covers presbyopia-correcting lenses, which aim to give a range of vision, such as distance and intermediate or near, with less need for reading glasses.
• CMS Ruling 1536-R (January 22, 2007) covers astigmatism-correcting lenses, also called toric lenses. Astigmatism is an uneven curve of the eye that blurs vision at all distances.

Under these rulings, you may be charged for the portion of the lens and physician or facility charges that exceeds the cost of a conventional lens. You may also be charged for the extra testing and fitting that these lenses require, such as additional measurements and refraction (the test for your glasses prescription) beyond what a standard lens needs.

The core surgery, meaning the incision, opening the lens capsule, and breaking up the cataract, cannot be billed to you when you choose a standard lens. To see what a presbyopia-correcting or toric lens might change in your daily vision, try the Lens Simulator (opens in a new tab).

What about laser-assisted cataract surgery?

CMS guidance from 2012 states that Medicare coverage and payment are the same whether the surgery is done with traditional techniques or with a laser. When a laser is used only to perform steps that Medicare already covers with a standard lens, you cannot be charged extra for it.

When the laser is used as part of a presbyopia-correcting or astigmatism-correcting lens package, the added services tied to that refractive goal can be a patient cost. Dr. Shomer has performed laser-assisted cataract surgery routinely for the past 10 years, and he can explain whether it adds value for your eyes.

What Does Cataract Surgery Cost at Eye MDs of Inland?

For most Medicare patients who choose a standard lens, your cost is limited to the Part B deductible and 20% coinsurance, less whatever your supplemental plan pays.

If you want less dependence on glasses, you can choose a lens upgrade. These are the current upgrade fees:

Upgrade fees are not covered by Medicare or most insurance plans. They are paid in addition to your usual deductible and coinsurance for the covered part of surgery.

Which upgrade, if any, makes sense depends on your eyes, your lifestyle, and how you feel about glasses. Try our Lens Simulator (opens in a new tab) to see how standard, extended depth of focus (EDOF), and multifocal lenses may look in real life. For a deeper comparison, read EDOF vs multifocal lenses.

How Commercial PPO Insurance Pays for Cataract Surgery

If you are under 65 or still working, you may have a commercial PPO plan (a preferred provider organization plan that lets you see in-network specialists without a referral). Most PPO plans cover medically necessary cataract surgery with a standard lens.

Your share depends on your plan's deductible, copay or coinsurance, and out-of-pocket maximum. As with Medicare, premium lens upgrades are usually not covered and are paid separately.

Our office can help verify your benefits before surgery. Eye MDs of Inland accepts Medicare and PPO plans but does not accept community HMO plans. See our accepted insurances page for details.

Cataract Surgery Near Upland, Rancho Cucamonga, and Ontario

Eye MDs of Inland is located at 1298 W 7th Street in Upland, California. We serve patients from Upland, Rancho Cucamonga, Ontario, Claremont, Montclair, Pomona, Fontana, and surrounding Inland Empire communities. Spanish is spoken in our office.

Dr. Marc Shomer is a board-certified cataract and refractive surgeon who has performed cataract surgery for over 20 years. He has taught cataract surgery at the Keck School of Medicine of USC since 2009, where he is an Adjunct Associate Professor of Ophthalmology. Learn more about cataract surgery, premium cataract surgery, and all of our lens implant options.

This article is for general education. Coverage depends on your specific plan. Please confirm benefits with Medicare or your insurer.

Works Cited

1. Medicare.gov. Medicare costs (2026 Part B premium and deductible). Centers for Medicare & Medicaid Services. https://www.medicare.gov/basics/costs/medicare-costs (accessed October 2026).
2. Medicare.gov. Cataract surgery. Centers for Medicare & Medicaid Services. https://www.medicare.gov/coverage/cataract-surgery (accessed October 2026).
3. Medicare.gov. Compare Original Medicare and Medicare Advantage. Centers for Medicare & Medicaid Services. https://www.medicare.gov/basics/get-started-with-medicare/get-more-coverage/your-coverage-options/compare-original-medicare-medicare-advantage (accessed October 2026).
4. Centers for Medicare & Medicaid Services. CMS Ruling No. CMS-1536-R: Astigmatism-correcting intraocular lenses. January 22, 2007. https://cms.gov/rulings/downloads/CMS1536R.pdf
5. Centers for Medicare & Medicaid Services. Laser-Assisted Cataract Surgery and CMS Rulings 05-01 and 1536-R. November 16, 2012. https://www.hhs.gov/guidance/sites/default/files/hhs-guidance-documents/CMS/CMS-PC-AC-IOL-laser-guidance.pdf