Cataract surgery is one of the most common procedures performed in ASCs, and it is also Medicare’s highest-volume operation, according to a Dec. 18 report on Medpage Today.
Here are five things to know:
1. Medicare cataract surgery payment has fallen about 20% since 2018, and another cut is coming.
Medicare reimbursement for routine cataract surgery has dropped by about one-fifth since 2018, and the CMS has finalized another double-digit cut for 2026, according to the report. That follows a 2025 reduction that marked the fifth straight year of physician payment cuts.
2. Inflation-adjusted Medicare physician pay has eroded roughly one-third since 2001
The American Medical Association estimates that inflation-adjusted Medicare reimbursement for physician services has dropped by 33% since 2001. While the payments rose by 7% during that period, medical practice costs jumped by 59%.
3. Payment pressure could hit rural and community access hardest.
According to Medpage, these cuts will particularly hurt community and rural settings, where cataract surgery is often the only readily available eye care.
4. Medicare telehealth flexibility for post-op care currently extends only through Jan. 30
During the COVID-19 pandemic, Medicare expanded telehealth access, allowing patients to use virtual care from home, including audio-only options, without rural restrictions. Those flexibilities have been repeatedly extended, but are currently set to expire Jan. 30, unless Congress acts. The report also cites studies that find that for uneventful cataract surgery, virtual or telephone follow-up can match in-person care for safety and patient satisfaction.
5. The issue could grow more significant for ASCs as cataract volume continues shifting to the outpatient setting.
The broader ASC market is projected to grow at a compound annual growth rate of about 6%, with expansion largely driven by increasing cataract surgeries performed in ASCs, according to a Technavio market report. That report identified cataract surgery and other ophthalmic procedures as key growth drivers, alongside increased partnerships, collaborations and joint ventures across the industry.
