Analysis suggests Medicare reimbursement undervalues complex cataract surgery

There is a $646.84 negative earnings difference between complex cataract surgery and simple cataract surgery, according to an economic analysis using time-driven activity-based costing to measure the difference in day-of-surgery costs and net earnings between the procedures.

The cost of complex cataract surgery was $877.85 more than simple cataract surgery, however, there was only incremental reimbursement of $231.01.

Time-based day-of-surgery costs were $1486.24 for simple cataract surgery (n = 13,904) and $2205.83 for complex cataract surgery (n = 2188), with a mean difference of $719.59.

Complex cataract surgery cost $158.26 more for supplies and materials.

Reference
Portney DS, Berkowitz ST, Garner DC, et al. Comparison of Incremental Costs and Medicare Reimbursement for Simple vs Complex Cataract Surgery Using Time-Driven Activity-Based Costing. JAMA Ophthalmol. Published online March 09, 2023. doi:10.1001/jamaophthalmol.2023.0091