When I was looking into strabismus surgery in 2020 to correct my eye turn, I was shocked to see the cost. The cost can vary SO much depending on where it is done, who does it, and the type of insurance that you have. In the United States, the government has set certain limits that can help us narrow it down though.
So how much does strabismus surgery actually cost? If you use my tips to keep the cost down, the cash pay rates for strabismus surgery for minor eye turns are around $3000, while surgery for more significant eye turns will be closer to $10,000. Insurance covers strabismus surgery so if you’ve met your deductible it could be pretty much free!
As an adult with strabismus (30-35 diopters of exoptria) I had surgery on two muscles in each eye, so four total, with adjustable sutures, in August of 2020. I paid about $9500 cash. My insurance ended up covering it and reimbursing me for everything except my deductible.
To learn more about the surgery process, you can head over here.
In the following charts, I break down what to expect to pay for strabismus surgery. Note that each column is for just one eye, but it is very likely that your surgeon will either do one muscle in each eye or two muscles in each eye. In that case, the codes will just each be billed twice.
I have prices listed for a hospital and for a surgery center, you won’t pay both of these, but it’s good to know that the price difference is huge, so choose wisely!
The lower range of the listed prices is the medicare pricing which is used by many doctors for the cash pay amount. The upper end comes from my personal research on multiple facilities/insurance companies throughout the US.
What Codes Will I Be Billed for?
|One Muscle||Two Muscle|
|Who Needs It?||This is for one muscle in one eye and is for very mild cases that are low angle. Usually less than 15 diopters. Sometimes this will be billed twice, one for each eye. In that case, double the hospital and surgeon fee and add a few hundred to the anesthesia bill.||Patients with previous surgeries, scar tissue, and larger angles will need both muscles to be operated on to achieve good alignment. In many cases, both muscles in both eyes are operated on. In this case, double the hospital and surgeon cost and add a few hundred to the anesthesia bill.|
|Surgery Center Cost||$850-$1500||$1350-$2000|
|Total Cost for Hospital||$3000-$4200||$4755-$6250|
|Total Cost for Surgery Center||$1850-$3200||$2800-$4250|
|Scar Tissue Bonus||Adjustable Sutures Bonus|
|Who Needs It?||If you have had previous surgeries, there is likely scar tissue build up and the surgeon will also bill this code for taking care of it.||If your surgeon chooses to use adjustable sutures (which greatly improve success rates) then there is an extra code billed for that procedure.|
Breaking it Down
For every surgery there are usually 3 different bills.
- The Hospital or Surgery Center Bill (Billed By Codes)
- The Ophthalmologist (surgeon) Bill (Billed By the same Codes)
- The Anesthesiologist Bill (Billed by Time)
Hospitals and surgeons usually have specific amounts they bill for each code that they use. The hospital is billing for use of the space, tools and resources while the surgeon is billing for the actual procedures.
Anesthesiologists generally bill by the length of the procedure. So the first 30 minutes might be $700 and then $100 for every additional 15 minutes.
The only way to get the actual cost of surgery is to meet with a surgeon and ask him a few important questions:
- Which codes will you be billing?
- How long is the procedure?
- Will You be Using Adjustable sutures?
- What facilities are you willing to do the procedure at?
With the answers to these questions, you can get your exact costs, but most strabismus surgeries use the same basic codes so the chart can get you in the ballpark.
For every strabismus surgery, the muscles operated on will depend on the personal preference of the surgeon, past surgeries and the type of strabismus.
If you’ve had previous surgeries and/or the eye turn is severe (higher than 25 diopters), you will probably need multiple muscles to be adjusted.
Tips For Saving Money on Strabismus Surgery
If you go about the process haphazardly, you could easily pay up to $20,000 for an eye surgery. Be proactive and ask questions to make sure you get the best deal possible.
These tips will make a big difference!
- Call your insurance company and find an in-network doctor. If there isn’t one, get a referral to an out of network one and wait for your insurance to approve it before moving forward. This makes a HUGE difference!
- Make offers to the facility, surgeon, and anesthesiologist to pay cash or pay in advance and ask for discounts. If you can’t pay in advance, ask for an exception. If you are proactive and write a convincing letter, they could definitely forgive part of your bill.
- Get the codes from your surgeon and call around and get pricing from multiple facilities. SURGERY CENTERS are going to be much more affordable than hospitals. You may have to wait longer for the surgery, but it will save thousands. The surgeon will probably prefer working in a hospital so you might need to dig and insist.
- Ask the doctor’s office to make sure you are “pre-approved” for the surgery through your insurance. It is not just cosmetic and pretty much all insurances cover it.
Is Strabismus Surgery Worth It?
Depending on your goals, strabismus surgery can definitely make a huge difference in your life!
You can schedule a consult with me and I can help you understand whether it might be the perfect next step for you. You can learn more here.
To see the strabismus surgery success rates, head over to this article.
For me, it made a HUGE difference and helped me become much more efficient at using my eyes together, plus I love having straight eyes!
30-35 diopters of exotropia
8-10 diopters of esotropia