A cornea transplant is the odd one out among transplants. It is the most common transplant performed in the United States by a wide margin, it is usually an outpatient procedure, and it does not require the Medicare-approved transplant center certification that a heart or liver transplant does. That makes it the only transplant in this category where a cash price is a real thing you can ask for and sometimes get.
It is also the transplant with the most commonly missed line item. Every keratoplasty carries a separate eye bank invoice for the donor tissue, billed under HCPCS code V2785, and it can be a fifth of what Medicare pays for the whole episode. This guide covers what each piece bills as of September 2026, what Medicare actually allowed in 2024 claims data, what three hospitals posted in their price transparency files, and where the negotiating room is.
What Does a Cornea Transplant Cost Without Insurance?
Two independent sources describe this price and they land in different places. Milliman’s 2025 transplant report estimates $57,000 in total billed charges. Adding up 2024 CMS Medicare claims line by line produces roughly $39,000 for endothelial keratoplasty and $47,000 for a full-thickness graft. Both are billed-charge numbers, not what anyone pays.
| Line item | Low | Average | High |
|---|---|---|---|
| Hospital outpatient facility fee, endothelial keratoplasty (CPT 65756) | n/a | $25,991 submitted | n/a |
| Hospital outpatient facility fee, penetrating keratoplasty (CPT 65730) | n/a | $33,355 submitted | n/a |
| Medicare allowed amount for that facility fee (either procedure) | $3,916 | n/a | $3,918 |
| Surgeon fee, CPT 65756 and 65730 (submitted charge) | $5,134 | n/a | $5,478 |
| Medicare allowed amount for the surgeon fee | $1,427 | n/a | $1,428 |
| Eye bank tissue processing, HCPCS V2785 (submitted vs. allowed) | $4,463 | n/a | $6,273 |
| Anesthesia, CPT 00144 (submitted vs. allowed) | $156 | n/a | $1,506 |
| Total billed charges for the episode, Milliman 2025 estimate | n/a | $57,000 | n/a |
| Total billed charges, 2024 CMS lines added up | $38,904 | n/a | $46,612 |
| Total Medicare allowed across those same lines | n/a | $9,962 | n/a |
| Hospital gross charge for the surgery line (Wills Eye and WVU files) | $8,765 | n/a | $29,134 |
| Hospital posted self-pay price where one exists (WVU) | $4,383 | n/a | $14,567 |
| Prednisolone acetate 1% post-op drops, 5 mL bottle at acquisition cost | $22 | n/a | $23 |
Sources: CMS Medicare Outpatient Hospitals by Geography and Service and CMS Medicare Physician & Other Practitioners by Geography and Service, both 2024 claims released in 2026; Milliman’s 2025 U.S. organ and tissue transplant report; Wills Eye Hospital standard charges file updated March 30, 2026; WVU Medicine standard charges file updated July 10, 2026; CMS Medicaid NADAC pricing effective August 19, 2026.
The disagreement between the two totals is worth stating plainly. Milliman assigns $18,900 to procurement for a cornea, while CMS claims put the average submitted charge for corneal tissue at $6,273. Milliman’s figure is a national billed-charge estimate normalized across payers and includes acquisition overhead; the CMS figure is what providers actually put on Medicare claims. Treat $6,273 to $18,900 as the honest range for the tissue line and expect the invoice from your eye bank to land closer to the low end.
What Drives the Price
Which layer of the cornea gets replaced
A penetrating keratoplasty (PK, CPT 65730) replaces the full thickness of the cornea. Endothelial keratoplasty (DSAEK and DMEK, both CPT 65756) replaces only the inner layer. On the facility side the full-thickness procedure bills higher, $33,355 versus $25,991 in 2024 Medicare outpatient claims, but Medicare allows within two dollars of the same amount for both. The Eye Bank Association of America reported that endothelial keratoplasty is now the dominant approach, with 19,042 DMEK and 15,953 DSAEK procedures performed domestically in 2025 against 14,802 penetrating keratoplasties.
The eye bank tissue fee
Eye banks are not Medicare providers. As CorneaGen explains in its billing guidance, donor tissue is billed as a pass-through under HCPCS V2785 and paid at reasonable cost rather than under the outpatient prospective payment system. That means the hospital marks it up on the gross charge master but Medicare reimburses close to invoice. Pre-cut and pre-loaded grafts cost more than whole tissue: Wills Eye Hospital’s price file lists $7,375 for a PKP graft, $9,653 to $10,835 for DMEK preparations, and $9,751 for DSAEK.
Where the surgery happens
The facility fee is the single largest billed line. A hospital outpatient department bills it under the intraocular procedures APC family, and in 2024 both keratoplasty codes mapped mostly to APC 5492, Level 2 Intraocular Procedures. An ambulatory surgery center generally bills less for the same work. If you are self-pay and your surgeon operates at both a hospital and an ASC, that choice is worth asking about before scheduling, the same way it is for cataract surgery.
Anesthesia
Corneal transplants are frequently done under monitored anesthesia care rather than general anesthesia, and it shows in the price. CPT 00144, anesthesia for a corneal transplant, carried an average submitted charge of $1,505.52 in 2024 Medicare claims and a Medicare allowed amount of $155.66. That is one of the widest billed-to-allowed gaps in the entire episode. Our anesthesia cost guide explains how anesthesia time units work if you get a surprise bill on this line.
Post-operative drops, which are cheap
Steroid and antibiotic drops run for months after a graft, and they are one of the few costs here that stay small. At CMS acquisition-cost benchmarks effective August 19, 2026, prednisolone acetate 1% runs $4.39 to $4.59 per mL, so a 5 mL bottle costs about $22 at wholesale, and moxifloxacin 0.5% drops run $1.54 per mL. Retail pharmacy prices sit above acquisition cost, but this is a $20 to $100 problem, not a $1,000 one.
Cash Price vs. Insurance
Here the three hospital price transparency files we pulled in September 2026 tell three different stories, and that is the finding.
WVU Medicine posts a discounted cash price on every corneal line at exactly 50% of gross: endothelial keratoplasty gross $8,765 to $11,691 with a self-pay price of $4,383 to $5,846, penetrating keratoplasty gross $14,617 to $29,134 with a self-pay price of $7,309 to $14,567, and corneal tissue gross $8,711 to $9,398 with a self-pay price of $4,356 to $4,699.
Wills Eye Hospital publishes a gross charge of $16,721 for both penetrating and endothelial keratoplasty and $7,375 to $10,835 for corneal tissue processing, but posts no discounted cash price on any of the 590 line items in its file. Houston Methodist publishes payer-negotiated dollar amounts for both keratoplasty codes, ranging from $4,152 for a Medicare Advantage plan to $16,609 for one commercial payer, but no self-pay price for those codes.
The lesson is that the self-pay discount is a hospital-by-hospital policy decision, not an industry standard, and it is the biggest single lever available to an uninsured patient. Ask for it explicitly and get it in writing. Our guide to hospital price transparency explains how to find and read these files yourself, and our fair price checker will tell you whether a quote is in range.
If you have insurance, the calculation flips. Medicare allowed roughly $9,962 across the facility, surgeon, tissue, and anesthesia lines in 2024, so standard 20% Part B coinsurance after the deductible works out to about $1,990. No cash discount at any hospital in our sample beats that.
How to Pay Less
- Ask for the eye bank invoice separately. The tissue line is billed as a pass-through at cost, so it is the one charge on the bill with a defensible reference price. Ask the hospital what the eye bank invoiced and compare it to what they are charging you. Our itemized hospital bill guide covers exactly how to request the line-level detail.
- Ask whether the surgery can be done at an ambulatory surgery center. The facility fee is the largest billed component, and hospital outpatient departments bill more than ASCs for the same intraocular procedure. This is a scheduling question, not a clinical one, so raise it early.
- Get the self-pay rate in writing before you schedule. WVU Medicine’s flat 50% self-pay discount and Wills Eye Hospital’s total absence of one show how much this varies. Two hospitals an hour apart can differ by thousands on identical work.
- Apply for hospital financial assistance in parallel. Nonprofit hospitals must maintain and publicize a written financial assistance policy, and an approved applicant cannot be billed more than Amounts Generally Billed. Run your situation through our charity care checker and follow the steps in our hospital charity care guide.
- Negotiate the balance against what Medicare allows, not against the charge. Medicare allowed about $9,962 across the whole episode in 2024. That is the benchmark to anchor on. Our medical bill negotiation guide and our negotiation script tool will build the ask for you.
- Buy the drops on the generic price, not the specialty pharmacy price. Prednisolone acetate and moxifloxacin drops are inexpensive generics. If a pharmacy quotes you a three-figure price for either, shop it.
Bottom Line
A cornea transplant bills at roughly $39,000 to $57,000 per eye and Medicare allows about $9,962 of that, which is a smaller gap than most transplants but still a factor of four. The eye bank tissue fee is the line most price guides miss and the one most worth asking about, running $6,273 to $18,900 depending on whose data you use and $4,463 on Medicare’s allowed schedule.
Unlike the solid-organ transplants in this cluster, this is a procedure a self-pay patient can genuinely shop. Where a hospital publishes a self-pay rate it can be half of gross, and where it does not, that itself is a reason to get a second quote. For the much harder economics of transplants that are never a cash purchase, see our guides to heart transplant cost, liver transplant cost, and lung transplant cost.