Medicare RVU Cuts Significantly Reduce Glaucoma Surgery Reimbursement

Overview

Medicare's 2026 updates to the physician fee schedule introduce substantial cuts to practice expense and work RVUs, leading to a 10-14% reduction in total reimbursement for glaucoma surgeons. These changes impact surgical procedures and diagnostic testing, prompting advocacy efforts to reverse the cuts.

Background

The Centers for Medicare and Medicaid Services (CMS) annually updates the physician fee schedule, which determines reimbursement rates for medical services. In 2026, CMS implemented two major changes: significant reductions in practice expense RVUs for surgical facilities and a 2.5% cut in work RVUs for many procedural and diagnostic services. Glaucoma surgeons are particularly affected due to their reliance on surgical facilities rather than office settings. These reimbursement cuts pose challenges to maintaining sustainable glaucoma care.

Data Highlights

Key Findings

• CMS introduced large, unprecedented cuts to practice expense RVUs in surgical facilities for 2026.
• Glaucoma surgeons face a 10-14% reduction in total reimbursement due to these practice expense RVU cuts.
• Work RVUs for procedural and diagnostic services, including perimetry, OCT, and fundus photography, were reduced by 2.5%.
• These combined cuts further reduce payments for glaucoma surgical procedures.
• An advocacy campaign has been launched to appeal these cuts, including support for House Resolution 7520.
• The American Academy of Ophthalmology is facilitating outreach to Congress to help mitigate the impact on glaucoma care.

Clinical Implications

Glaucoma surgeons should anticipate decreased Medicare reimbursement for both surgical and diagnostic services in 2026, which may affect practice sustainability and patient care delivery. Engagement in advocacy efforts, such as supporting H.R. 7520, is critical to help reverse or mitigate these cuts. Clinicians should also monitor communications from professional societies for updates and guidance.

Conclusion

The 2026 Medicare fee schedule changes impose significant financial challenges for glaucoma surgeons through cuts to practice expense and work RVUs. Active advocacy and awareness are essential to protect reimbursement levels and ensure continued quality glaucoma care.

Related Resources & Content

1. Andrew Pouw, MD / American Glaucoma Society Meeting 2026 -- Video: Medicare RVU Cuts Reduce Glaucoma Reimbursement