In 2024, South Dakota removed cataracts on about three times the share of fee-for-service Medicare patients as Vermont — counting patients, not billed lines
South Dakota removed cataracts on about 118 of every 1,000 fee-for-service beneficiaries — the highest of any state. Vermont, about 37, the lowest. The national rate was about 67.
The spread runs about 3.2 times, top to bottom — measured by patients. Counting billed lines instead would show a wider gap, because post-operative co-management visits fall under the same family and vary by state.
What sits behind the pattern is a separate question. Patient age and cataract prevalence, local practice patterns, and the supply of ophthalmologists could all plausibly matter.
This figure measures the variation, not its cause. Cataract removal is delivered locally, so volume books to roughly where the surgery happens.
A volume record, not a verdict on need, quality, or appropriate care — a higher rate means more procedures per patient, not better or worse care.
A count of how many fee-for-service Medicare patients had a cataract removed, per 1,000, by state, 2024.
Not billed claim lines, not a count of operations, not where patients live, not a share of all Medicare enrollees, and not all-payer.