Cross Border Directive Refund: €1,081 for a Cataract in 2026

Ireland's Cross Border Directive (CBD) scheme lets a public patient have treatment in another EU or EEA country and claim the cost back from the Health Service Executive (HSE).¹ The refund is not a percentage of your bill. It is a fixed price, read off a list the HSE publishes.¹

For the most common cataract operation, that price is €1,081 from 1 September 2026.² In May 2023 it was €1,456.³ This article sets out how the refund is worked out, what the current list pays, and how it compares with what clinics charge.

How the refund is calculated

The HSE pays the smaller of two amounts: what your care cost abroad, or what the same care costs in the Irish public system.¹ Its own example: if treatment abroad costs €2,000 and the Irish cost is €1,500, you can claim €1,500.¹

The "Irish cost" is a price per diagnosis-related group (DRG). A DRG is a code that groups hospital cases of similar type and cost.¹ The HSE assigns one code to each case, based on the diagnosis and the procedures done.¹ It then pays the price for that code, as a day case or an inpatient stay, depending on how the procedure would be done in Ireland.¹

Outpatient care has a separate cap. The most you can claim for one or more outpatient appointments on the same day is €194, for appointments from 1 May 2023.¹

The scheme does not cover travel, accommodation, translation, or any fee paid to an agency that arranges treatment.¹

A public guide that is out of date

Citizens Information, the state's own information service, still gives a different cap. Its page on the scheme says "the maximum refund for a hospital outpatient consultation is €130".⁴ That page was last edited in November 2021.⁴ The HSE's figure, for appointments since May 2023, is €194.¹

What the current list pays

Sources: HSE admitted patient price lists.²⁵

The HSE says most cataract treatments are expected to fall under C16Z.¹ The two C15 codes are for the most complex cases.¹

The new list took effect on 1 September 2026.¹ The standard cataract price fell by €37. The price for complex cases with major complications fell by €832.

How the cataract refund has moved

The price for the standard cataract code has fallen at each update since 2023. The HSE's 2023 list paid €1,456.³ The list from July 2024 paid €1,171.⁶ It fell to €1,118 in July 2025, and to €1,081 in September 2026.⁵²

The 2024 change drew complaints. The Killarney Advertiser reported in July 2024 that the HSE had postponed it from 1 July to 1 September 2024.⁷ It reported that the less complex code fell from €1,912 to €863, and the standard code from €1,456 to €1,171.⁷ The complex code with major complications rose from €1,912 to €4,206.⁷ The 2024 HSE list confirms the new figures.⁶

The HSE says it reviews prices every year and that they "can go up or down based on changes in clinical practice".¹ The 2026 list explains that individual DRG cost changes are now reflected in prices, rather than all prices rising together with inflation.²

The HSE's own guide to common procedures has not caught up. It still lists €1,171 for the standard cataract code, the price from July 2024.⁸⁶

What clinics charge

The refund only matters against a real quote.

Ireland, private. Clear Sight Abroad, an agency that sends Irish patients to Prague, puts private cataract surgery in Ireland at €2,200 to €3,500 an eye with a standard lens.⁹ It quotes €4,500 to €7,000 with a premium multifocal lens.⁹ We did not find an Irish private hospital publishing its own price.

Poland. The comparison site 123.clinic lists an average of €1,920 an eye, with a range of €1,500 to €2,240.¹⁰ Several clinics in Warsaw and Kraków start from €1,500.¹⁰

Czechia. Clear Sight Abroad quotes Prague from €1,100 an eye with a standard lens, including transfers and aftercare.⁹

Northern Ireland. Belfast is outside the EU, and Irish patients reach it through a separate scheme with the same price lists.⁸

In July 2026, Veonet Ireland offered cataract surgery at its Belfast clinic for €1,312, according to Galway Bay FM. It described that as the most eligible patients can reclaim, against a usual price of about €2,000.¹¹ The €1,312 matches the June to August 2026 cataract price of €1,118 plus one €194 outpatient appointment.⁵¹

All of these prices come from sellers or agencies, not audited bills.

What that leaves you to pay

At the 1 September 2026 price, a €1,500 Polish quote leaves about €419 to pay, before travel. A €2,240 quote leaves about €1,159. A €1,100 Prague quote leaves about €19. These are our calculations from the quotes above and the HSE price.²⁹¹⁰ They assume your operation is coded C16Z, and that no outpatient appointment is claimed separately.

An Irish private quote of €2,200 to €3,500 is not refunded by this scheme at all. The scheme covers care in other EU and EEA countries.¹

What the headline numbers leave out

Dental is not a general refund. D40Z is a hospital admission price for extractions and restorations. The HSE pays according to the setting in which you would have had the care in Ireland.¹

Dental care is covered only where it is available publicly in Ireland to you.¹² For orthodontics, the HSE says you must be eligible for the same public treatment at home, usually only children under 16.¹² A crown or implant at a private dentist abroad is not, on these rules, a €2,834 refund.

The code can change. A clinic abroad can choose a different code after treatment, if the medical notes support it.¹ The HSE sometimes sends claims to the Healthcare Pricing Office for independent review, and the correct code sets the maximum refund.¹

You pay first. The patient pays the provider, then applies to the HSE.¹ In 2019, the Southern Star reported waits of around three months for refunds, against an expected 30 days, as claims rose from about 1,000 to 3,900 in three years.¹³

Eligibility comes first. Generally, the healthcare must be available publicly in Ireland for you to be referred for it abroad.¹²

How to use these numbers

1. Before you book, ask your referring doctor or the HSE which DRG code your procedure is likely to get.
2. Look up that code on the price list in force on the date of your treatment, not the date you book.¹
3. Ask the clinic abroad for a written quote for one eye, including the lens, the consultation and aftercare.
4. Subtract the HSE price. What is left, plus travel, is your cost.
5. Keep every invoice and medical note. The HSE needs them to confirm the code.

For how dental refunds work under a different country's rules, see our guide to what Austria's health insurer refunds for dental work in Hungary. For a cataract with a premium lens, our multifocal cataract cost comparison sets out what the NHS, US and German systems pay.