The current operating budget for American eyebanks is more than $5 million per year, and an increasing portion of this expense is being paid by third-party payers. American eyebanks were surveyed to determine what a reasonable cost per transplant tissue might be and to see if recommendations could be made that would help optimize cost-effectiveness in American eyebanking. Most well-run eyebanks needed between $222 to $464 to process each donor cornea for transplantation. This cost-effective goal was most often met if the bank provided at least 150 corneas annually and if there was a full-time professional staff using modern tissue preservation techniques. An eyebank unable to meet these goals should consider obtaining its tissue from the nearest cost-effective eyebank, allowing the redirection of charitable contributions to other more cost-effective eye care-related community activities.