CPT code 39503: Diaphragm hernia repair, including neonatal repair2026 Medicare rate & RVUs in South Dakota

In South Dakota, Medicare pays $4,758.78 for 39503 in a facility. There’s no office rate.

Check a contract rate as a % of Medicare · 39503 nationwide

Medicare allowed amount for participating (non-QP) physicians, before deductible, coinsurance and claim adjustments. Not a patient’s bill or a hospital charge.

What 39503 covers

This code covers operative repair of a diaphragmatic hernia, most commonly a congenital defect treated in a newborn. The surgeon returns displaced abdominal contents to the abdomen and repairs the opening in the diaphragm. The operation is generally performed in a hospital operating room by a thoracic or pediatric surgeon, often with neonatal surgical and anesthesia teams involved. The code’s scope includes chest tube insertion when performed as part of the repair.

Select this code for diaphragmatic hernia repair in the included neonatal context, rather than repair of a traumatic diaphragmatic hernia in a non-neonate. The operative report should establish the hernia, the repair performed, and the patient’s relevant clinical context. Medicare assigns a 90-day global period, including the day-before preoperative visit and related postoperative care for 90 days. When multiple procedures occur in the same session, the highest-valued procedure is paid in full and others are subject to the standard 50% reduction. Modifier 50 is inappropriate. Assistant-at-surgery payment may be available; co-surgeon payment requires supporting documentation, and team surgery is not permitted.

This summary was written with AI assistance from CMS physician fee schedule data and checked against the CMS billing rules shown here. Rates on this page come directly from CMS files.

How South Dakota compares for 39503

Across 109 of 109 payment localities, the facility rate for 39503 runs from $4,695.46 in Wisconsin to $6,783.69 in Alaska. South Dakota pays $4,758.78. The RVUs are the same everywhere; the geographic indexes change the dollars.

Every other payment area

39503 rates by state

Office rate range in each state. Select a state to see its payment localities.

See 39503 in every payment locality

How the 39503 rate is calculated

Each of 39503’s three RVUs is multiplied by a geographic index (GPCI) for the payment locality, added up, and multiplied by the conversion factor. Drag the indexes or enter a ZIP to see what moves the rate.

Payment rules and modifiers for 39503

39503 has a 90-day global period: related visits in that window are included in the surgery payment.

What modifiers do to the payment

When to use modifier 51

Codes related to 39503

Related codes aren’t interchangeable: bill the code that matches the service performed.

How 39503 has changed in South Dakota

Price 39503 for an earlier date of service

Where the South Dakota rate applies

South Dakota is a Medicare payment area, not a city. Our Census mapping connects it to 485 cities and communities in South Dakota. Some span more than one payment area; confirm with the service ZIP.

• Aberdeen
• Agar
• Agency Village
• Akaska
• Albee
• Alcester
• Alexandria
• Allen

Browse all communities in South Dakota

Where these rates come from

FeeBase calculates base physician payments from CMS work, practice-expense and malpractice RVUs, adjusted by each locality’s geographic indexes and the conversion factor. Services without a published rate are labeled, never given a made-up amount. Amounts are Medicare allowed amounts before claim adjustments: not a patient’s bill or a commercial rate.

CMS RVU26D · effective Oct 1, 2026 through the day before Jan 1, 2027

Open CMS sourceHow we calculate rates