CPT code 49500: Inguinal hernia repair, initial, reducible, age 5 or younger2026 Medicare rate & RVUs in Minnesota

In Minnesota, Medicare pays $381.98 for 49500 in a facility. There’s no office rate.

Check a contract rate as a % of Medicare · 49500 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 49500 covers

A surgeon repairs a first-time inguinal hernia in a child age 5 years or younger when the hernia is reducible. The operation typically involves exposing the inguinal canal, returning the hernia contents to the abdomen, and repairing the defect and hernia sac. Pediatric and general surgeons commonly perform the repair in an operating room, including for infants and young children with a groin bulge that can be reduced.

Choose this code when the record supports an initial inguinal hernia, reducibility, and the patient’s age; document the operative findings and repair performed. An incarcerated or strangulated hernia belongs to a different code, as does a repair of a recurrent hernia. This major surgery has a 90-day global period, including the day-before preoperative visit and 90 days of related postoperative care. For bilateral repair with modifier 50, CMS pays at 150%. In a same-session multiple-procedure claim, the highest-valued procedure is paid in full and other procedures at 50%. 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 Minnesota compares for 49500

Across 109 of 109 payment localities, the facility rate for 49500 runs from $363.79 in Arkansas to $500.40 in NYC suburbs and Long Island, NY. Minnesota pays $381.98. The RVUs are the same everywhere; the geographic indexes change the dollars.

Every other payment area

49500 rates by state

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

See 49500 in every payment locality

How the 49500 rate is calculated

Each of 49500’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 49500

49500 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 50

Codes related to 49500

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

How 49500 has changed in Minnesota

Price 49500 for an earlier date of service

Where the Minnesota rate applies

Minnesota is a Medicare payment area, not a city. Our Census mapping connects it to 916 cities and communities in Minnesota. Some span more than one payment area; confirm with the service ZIP.

• Ada
• Adams
• Adrian
• Afton
• Aitkin
• Akeley
• Albany
• Albert Lea

Browse all communities in Minnesota

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