CPT code 49501: Inguinal hernia repair, incarcerated, age 6 months to under 52026 Medicare rate & RVUs

Medicare pays $586.52 for 49501 nationally in a facility.

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

What 49501 covers

This code describes initial surgical repair of an inguinal hernia that is incarcerated or strangulated in a child aged 6 months to younger than 5 years. A pediatric or general surgeon typically performs the repair in an operating room, addressing the hernia and its contents through a surgical approach. The defining distinctions are the child’s age, an initial rather than recurrent repair, and documentation that the hernia is incarcerated or strangulated rather than reducible.

The operative report should support the hernia’s location and status, the patient’s age, and that this is the first repair. CMS assigns a 90-day global period, including the day-before preoperative visit and 90 days of related postoperative care. When multiple procedures are performed in the same session, the highest-valued procedure is paid in full and other procedures at 50%. For bilateral repair reported with modifier 50, CMS pays at 150%. Assistant-at-surgery services may be paid; 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.

Where 49501 pays more and less

The same RVUs, adjusted for each area’s costs. Open a locality for its calculation, history and nearby areas.

109 of 109 payment localities

49501 rates by state

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

How the 49501 rate is calculated

Each of 49501’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 49501

49501 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

49501 compared with similar codes

How to choose

49500Inguinal hernia repairInitial, reducible, age 5 or younger

Use 49500 for an initial reducible inguinal hernia in a child under 5. Use 49501 when the hernia is incarcerated or strangulated.

49507Inguinal hernia repairInitial, incarcerated, age 5+

Both codes describe an initial incarcerated or strangulated inguinal hernia repair; 49507 is for patients aged 5 years or older, while 49501 is for children aged 6 months to younger than 5 years.

49521Inguinal hernia repairRecurrent, incarcerated or strangulated

49521 describes repair of a recurrent incarcerated inguinal hernia. Choose 49501 when the incarcerated or strangulated hernia is being repaired for the first time in a child under 5.

Codes related to 49501

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

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