CPT code 49501: Inguinal hernia repair, incarcerated, age 6 months to under 52026 Medicare rate & RVUs in Colorado
Reports initial surgical repair of an incarcerated or strangulated inguinal hernia in a child aged 6 months to younger than 5 years.
In Colorado, Medicare pays $585.14 for 49501 in a facility. There’s no office rate.
Check a contract rate as a % of Medicare · 49501 nationwide
Medicare allowed amount for participating (non-QP) physicians, before deductible, coinsurance and claim adjustments. Not a patient’s bill or a hospital charge.
On this page 11 sections
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.
How Colorado compares for 49501
Across 109 of 109 payment localities, the facility rate for 49501 runs from $518.78 in Arkansas to $719.33 in Miami, FL. Colorado pays $585.14. The RVUs are the same everywhere; the geographic indexes change the dollars.
- Colorado · this page$585.14
- Los Angeles, CA · California$608.25+$23.11
- Washington, DC area · District of Columbia$647.81+$62.67
- Miami, FL · Florida$719.33+$134.19
- Chicago, IL · Illinois$695.19+$110.05
- Manhattan, NY · New York$686.21+$101.07
- Alaska · Alaska$715.41+$130.27
Other areas in Colorado first, then benchmark localities. Bars start at $0.
Every other payment area
| Payment locality | Office | Facility |
|---|---|---|
| AlabamaAlabama | — | $526.14 |
| ArkansasArkansas | — | $518.78 |
| ArizonaArizona | — | $568.58 |
| Bakersfield, CACalifornia | — | $579.65 |
| Chico, CACalifornia | — | $573.10 |
| El Centro, CACalifornia | — | $573.50 |
| Fresno, CACalifornia | — | $573.10 |
| Hanford, CACalifornia | — | $573.10 |
| Madera, CACalifornia | — | $573.10 |
| Merced, CACalifornia | — | $573.10 |
| Modesto, CACalifornia | — | $573.10 |
| Napa, CACalifornia | — | $629.26 |
| Oxnard, CACalifornia | — | $600.75 |
| Redding, CACalifornia | — | $573.10 |
| Rest of CaliforniaCalifornia | — | $573.10 |
| Riverside, CACalifornia | — | $599.24 |
| Sacramento, CACalifornia | — | $592.29 |
| Salinas, CACalifornia | — | $589.97 |
| San Diego, CACalifornia | — | $597.56 |
| Marin County, CACalifornia | — | $653.43 |
| San Francisco, CACalifornia | — | $650.66 |
| San Benito County, CACalifornia | — | $670.68 |
| Santa Clara County, CACalifornia | — | $659.35 |
| San Luis Obispo, CACalifornia | — | $581.70 |
| Santa Cruz, CACalifornia | — | $598.12 |
| Santa Maria, CACalifornia | — | $590.46 |
| Santa Rosa, CACalifornia | — | $603.47 |
| Stockton, CACalifornia | — | $573.10 |
| Vallejo, CACalifornia | — | $625.26 |
| Visalia, CACalifornia | — | $573.10 |
| Yuba City, CACalifornia | — | $573.10 |
| ConnecticutConnecticut | — | $625.14 |
| DelawareDelaware | — | $577.41 |
| Fort Lauderdale, FLFlorida | — | $654.97 |
| Rest of FloridaFlorida | — | $618.71 |
| Atlanta, GAGeorgia | — | $607.02 |
| Rest of GeorgiaGeorgia | — | $580.56 |
| Hawaii, Guam, HIHawaii | — | $579.62 |
| IowaIowa | — | $520.37 |
| IdahoIdaho | — | $527.56 |
| East St. Louis, ILIllinois | — | $653.15 |
| Rest of IllinoisIllinois | — | $615.00 |
| Suburban Chicago, ILIllinois | — | $656.97 |
| IndianaIndiana | — | $530.02 |
| KansasKansas | — | $526.89 |
| KentuckyKentucky | — | $557.38 |
| New Orleans, LALouisiana | — | $585.80 |
| Rest of LouisianaLouisiana | — | $560.09 |
| Metropolitan Boston, MAMassachusetts | — | $628.87 |
| Rest of MassachusettsMassachusetts | — | $585.46 |
| Baltimore area, MDMaryland | — | $625.32 |
| Rest of MarylandMaryland | — | $585.29 |
| Rest of MaineMaine | — | $539.71 |
| Southern Maine, MEMaine | — | $554.65 |
| Detroit, MIMichigan | — | $635.43 |
| Rest of MichiganMichigan | — | $579.63 |
| MinnesotaMinnesota | — | $534.95 |
| Metropolitan Kansas City, MOMissouri | — | $572.44 |
| Metropolitan St. Louis, MOMissouri | — | $577.08 |
| Rest of MissouriMissouri | — | $556.79 |
| MississippiMississippi | — | $537.44 |
| MontanaMontana | — | $586.36 |
| North CarolinaNorth Carolina | — | $543.69 |
| North DakotaNorth Dakota | — | $538.11 |
| NebraskaNebraska | — | $520.42 |
| New HampshireNew Hampshire | — | $584.54 |
| Northern New JerseyNew Jersey | — | $643.28 |
| Rest of New JerseyNew Jersey | — | $625.03 |
| New MexicoNew Mexico | — | $586.30 |
| NevadaNevada | — | $573.11 |
| NYC suburbs and Long Island, NYNew York | — | $713.69 |
| Poughkeepsie and northern NYC suburbs, NYNew York | — | $636.36 |
| Queens, NYNew York | — | $678.47 |
| Rest of New YorkNew York | — | $552.31 |
| OhioOhio | — | $569.77 |
| OklahomaOklahoma | — | $546.94 |
| Portland, OROregon | — | $592.74 |
| Rest of OregonOregon | — | $561.51 |
| Metropolitan Philadelphia, PAPennsylvania | — | $615.94 |
| Rest of PennsylvaniaPennsylvania | — | $565.63 |
| Puerto RicoPuerto Rico | — | $587.50 |
| Rhode IslandRhode Island | — | $590.11 |
| South CarolinaSouth Carolina | — | $559.09 |
| South DakotaSouth Dakota | — | $532.41 |
| TennesseeTennessee | — | $530.58 |
| Austin, TXTexas | — | $589.44 |
| Beaumont, TXTexas | — | $562.73 |
| Brazoria, TXTexas | — | $569.23 |
| Dallas, TXTexas | — | $576.89 |
| Fort Worth, TXTexas | — | $575.95 |
| Galveston, TXTexas | — | $573.54 |
| Houston, TXTexas | — | $618.20 |
| Rest of TexasTexas | — | $568.41 |
| UtahUtah | — | $566.20 |
| VirginiaVirginia | — | $559.16 |
| Virgin Islands, VIUnited States Virgin Islands | — | $587.50 |
| VermontVermont | — | $544.26 |
| Rest of WashingtonWashington | — | $581.61 |
| King County, WAWashington | — | $632.27 |
| WisconsinWisconsin | — | $521.72 |
| West VirginiaWest Virginia | — | $595.44 |
| WyomingWyoming | — | $565.33 |
49501 rates by state
Office rate range in each state. Select a state to see its payment localities.
Explore a state
Local rates. Clear comparisons.
Hover or focus a tile to see its rate range. Select it to open the state’s fee schedule.
View every state and territory as a table
| State / territory | Office rate range | Localities |
|---|---|---|
| AK | No published base rate | 1 |
| AL | No published base rate | 1 |
| AR | No published base rate | 1 |
| AZ | No published base rate | 1 |
| CA | No published base rate | 29 |
| CO | No published base rate | 1 |
| CT | No published base rate | 1 |
| DC | No published base rate | 1 |
| DE | No published base rate | 1 |
| FL | No published base rate | 3 |
| GA | No published base rate | 2 |
| GU | No published base rate | 1 |
| HI | No published base rate | 1 |
| IA | No published base rate | 1 |
| ID | No published base rate | 1 |
| IL | No published base rate | 4 |
| IN | No published base rate | 1 |
| KS | No published base rate | 1 |
| KY | No published base rate | 1 |
| LA | No published base rate | 2 |
| MA | No published base rate | 2 |
| MD | No published base rate | 3 |
| ME | No published base rate | 2 |
| MI | No published base rate | 2 |
| MN | No published base rate | 1 |
| MO | No published base rate | 3 |
| MS | No published base rate | 1 |
| MT | No published base rate | 1 |
| NC | No published base rate | 1 |
| ND | No published base rate | 1 |
| NE | No published base rate | 1 |
| NH | No published base rate | 1 |
| NJ | No published base rate | 2 |
| NM | No published base rate | 1 |
| NV | No published base rate | 1 |
| NY | No published base rate | 5 |
| OH | No published base rate | 1 |
| OK | No published base rate | 1 |
| OR | No published base rate | 2 |
| PA | No published base rate | 2 |
| PR | No published base rate | 1 |
| RI | No published base rate | 1 |
| SC | No published base rate | 1 |
| SD | No published base rate | 1 |
| TN | No published base rate | 1 |
| TX | No published base rate | 8 |
| UT | No published base rate | 1 |
| VA | No published base rate | 2 |
| VI | No published base rate | 1 |
| VT | No published base rate | 1 |
| WA | No published base rate | 2 |
| WI | No published base rate | 1 |
| WV | No published base rate | 1 |
| WY | No published base rate | 1 |
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.
How the rate is built · 49501
RVUs × geographic indexes × conversion factor
Work9.13
9.13 RVUs× 1.000 GPCI
Practice expense5.99
5.99 RVUs× 1.000 GPCI
Malpractice2.44
2.44 RVUs× 1.000 GPCI
Adjusted RVUs
17.5600
Conversion factor
$33.4009
Medicare rate
$586.52
Every GPCI starts at 1.000, the national rate. Enter a ZIP or drag a slider.
The exact Colorado inputs and CMS source lines
PPRRVU2026_Oct_nonQPP.csv
5,826
- Code
- 49501
- Physician work
- 9.13
- Practice expense
- 5.99
- Malpractice
- 2.44
GPCI2026.csv
37
- Locality
- Colorado
- Physician work
- 1.012
- Practice expense
- 1.064
- Malpractice
- 0.781
| Component | RVU | Locality factor | Adjusted |
|---|---|---|---|
| Physician work | 9.13 | × 1.012 | 9.2396 |
| Practice expense | 5.99 | × 1.064 | 6.3734 |
| Malpractice | 2.44 | × 0.781 | 1.9056 |
| Total RVUs | 17.5186 | ||
| Conversion factor | × 33.4009 | ||
Facility rate, Colorado$585.14
Facility: (9.13 × 1.012 + 5.99 × 1.064 + 2.44 × 0.781) × $33.4009 = $585.14
Payment rules and modifiers for 49501
49501 has a 90-day global period: related visits in that window are included in the surgery payment.
CMS payment indicators · 49501
Inguinal hernia repair, incarcerated, age 6 months to under 5
| Rule | CMS value | What it means |
|---|---|---|
| Global period | 090 | Major surgery: the day before, the day of, and 90 days after are included. |
| Multiple procedures | 2 | Standard reduction: highest-valued procedure at 100%, others at 50%. |
| Bilateral (modifier 50) | 1 | Bilateral with modifier 50 pays 150% of the fee schedule amount. |
| Assistant at surgery (80/81/82/AS) | 2 | Paid. |
| Co-surgeons (62) | 1 | Permitted with supporting documentation. |
| Team surgery (66) | 0 | Not permitted. |
| Professional/technical | 0 | Physician service: no professional/technical split. |
| Split (54/55/56) | 0.09/0.81/0.10 | Share of the payment for pre-op, the procedure itself, and post-op care. |
Global surgery period · 49501
Inguinal hernia repair, incarcerated, age 6 months to under 5
90-day global period ends
Dec 30, 2026
Covers Sep 30, 2026 through Dec 30, 2026 (92 days, including the day before surgery).
Visit on Oct 31, 2026
Day 30 of the 90-day post-op period: related follow-up care is included in the surgical payment.
Pre-op dayGlobal period
What modifiers do to the payment
Modifier 50 · payment effect
With and without the modifier
49501 without 50 · national facility
$586.52
Inguinal hernia repair, incarcerated, age 6 months to under 5
49501-50 · Bilateral: 150%
$879.78
Both sides on one line with modifier 50 are paid at 150% of the fee schedule amount (subject to multiple-procedure rules with other procedures).
How 49501 has changed in Colorado
49501 · Office / nonfacility
Rate unavailable
Effective 2026-10-01
A rate is unavailable in one of these releases, so a change cannot be calculated.
One bar per available release, ordered by effective date. Missing rates remain gaps. These comparisons hold the code, setting and locality identifiers constant; they do not isolate which policy or input caused a change.
What changed, release by release
| Effective from | Office | Facility | CMS release |
|---|---|---|---|
| 2026-10-01 | Not available in this setting | $585.14 | RVU26D |
| 2026-07-01 | Not available in this setting | $585.14 | RVU26C |
| 2026-04-01 | Not available in this setting | $585.14 | RVU26B |
| 2026-01-01 | Not available in this setting | $585.14 | RVU26A |
| 2025-10-01 | Not available in this setting | $598.69 | RVU25D |
| 2025-07-01 | Not available in this setting | $598.69 | RVU25C |
| 2025-04-01 | Not available in this setting | $598.69 | RVU25B |
| 2025-01-01 | Not available in this setting | $598.69 | RVU25A |
| 2024-10-01 | Not available in this setting | $611.12 | RVU24D |
| 2024-07-01 | Not available in this setting | $611.12 | RVU24C |
| 2024-04-01 | Not available in this setting | $611.12 | RVU24B |
| 2024-03-09 | Not available in this setting | $611.12 | RVU24AR |
| 2024-01-01 | Not available in this setting | $601.15 | RVU24A |
| 2023-10-01 | Not available in this setting | $614.23 | RVU23D |
| 2023-07-01 | Not available in this setting | $614.23 | RVU23C |
| 2023-04-01 | Not available in this setting | $614.23 | RVU23B |
| 2023-01-01 | Not available in this setting | $614.23 | RVU23A |
| 2022-10-01 | Not available in this setting | $620.94 | RVU22D |
| 2022-07-01 | Not available in this setting | $620.94 | RVU22C |
| 2022-04-01 | Not available in this setting | $620.94 | RVU22B |
| 2022-01-01 | Not available in this setting | $620.94 | RVU22A |
| 2021-10-01 | Not available in this setting | $619.47 | RVU21D |
| 2021-07-01 | Not available in this setting | $619.47 | RVU21C |
| 2021-04-01 | Not available in this setting | $619.47 | RVU21B |
| 2021-01-01 | Not available in this setting | $619.47 | RVU21A |
| 2020-10-01 | Not available in this setting | $635.58 | RVU20D |
| 2020-07-01 | Not available in this setting | $635.58 | RVU20C |
| 2020-04-01 | Not available in this setting | $635.58 | RVU20B |
| 2020-01-01 | Not available in this setting | $635.58 | RVU20A |
| 2019-10-01 | Not available in this setting | $639.76 | RVU19D |
| 2019-07-01 | Not available in this setting | $639.76 | RVU19C |
| 2019-04-01 | Not available in this setting | $639.76 | RVU19B |
| 2019-01-01 | Not available in this setting | $639.76 | RVU19A |
| 2018-10-01 | Not available in this setting | $637.58 | RVU18D |
| 2018-07-01 | Not available in this setting | $637.58 | RVU18C |
| 2018-04-01 | Not available in this setting | $637.58 | RVU18B |
| 2018-01-01 | Not available in this setting | $637.58 | RVU18AR1 |
| 2017-10-01 | Not available in this setting | $636.94 | RVU17D |
| 2017-07-01 | Not available in this setting | $636.94 | RVU17C |
| 2017-04-01 | Not available in this setting | $636.94 | RVU17B |
| 2017-01-01 | Not available in this setting | $636.94 | RVU17A |
| 2016-10-01 | Not available in this setting | $611.71 | RVU16D |
| 2016-07-01 | Not available in this setting | $611.71 | RVU16C |
| 2016-04-01 | Not available in this setting | $611.71 | RVU16B |
| 2016-01-01 | Not available in this setting | $611.71 | RVU16A |
| 2015-10-01 | Not available in this setting | $638.47 | RVU15D |
| 2015-07-01 | Not available in this setting | $638.47 | RVU15C |
| 2015-04-01 | Not available in this setting | $635.29 | RVU15B |
| 2015-01-01 | Not available in this setting | $635.29 | RVU15A |
| 2014-10-01 | Not available in this setting | $615.12 | RVU14D |
| 2014-07-01 | Not available in this setting | $615.12 | RVU14C |
| 2014-04-01 | Not available in this setting | $615.12 | RVU14B |
| 2014-01-01 | Not available in this setting | $615.12 | RVU14A |
| 2013-10-01 | Not available in this setting | $602.94 | RVU13D |
| 2013-07-01 | Not available in this setting | $602.94 | RVU13C |
| 2013-04-01 | Not available in this setting | $602.94 | RVU13B |
| 2013-01-01 | Not available in this setting | $602.94 | RVU13AR |
Where the Colorado rate applies
Colorado is a Medicare payment area, not a city. Our Census mapping connects it to 485 cities and communities in Colorado. Some span more than one payment area; confirm with the service ZIP.
- Acres Green
- Aetna Estates
- Aguilar
- Air Force Academy
- Akron
- Alamosa
- Alamosa East
- Allenspark
49501 billing questions
How does this code differ from 49500?
Both describe an initial inguinal hernia repair in a child younger than 5 years. Use 49501 when the hernia is incarcerated or strangulated; 49500 is for a reducible hernia.
When is 49507 used instead?
49507 describes an initial incarcerated or strangulated inguinal hernia repair in a patient aged 5 years or older. This code is for a child aged 6 months to younger than 5 years.
What documentation supports reporting 49501?
The operative record should identify the inguinal hernia as incarcerated or strangulated, establish that the repair is initial, and support the patient’s age.
How are bilateral repairs handled?
For bilateral repair reported with modifier 50, CMS pays at 150%. The record should support repair on both sides.
What postoperative care is included?
The 90-day global period includes the day-before preoperative visit and 90 days of related postoperative care.
Can an assistant or co-surgeon be reported?
Assistant-at-surgery services may be paid. Co-surgeon payment requires supporting documentation; CMS does not permit team-surgery payment for this code.
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
Show the CMS file lines behind this rate
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