CPT code 49505: Inguinal hernia repair, initial, reducible, age 5+2026 Medicare rate & RVUs in Colorado

In Colorado, Medicare pays $507.69 for 49505 in a facility. There’s no office rate.

Check a contract rate as a % of Medicare · 49505 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 49505 covers

This code represents open surgery for a primary inguinal hernia that is reducible in a patient age five or older. The surgeon exposes the groin, addresses the hernia contents, and repairs the inguinal defect. General surgeons commonly perform the operation in an operating room for adults and older children with a first-time, reducible groin hernia.

Select the code based on the patient’s age, inguinal site, initial-repair status, and reducibility. Document these details and the operative findings. CMS assigns a 90-day global period, including the day-before preoperative visit and 90 days of related postoperative care. When multiple procedures occur in the same session, the highest-valued procedure is paid in full and the others at 50%. Bilateral reporting with modifier 50 is paid at 150%. An assistant at surgery may be paid; co-surgeons require 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 49505

Across 109 of 109 payment localities, the facility rate for 49505 runs from $449.39 in Arkansas to $620.12 in Miami, FL. Colorado pays $507.69. The RVUs are the same everywhere; the geographic indexes change the dollars.

Every other payment area

49505 rates by state

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

See 49505 in every payment locality

How the 49505 rate is calculated

Each of 49505’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 49505

49505 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 49505

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

How 49505 has changed in Colorado

Price 49505 for an earlier date of service

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

Browse all communities in Colorado

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