CPT code 49507: Inguinal hernia repair, initial, incarcerated, age 5+2026 Medicare rate & RVUs

Medicare pays $568.15 for 49507 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 49507 covers

This code describes open repair of an initial inguinal hernia in a patient age five or older when the hernia is incarcerated or strangulated. Incarceration means the hernia contents cannot be returned to the abdomen; strangulation involves compromised blood supply and may require urgent surgery. General surgeons commonly perform the repair in a hospital operating room or ambulatory surgery center. The operative report should identify the inguinal hernia, the patient’s age, and the incarcerated or strangulated status.

Choose this code instead of the reducible-hernia code when the operative documentation supports incarceration or strangulation. Use a recurrent-repair code when the hernia is at a previously repaired site. CMS assigns a 90-day global period, including the day-before preoperative visit and 90 days of related postoperative care. For multiple procedures in one session, the highest-valued procedure is paid in full and others at 50%. Bilateral reporting with modifier 50 is paid 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 49507 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

49507 rates by state

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

How the 49507 rate is calculated

Each of 49507’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 49507

49507 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

49507 compared with similar codes

How to choose

49505Inguinal hernia repairInitial, reducible, age 5+

Use 49505 for an initial, reducible inguinal hernia in a patient age five or older; 49507 requires incarceration or strangulation.

49501Inguinal hernia repairIncarcerated, age 6 months to under 5

Both codes address an initial incarcerated or strangulated inguinal hernia, but 49501 is for a younger patient and 49507 is for age five or older.

49520Inguinal hernia repairRecurrent, reducible

Use 49520 for a recurrent, reducible inguinal hernia. 49507 is for an initial incarcerated or strangulated hernia.

49521Inguinal hernia repairRecurrent, incarcerated or strangulated

Use 49521 for a recurrent incarcerated or strangulated inguinal hernia; 49507 is for an initial repair.

Codes related to 49507

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