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CPT code 49520: Inguinal hernia repair, recurrent, reducible2026 Medicare rate & RVUs

Open repair of a previously repaired inguinal hernia when the recurrent defect is reducible, reported for operative treatment of the recurrence.

CMS RVU26DEffective Oct 1, 2026109 payment localities4.9K Medicare services in 2024

Medicare pays $608.23 for 49520 nationally in a facility.

Medicare rate · 49520

Inguinal hernia repair, recurrent, reducible

Office or facility?

Work RVUs
9.74
Total RVUs
18.21
Global days
090

National rate · 2026

$608.23

Facility setting, before claim adjustments.

See every locality for 49520 →Billed by an NP, PA or therapist? →

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

Your location

Medicare pays by the payment locality where the service is performed.

On this page 10 sections
  1. Medicare rate
  2. What 49520 covers
  3. By payment locality
  4. Rate map
  5. How it’s calculated
  6. Payment rules
  7. Similar codes
  8. Related codes
  9. Billing questions
  10. Sources

What 49520 covers

Code 49520 describes operative repair of a recurrent inguinal hernia that is reducible, meaning the protruding contents can be returned rather than remaining trapped. It applies when the hernia has returned at a site previously repaired, not to a first-time hernia. General surgeons commonly perform this open repair in a hospital operating room or ambulatory surgery center; a laparoscopic repair is coded separately.

Document the prior repair or history establishing recurrence, the inguinal location, reducibility, and the procedure performed. The service has a 90-day global period: the day-before preoperative visit and related postoperative care through day 90 are included. For bilateral repair, modifier 50 is paid at 150%. When multiple procedures occur in one session, the highest-valued procedure is paid in full and others at 50%. Assistant-at-surgery payment may be made; 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 49520 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

49520 office and facility rates by payment locality
Payment localityOfficeFacility
AlabamaUnavailable$546.45
AlaskaUnavailable$745.33
ArizonaUnavailable$589.80
ArkansasUnavailable$538.93
Atlanta, GAUnavailable$629.55
Austin, TXUnavailable$610.58
Bakersfield, CAUnavailable$599.93
Baltimore area, MDUnavailable$648.11
Beaumont, TXUnavailable$584.39
Brazoria, TXUnavailable$590.25

49520 rates by state

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

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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
49520 office rate range by state
State / territoryOffice rate rangeLocalities
AKNo published base rate1
ALNo published base rate1
ARNo published base rate1
AZNo published base rate1
CANo published base rate29
CONo published base rate1
CTNo published base rate1
DCNo published base rate1
DENo published base rate1
FLNo published base rate3
GANo published base rate2
GUNo published base rate1
HINo published base rate1
IANo published base rate1
IDNo published base rate1
ILNo published base rate4
INNo published base rate1
KSNo published base rate1
KYNo published base rate1
LANo published base rate2
MANo published base rate2
MDNo published base rate3
MENo published base rate2
MINo published base rate2
MNNo published base rate1
MONo published base rate3
MSNo published base rate1
MTNo published base rate1
NCNo published base rate1
NDNo published base rate1
NENo published base rate1
NHNo published base rate1
NJNo published base rate2
NMNo published base rate1
NVNo published base rate1
NYNo published base rate5
OHNo published base rate1
OKNo published base rate1
ORNo published base rate2
PANo published base rate2
PRNo published base rate1
RINo published base rate1
SCNo published base rate1
SDNo published base rate1
TNNo published base rate1
TXNo published base rate8
UTNo published base rate1
VANo published base rate2
VINo published base rate1
VTNo published base rate1
WANo published base rate2
WINo published base rate1
WVNo published base rate1
WYNo published base rate1

How the 49520 rate is calculated

Each of 49520’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 · 49520

RVUs × geographic indexes × conversion factor

Office or facility?

Work9.74

9.74 RVUs× 1.000 GPCI

Practice expense5.91

5.91 RVUs× 1.000 GPCI

Malpractice2.56

2.56 RVUs× 1.000 GPCI

Adjusted RVUs

18.2100

Conversion factor

$33.4009

Medicare rate

$608.23

Every GPCI starts at 1.000, the national rate. Enter a ZIP or drag a slider.

Payment rules and modifiers for 49520

49520 has a 90-day global period: related visits in that window are included in the surgery payment.

CMS payment indicators · 49520

Inguinal hernia repair, recurrent, reducible

RuleCMS valueWhat it means
Global period090Major surgery: the day before, the day of, and 90 days after are included.
Multiple procedures2Standard reduction: highest-valued procedure at 100%, others at 50%.
Bilateral (modifier 50)1Bilateral with modifier 50 pays 150% of the fee schedule amount.
Assistant at surgery (80/81/82/AS)2Paid.
Co-surgeons (62)1Permitted with supporting documentation.
Team surgery (66)0Not permitted.
Professional/technical0Physician service: no professional/technical split.
Split (54/55/56)0.09/0.81/0.10Share of the payment for pre-op, the procedure itself, and post-op care.

Global surgery period · 49520

Inguinal hernia repair, recurrent, reducible

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.

  • 24Unrelated E/M visit by the same physician
  • 79Unrelated procedure (starts its own global period)
  • 58Staged, more extensive, or therapy procedure that was planned
  • 78Unplanned return to the operating room for a related complication
SurgeryVisit
Sep 23, 2026Jan 10, 2027

Pre-op dayGlobal period

What modifiers do to the payment

Modifier 50 · payment effect

With and without the modifier

49520 without 50 · national facility

$608.23

Inguinal hernia repair, recurrent, reducible

49520-50 · Bilateral: 150%

$912.35

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).

When to use modifier 50

49520 compared with similar codes

Compare codes · National

5 codes, side by side

Office or facility?

  • 49520

    Inguinal hernia repair, recurrent, reducible9.74 wRVU

    Not priced

  • 49521

    Inguinal hernia repair, recurrent, incarcerated or strangulated11.19 wRVU

    Not priced

  • 49505

    Inguinal hernia repair, initial, reducible, age 5+7.76 wRVU

    Not priced

  • 49651

    Inguinal hernia repair, laparoscopic, recurrent8.17 wRVU

    Not priced

  • 49555

    Femoral hernia repair, recurrent, reducible9.16 wRVU

    Not priced

How to choose

49521Inguinal hernia repairRecurrent, incarcerated or strangulated
Both describe recurrent inguinal hernia repair. Choose 49520 when the hernia is reducible; 49521 is for an incarcerated or strangulated hernia.
49505Inguinal hernia repairInitial, reducible, age 5+
49505 describes initial reducible inguinal hernia repair in a patient age five or older. Use 49520 when the hernia has recurred after a prior repair.
49651Inguinal hernia repairLaparoscopic, recurrent
49651 is the laparoscopic option for recurrent inguinal hernia repair. Code 49520 describes open repair.
49555Femoral hernia repairRecurrent, reducible
49555 is for recurrent reducible femoral hernia repair. Code 49520 is for an inguinal hernia.

Codes related to 49520

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

Codes related to 49520
CodeHow it relatesNational office range
Same family
49521Inguinal hernia repair, recurrent, incarcerated or strangulatedRecurrent inguinal hernia repair when the hernia is incarcerated or strangulated.No office rate
Used instead
49505Inguinal hernia repair, initial, reducible, age 5+Initial, reducible inguinal hernia repair for patients age five or older.No office rate
49651Inguinal hernia repair, laparoscopic, recurrentLaparoscopic repair of a recurrent inguinal hernia.No office rate
49555Femoral hernia repair, recurrent, reducibleRecurrent reducible femoral hernia repair; the hernia is femoral, not inguinal.No office rate
49525Inguinal hernia repair, sliding herniaRepair for a sliding inguinal hernia, a distinct hernia type.No office rate

49520 billing questions

How does 49520 differ from 49505?

49520 is for a reducible inguinal hernia that has recurred after a prior repair. 49505 describes an initial reducible inguinal hernia in a patient age five or older.

When should 49521 be used instead?

Use 49521 for recurrent inguinal hernia repair when the hernia is incarcerated or strangulated, rather than reducible.

Does 49520 describe open or laparoscopic repair?

49520 describes open repair. Laparoscopic repair of a recurrent inguinal hernia is reported with 49651.

What documentation supports reporting recurrent repair?

Document that the hernia is at a previously repaired inguinal site, that it is reducible, and what repair was performed. A first-time hernia does not meet the recurrence criterion.

How is bilateral repair handled?

When both sides are repaired in the same session, modifier 50 is paid at 150% under the CMS bilateral rule.

Can an assistant or co-surgeon be reported?

Assistant-at-surgery payment may be made. Co-surgeon payment requires supporting documentation; team surgery is not permitted.

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
RVUs for 49520PPRRVU2026_Oct_nonQPP.csv, line 5,829 (RVU26D)

Open CMS sourceHow we calculate rates

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