CPT code 49520: Inguinal hernia repair, recurrent, reducible2026 Medicare rate & RVUs in Florida
Open repair of a previously repaired inguinal hernia when the recurrent defect is reducible, reported for operative treatment of the recurrence.
CMS doesn’t publish an office rate for 49520 in Florida.
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
On this page 9 sections
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 in Florida
The same RVUs, adjusted for each area’s costs. Open a locality for its calculation, history and nearby areas.
| Payment locality | Office | Facility |
|---|---|---|
| Fort Lauderdale, FL | Unavailable | $679.89 |
| Miami, FL | Unavailable | $747.06 |
| Rest of Florida | Unavailable | $642.55 |
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
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
| 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 · 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.
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).
49520 compared with similar codes
Compare codes · National
5 codes, side by side
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.
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
Fee sheets · Coming soon
Put 49520 and the rest of your codes on one sheet
Your codes at your locality, with payer contracts beside Medicare.
Join the waitlist