CPT code 49521: Inguinal hernia repair, recurrent, incarcerated or strangulated2026 Medicare rate & RVUs

Medicare pays $685.05 for 49521 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 49521 covers

This code represents operative repair of an inguinal hernia that has recurred after an earlier repair and is incarcerated or strangulated. Incarceration means the hernia contents are trapped and cannot be returned; strangulation involves compromised blood supply. A surgeon releases the trapped contents as needed and repairs the recurrent defect. General surgeons commonly perform the operation in a hospital or ambulatory surgery setting.

Report this code when the operative record supports both a prior inguinal hernia repair and incarceration or strangulation at the current operation. The day-before preoperative visit and 90 days of related postoperative care are included in the major-surgery global period. 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%. An assistant at surgery 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 49521 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

49521 rates by state

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

How the 49521 rate is calculated

Each of 49521’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 49521

49521 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

49521 compared with similar codes

How to choose

49520Inguinal hernia repairRecurrent, reducible

Both are for recurrent inguinal hernias. Choose 49521 for incarceration or strangulation and 49520 when the recurrent hernia is reducible.

49501Inguinal hernia repairIncarcerated, age 6 months to under 5

This is an initial incarcerated inguinal hernia repair for a patient under age five. 49521 requires recurrence after a prior repair.

49507Inguinal hernia repairInitial, incarcerated, age 5+

This is an initial incarcerated inguinal hernia repair for a patient age five or older. 49521 describes recurrent disease.

49557Femoral hernia repairRecurrent, incarcerated or strangulated

Both describe recurrent hernia repair with incarceration or strangulation, but 49557 is for a femoral hernia rather than an inguinal hernia.

Codes related to 49521

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