CPT code 49525: Inguinal hernia repair, sliding hernia2026 Medicare rate & RVUs in Texas
Report this code for operative repair of a sliding inguinal hernia, where an organ forms part of the hernia sac.
CMS doesn’t publish an office rate for 49525 in Texas.
Medicare allowed amount for participating (non-QP) physicians, before deductible, coinsurance and claim adjustments. Not a patient’s bill or a hospital charge.
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On this page 9 sections
What 49525 covers
A sliding inguinal hernia has an organ wall, commonly colon or bladder, forming part of the hernia sac. A surgeon repairs the hernia through an open operation, carefully identifying and managing the organ that contributes to the sac. These repairs are generally performed in an operating room, most often by a general surgeon.
Select this code when the operative findings establish sliding anatomy, rather than choosing an ordinary inguinal hernia code based only on reducibility or recurrence. The operative report should identify the side, the organ or tissue forming part of the sac when known, and the repair performed. 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 repair with modifier 50 is paid at 150%. Assistant-at-surgery payment may be available; co-surgeon payment requires supporting documentation, and team-surgery payment 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 49525 pays more and less in Texas
The same RVUs, adjusted for each area’s costs. Open a locality for its calculation, history and nearby areas.
8 of 8 payment localities
| Payment locality | Office | Facility |
|---|---|---|
| Austin, TX | Unavailable | $557.22 |
| Beaumont, TX | Unavailable | $532.18 |
| Brazoria, TX | Unavailable | $538.34 |
| Dallas, TX | Unavailable | $545.51 |
| Fort Worth, TX | Unavailable | $544.63 |
| Galveston, TX | Unavailable | $542.37 |
| Houston, TX | Unavailable | $584.10 |
| Rest of Texas | Unavailable | $537.51 |
How the 49525 rate is calculated
Each of 49525’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 · 49525
RVUs × geographic indexes × conversion factor
Work8.71
8.71 RVUs× 1.000 GPCI
Practice expense5.61
5.61 RVUs× 1.000 GPCI
Malpractice2.28
2.28 RVUs× 1.000 GPCI
Adjusted RVUs
16.6000
Conversion factor
$33.4009
Medicare rate
$554.45
Every GPCI starts at 1.000, the national rate. Enter a ZIP or drag a slider.
Payment rules and modifiers for 49525
49525 has a 90-day global period: related visits in that window are included in the surgery payment.
CMS payment indicators · 49525
Inguinal hernia repair, sliding hernia
| 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 · 49525
Inguinal hernia repair, sliding hernia
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
49525 without 50 · national facility
$554.45
Inguinal hernia repair, sliding hernia
49525-50 · Bilateral: 150%
$831.68
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).
49525 compared with similar codes
Compare codes · National
5 codes, side by side
How to choose
- 49505Inguinal hernia repairInitial, reducible, age 5+
- 49505 describes an initial, reducible inguinal hernia in a patient age five or older. Choose 49525 when the operative findings establish a sliding hernia.
- 49507Inguinal hernia repairInitial, incarcerated, age 5+
- 49507 is for an initial incarcerated or strangulated inguinal hernia in a patient age five or older. Sliding anatomy is the defining feature for 49525.
- 49520Inguinal hernia repairRecurrent, reducible
- 49520 describes repair of a recurrent, reducible inguinal hernia. Use 49525 when the hernia is documented as sliding rather than coding by recurrence and reducibility alone.
- 49521Inguinal hernia repairRecurrent, incarcerated or strangulated
- 49521 is for a recurrent incarcerated or strangulated inguinal hernia. 49525 identifies the sliding anatomy of the hernia.
49525 billing questions
How is 49525 distinguished from an ordinary inguinal hernia repair?
Use 49525 when the operative findings establish that an organ wall forms part of the hernia sac. Ordinary inguinal hernia codes are selected using their applicable age, recurrence, and reducibility criteria.
What operative documentation supports 49525?
Document the sliding anatomy and the operative findings showing the organ or tissue that contributes to the sac. Record the side and the repair performed.
Can 49525 be reported for bilateral repair?
Yes. CMS pays bilateral procedures reported with modifier 50 at 150%.
How does the 90-day global period affect postoperative billing?
The global period includes the day-before preoperative visit and 90 days of related postoperative care. Those included services are part of the surgical global package.
Can an assistant or co-surgeon be paid for this operation?
Assistant-at-surgery payment may be available. Co-surgeon payment requires supporting documentation; team-surgery payment is not permitted.
What happens when another procedure is performed in the same session?
Under the standard multiple procedure reduction, the highest-valued procedure is paid in full and the other procedures are paid at 50%.
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
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