CPT code 49591: Hernia repair, initial, under 3 cm, reducible2026 Medicare rate & RVUs

Medicare pays $315.64 for 49591 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 49591 covers

This code describes an initial operation to repair a reducible anterior abdominal wall hernia with a defect measuring less than 3 cm. Typical examples include umbilical, epigastric, and ventral hernias. A general surgeon or other qualified surgeon may perform the repair in a hospital or ambulatory surgery setting, using an open, laparoscopic, or robotic approach. Mesh may be used as part of the repair.

Choose this code when the hernia is not a recurrence after prior repair, is reducible, and the operative documentation supports a defect under 3 cm. Record the hernia site, reducibility, prior repair history, and measured defect size. CMS assigns a 0-day global period, so same-day preoperative and postoperative care is included. When multiple procedures are performed in the same session, the highest-valued procedure is paid in full and other procedures are subject to the standard multiple procedure reduction. Modifier 50 is inappropriate for this code. 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 49591 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

49591 rates by state

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

How the 49591 rate is calculated

Each of 49591’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 49591

The CMS indicators that decide how 49591 is paid alongside other services.

What modifiers do to the payment

When to use modifier 51

49591 compared with similar codes

How to choose

49592Abdominal hernia repairIncarcerated or strangulated, under 3 cm

The defect-size category is the same, but 49592 is for an incarcerated or strangulated hernia rather than a reducible one.

49593Abdominal hernia repairInitial, reducible, 3–10 cm

Both are initial repairs of reducible anterior abdominal hernias; 49593 is for a defect measuring 3 to 10 cm.

49595Abdominal hernia repairInitial, over 10 cm, reducible

Both describe initial repair of a reducible hernia, but 49595 is for a defect larger than 10 cm.

Codes related to 49591

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