CPT code 49591: Hernia repair, initial, under 3 cm, reducible2026 Medicare rate & RVUs in Mississippi
Reports initial repair of a reducible anterior abdominal hernia when the measured defect is under 3 cm, including open or minimally invasive approaches.
In Mississippi, Medicare pays $292.67 for 49591 in a facility. There’s no office rate.
Check a contract rate as a % of Medicare · 49591 nationwide
Medicare allowed amount for participating (non-QP) physicians, before deductible, coinsurance and claim adjustments. Not a patient’s bill or a hospital charge.
On this page 11 sections
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.
How Mississippi compares for 49591
Across 109 of 109 payment localities, the facility rate for 49591 runs from $278.18 in Wisconsin to $394.99 in Alaska. Mississippi pays $292.67. The RVUs are the same everywhere; the geographic indexes change the dollars.
- Mississippi · this page$292.67
- Los Angeles, CA · California$320.01+$27.34
- Washington, DC area · District of Columbia$344.52+$51.85
- Miami, FL · Florida$394.68+$102.01
- Chicago, IL · Illinois$381.80+$89.13
- Manhattan, NY · New York$368.86+$76.19
- Alaska · Alaska$394.99+$102.32
Other areas in Mississippi first, then benchmark localities. Bars start at $0.
Every other payment area
| Payment locality | Office | Facility |
|---|---|---|
| AlabamaAlabama | — | $285.06 |
| ArkansasArkansas | — | $281.38 |
| ArizonaArizona | — | $306.25 |
| Bakersfield, CACalifornia | — | $306.76 |
| Chico, CACalifornia | — | $302.74 |
| El Centro, CACalifornia | — | $302.99 |
| Fresno, CACalifornia | — | $302.74 |
| Hanford, CACalifornia | — | $302.74 |
| Madera, CACalifornia | — | $302.74 |
| Merced, CACalifornia | — | $302.74 |
| Modesto, CACalifornia | — | $302.74 |
| Napa, CACalifornia | — | $326.21 |
| Oxnard, CACalifornia | — | $315.38 |
| Redding, CACalifornia | — | $302.74 |
| Rest of CaliforniaCalifornia | — | $302.74 |
| Riverside, CACalifornia | — | $318.71 |
| Sacramento, CACalifornia | — | $311.24 |
| Salinas, CACalifornia | — | $309.98 |
| San Diego, CACalifornia | — | $312.74 |
| Marin County, CACalifornia | — | $336.59 |
| San Francisco, CACalifornia | — | $334.90 |
| San Benito County, CACalifornia | — | $345.63 |
| Santa Clara County, CACalifornia | — | $338.72 |
| San Luis Obispo, CACalifornia | — | $305.83 |
| Santa Cruz, CACalifornia | — | $312.06 |
| Santa Maria, CACalifornia | — | $309.90 |
| Santa Rosa, CACalifornia | — | $314.74 |
| Stockton, CACalifornia | — | $302.74 |
| Vallejo, CACalifornia | — | $323.78 |
| Visalia, CACalifornia | — | $302.74 |
| Yuba City, CACalifornia | — | $302.74 |
| ColoradoColorado | — | $311.66 |
| ConnecticutConnecticut | — | $335.50 |
| DelawareDelaware | — | $310.72 |
| Fort Lauderdale, FLFlorida | — | $356.78 |
| Rest of FloridaFlorida | — | $337.51 |
| Atlanta, GAGeorgia | — | $327.37 |
| Rest of GeorgiaGeorgia | — | $317.44 |
| Hawaii, Guam, HIHawaii | — | $304.52 |
| IowaIowa | — | $279.52 |
| IdahoIdaho | — | $283.67 |
| East St. Louis, ILIllinois | — | $360.36 |
| Rest of IllinoisIllinois | — | $337.41 |
| Suburban Chicago, ILIllinois | — | $357.36 |
| IndianaIndiana | — | $284.82 |
| KansasKansas | — | $284.06 |
| KentuckyKentucky | — | $303.44 |
| New Orleans, LALouisiana | — | $318.17 |
| Rest of LouisianaLouisiana | — | $305.29 |
| Metropolitan Boston, MAMassachusetts | — | $332.05 |
| Rest of MassachusettsMassachusetts | — | $312.45 |
| Baltimore area, MDMaryland | — | $335.78 |
| Rest of MarylandMaryland | — | $314.36 |
| Rest of MaineMaine | — | $291.08 |
| Southern Maine, MEMaine | — | $296.63 |
| Detroit, MIMichigan | — | $347.27 |
| Rest of MichiganMichigan | — | $315.81 |
| MinnesotaMinnesota | — | $282.68 |
| Metropolitan Kansas City, MOMissouri | — | $310.11 |
| Metropolitan St. Louis, MOMissouri | — | $312.29 |
| Rest of MissouriMissouri | — | $304.43 |
| MontanaMontana | — | $315.54 |
| North CarolinaNorth Carolina | — | $292.86 |
| North DakotaNorth Dakota | — | $286.08 |
| NebraskaNebraska | — | $279.15 |
| New HampshireNew Hampshire | — | $312.36 |
| Northern New JerseyNew Jersey | — | $342.74 |
| Rest of New JerseyNew Jersey | — | $334.84 |
| New MexicoNew Mexico | — | $319.68 |
| NevadaNevada | — | $307.40 |
| NYC suburbs and Long Island, NYNew York | — | $384.28 |
| Poughkeepsie and northern NYC suburbs, NYNew York | — | $341.64 |
| Queens, NYNew York | — | $363.13 |
| Rest of New YorkNew York | — | $297.27 |
| OhioOhio | — | $309.79 |
| OklahomaOklahoma | — | $296.86 |
| Portland, OROregon | — | $313.97 |
| Rest of OregonOregon | — | $300.57 |
| Metropolitan Philadelphia, PAPennsylvania | — | $331.68 |
| Rest of PennsylvaniaPennsylvania | — | $307.01 |
| Puerto RicoPuerto Rico | — | $315.68 |
| Rhode IslandRhode Island | — | $316.32 |
| South CarolinaSouth Carolina | — | $302.72 |
| South DakotaSouth Dakota | — | $282.59 |
| TennesseeTennessee | — | $286.06 |
| Austin, TXTexas | — | $314.52 |
| Beaumont, TXTexas | — | $305.64 |
| Brazoria, TXTexas | — | $305.60 |
| Dallas, TXTexas | — | $310.03 |
| Fort Worth, TXTexas | — | $309.96 |
| Galveston, TXTexas | — | $308.13 |
| Houston, TXTexas | — | $335.40 |
| Rest of TexasTexas | — | $307.15 |
| UtahUtah | — | $306.25 |
| VirginiaVirginia | — | $299.79 |
| Virgin Islands, VIUnited States Virgin Islands | — | $315.68 |
| VermontVermont | — | $290.34 |
| Rest of WashingtonWashington | — | $310.07 |
| King County, WAWashington | — | $332.54 |
| WisconsinWisconsin | — | $278.18 |
| West VirginiaWest Virginia | — | $327.68 |
| WyomingWyoming | — | $302.70 |
49591 rates by state
Office rate range in each state. Select a state to see its payment localities.
Explore a state
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
| State / territory | Office rate range | Localities |
|---|---|---|
| AK | No published base rate | 1 |
| AL | No published base rate | 1 |
| AR | No published base rate | 1 |
| AZ | No published base rate | 1 |
| CA | No published base rate | 29 |
| CO | No published base rate | 1 |
| CT | No published base rate | 1 |
| DC | No published base rate | 1 |
| DE | No published base rate | 1 |
| FL | No published base rate | 3 |
| GA | No published base rate | 2 |
| GU | No published base rate | 1 |
| HI | No published base rate | 1 |
| IA | No published base rate | 1 |
| ID | No published base rate | 1 |
| IL | No published base rate | 4 |
| IN | No published base rate | 1 |
| KS | No published base rate | 1 |
| KY | No published base rate | 1 |
| LA | No published base rate | 2 |
| MA | No published base rate | 2 |
| MD | No published base rate | 3 |
| ME | No published base rate | 2 |
| MI | No published base rate | 2 |
| MN | No published base rate | 1 |
| MO | No published base rate | 3 |
| MS | No published base rate | 1 |
| MT | No published base rate | 1 |
| NC | No published base rate | 1 |
| ND | No published base rate | 1 |
| NE | No published base rate | 1 |
| NH | No published base rate | 1 |
| NJ | No published base rate | 2 |
| NM | No published base rate | 1 |
| NV | No published base rate | 1 |
| NY | No published base rate | 5 |
| OH | No published base rate | 1 |
| OK | No published base rate | 1 |
| OR | No published base rate | 2 |
| PA | No published base rate | 2 |
| PR | No published base rate | 1 |
| RI | No published base rate | 1 |
| SC | No published base rate | 1 |
| SD | No published base rate | 1 |
| TN | No published base rate | 1 |
| TX | No published base rate | 8 |
| UT | No published base rate | 1 |
| VA | No published base rate | 2 |
| VI | No published base rate | 1 |
| VT | No published base rate | 1 |
| WA | No published base rate | 2 |
| WI | No published base rate | 1 |
| WV | No published base rate | 1 |
| WY | No published base rate | 1 |
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.
How the rate is built · 49591
RVUs × geographic indexes × conversion factor
Work5.81
5.81 RVUs× 1.000 GPCI
Practice expense2.15
2.15 RVUs× 1.000 GPCI
Malpractice1.49
1.49 RVUs× 1.000 GPCI
Adjusted RVUs
9.4500
Conversion factor
$33.4009
Medicare rate
$315.64
Every GPCI starts at 1.000, the national rate. Enter a ZIP or drag a slider.
The exact Mississippi inputs and CMS source lines
PPRRVU2026_Oct_nonQPP.csv
5,837
- Code
- 49591
- Physician work
- 5.81
- Practice expense
- 2.15
- Malpractice
- 1.49
GPCI2026.csv
67
- Locality
- Mississippi
- Physician work
- 1.000
- Practice expense
- 0.861
- Malpractice
- 0.739
| Component | RVU | Locality factor | Adjusted |
|---|---|---|---|
| Physician work | 5.81 | × 1.000 | 5.8100 |
| Practice expense | 2.15 | × 0.861 | 1.8511 |
| Malpractice | 1.49 | × 0.739 | 1.1011 |
| Total RVUs | 8.7623 | ||
| Conversion factor | × 33.4009 | ||
Facility rate, Mississippi$292.67
Facility: (5.81 × 1 + 2.15 × 0.861 + 1.49 × 0.739) × $33.4009 = $292.67
Payment rules and modifiers for 49591
The CMS indicators that decide how 49591 is paid alongside other services.
CMS payment indicators · 49591
Hernia repair, initial, under 3 cm, reducible
| Rule | CMS value | What it means |
|---|---|---|
| Global period | 000 | Same-day global: pre- and post-op care on the day of the procedure is included. |
| Multiple procedures | 2 | Standard reduction: highest-valued procedure at 100%, others at 50%. |
| Bilateral (modifier 50) | 0 | The 150% bilateral adjustment doesn’t apply. |
| 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. |
What modifiers do to the payment
Modifier 51 · payment effect
With and without the modifier
49591 without 51 · national facility
$315.64
Hernia repair, initial, under 3 cm, reducible
49591-51 · Second procedure: 50%
$157.82
When this isn’t the highest-valued procedure in the session, Medicare pays 50% of its fee schedule amount (the highest is paid at 100%).
How 49591 has changed in Mississippi
49591 · Office / nonfacility
Rate unavailable
Effective 2026-10-01
A rate is unavailable in one of these releases, so a change cannot be calculated.
One bar per available release, ordered by effective date. Missing rates remain gaps. These comparisons hold the code, setting and locality identifiers constant; they do not isolate which policy or input caused a change.
What changed, release by release
January 1, 2023
RVU23A
No ratechanged toNo rate
Held through RVU23B, RVU23C, RVU23D, RVU24A, RVU24AR, RVU24B, RVU24C, RVU24D, RVU25A, RVU25B, RVU25C, RVU25D, RVU26A, RVU26B, RVU26C, RVU26D.
January 1, 2013
RVU13AR
Earliest loaded release: No rate
Held through RVU13B, RVU13C, RVU13D, RVU14A, RVU14B, RVU14C, RVU14D, RVU15A, RVU15B, RVU15C, RVU15D, RVU16A, RVU16B, RVU16C, RVU16D, RVU17A, RVU17B, RVU17C, RVU17D, RVU18AR1, RVU18B, RVU18C, RVU18D, RVU19A, RVU19B, RVU19C, RVU19D, RVU20A, RVU20B, RVU20C, RVU20D, RVU21A, RVU21B, RVU21C, RVU21D, RVU22A, RVU22B, RVU22C, RVU22D.
| Effective from | Office | Facility | CMS release |
|---|---|---|---|
| 2026-10-01 | Not available in this setting | $292.67 | RVU26D |
| 2026-07-01 | Not available in this setting | $292.67 | RVU26C |
| 2026-04-01 | Not available in this setting | $292.67 | RVU26B |
| 2026-01-01 | Not available in this setting | $292.67 | RVU26A |
| 2025-10-01 | Not available in this setting | $308.67 | RVU25D |
| 2025-07-01 | Not available in this setting | $308.67 | RVU25C |
| 2025-04-01 | Not available in this setting | $308.67 | RVU25B |
| 2025-01-01 | Not available in this setting | $308.67 | RVU25A |
| 2024-10-01 | Not available in this setting | $315.90 | RVU24D |
| 2024-07-01 | Not available in this setting | $315.90 | RVU24C |
| 2024-04-01 | Not available in this setting | $315.90 | RVU24B |
| 2024-03-09 | Not available in this setting | $315.90 | RVU24AR |
| 2024-01-01 | Not available in this setting | $310.74 | RVU24A |
| 2023-10-01 | Not available in this setting | $317.43 | RVU23D |
| 2023-07-01 | Not available in this setting | $317.43 | RVU23C |
| 2023-04-01 | Not available in this setting | $317.43 | RVU23B |
| 2023-01-01 | Not available in this setting | $317.43 | RVU23A |
| 2022-10-01 | Not in this release | Not in this release | RVU22D |
| 2022-07-01 | Not in this release | Not in this release | RVU22C |
| 2022-04-01 | Not in this release | Not in this release | RVU22B |
| 2022-01-01 | Not in this release | Not in this release | RVU22A |
| 2021-10-01 | Not in this release | Not in this release | RVU21D |
| 2021-07-01 | Not in this release | Not in this release | RVU21C |
| 2021-04-01 | Not in this release | Not in this release | RVU21B |
| 2021-01-01 | Not in this release | Not in this release | RVU21A |
| 2020-10-01 | Not in this release | Not in this release | RVU20D |
| 2020-07-01 | Not in this release | Not in this release | RVU20C |
| 2020-04-01 | Not in this release | Not in this release | RVU20B |
| 2020-01-01 | Not in this release | Not in this release | RVU20A |
| 2019-10-01 | Not in this release | Not in this release | RVU19D |
| 2019-07-01 | Not in this release | Not in this release | RVU19C |
| 2019-04-01 | Not in this release | Not in this release | RVU19B |
| 2019-01-01 | Not in this release | Not in this release | RVU19A |
| 2018-10-01 | Not in this release | Not in this release | RVU18D |
| 2018-07-01 | Not in this release | Not in this release | RVU18C |
| 2018-04-01 | Not in this release | Not in this release | RVU18B |
| 2018-01-01 | Not in this release | Not in this release | RVU18AR1 |
| 2017-10-01 | Not in this release | Not in this release | RVU17D |
| 2017-07-01 | Not in this release | Not in this release | RVU17C |
| 2017-04-01 | Not in this release | Not in this release | RVU17B |
| 2017-01-01 | Not in this release | Not in this release | RVU17A |
| 2016-10-01 | Not in this release | Not in this release | RVU16D |
| 2016-07-01 | Not in this release | Not in this release | RVU16C |
| 2016-04-01 | Not in this release | Not in this release | RVU16B |
| 2016-01-01 | Not in this release | Not in this release | RVU16A |
| 2015-10-01 | Not in this release | Not in this release | RVU15D |
| 2015-07-01 | Not in this release | Not in this release | RVU15C |
| 2015-04-01 | Not in this release | Not in this release | RVU15B |
| 2015-01-01 | Not in this release | Not in this release | RVU15A |
| 2014-10-01 | Not in this release | Not in this release | RVU14D |
| 2014-07-01 | Not in this release | Not in this release | RVU14C |
| 2014-04-01 | Not in this release | Not in this release | RVU14B |
| 2014-01-01 | Not in this release | Not in this release | RVU14A |
| 2013-10-01 | Not in this release | Not in this release | RVU13D |
| 2013-07-01 | Not in this release | Not in this release | RVU13C |
| 2013-04-01 | Not in this release | Not in this release | RVU13B |
| 2013-01-01 | Not in this release | Not in this release | RVU13AR |
Where the Mississippi rate applies
Mississippi is a Medicare payment area, not a city. Our Census mapping connects it to 427 cities and communities in Mississippi. Some span more than one payment area; confirm with the service ZIP.
- Abbeville
- Aberdeen
- Ackerman
- Agricola
- Alcorn State University
- Algoma
- Alligator
- Amory
49591 billing questions
How is 49591 distinguished from 49592?
Both describe an initial anterior abdominal hernia repair for a defect under 3 cm. Use 49591 for a reducible hernia and 49592 when it is incarcerated or strangulated.
What documentation supports the size level?
The operative report should state the hernia site and the measured defect size. The defect must measure less than 3 cm for 49591.
Can mesh be billed separately with this repair?
Mesh may be used in the repair, but its placement is included in the hernia repair service represented by this code.
Should modifier 50 be appended for bilateral hernias?
No. Modifier 50 is inappropriate for this code under the CMS bilateral adjustment rule.
How does Medicare handle other procedures performed in the same session?
The highest-valued procedure is paid in full, and other procedures in the same session are subject to the standard multiple procedure reduction.
Can an assistant or co-surgeon be reported?
An assistant at surgery may be paid. 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
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