CPT code 49592: Abdominal hernia repair, incarcerated or strangulated, under 3 cm2026 Medicare rate & RVUs

Medicare pays $436.88 for 49592 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 49592 covers

A surgeon uses this code for the first repair of an anterior abdominal hernia, such as an umbilical, epigastric, ventral, incisional, or Spigelian hernia, when the contents cannot be returned to the abdomen or the hernia is strangulated and the defect is under 3 cm. The repair may be open, laparoscopic, or robotic. Mesh or another prosthesis is included when placed. These cases are commonly performed in an operating room for a painful or obstructed abdominal-wall bulge.

Select the code based on initial versus recurrent repair, reducibility or strangulation, and total transverse defect length. When multiple defects are repaired, add their lengths under the family rules. The operative report should support the hernia site, clinical condition, measurements, approach, and prosthesis use. CMS assigns a 0-day global period, so same-day preoperative and postoperative care is included. For multiple procedures in one session, the highest-valued procedure is paid in full and others at 50%. Modifier 50 is inappropriate. 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 49592 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

49592 rates by state

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

How the 49592 rate is calculated

Each of 49592’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 49592

The CMS indicators that decide how 49592 is paid alongside other services.

What modifiers do to the payment

When to use modifier 51

49592 compared with similar codes

How to choose

49591Hernia repairInitial, under 3 cm, reducible

This code applies when the under-3-cm hernia is incarcerated or strangulated. Use 49591 for the same size and initial-repair category when the hernia is reducible.

49594Hernia repairInitial, 3–10 cm, incarcerated

Both cover initial incarcerated or strangulated repairs, but 49594 is for a total defect length from 3 cm through 10 cm; this code is for under 3 cm.

49596Abdominal hernia repairInitial, over 10 cm, incarcerated

Both cover initial incarcerated or strangulated repairs, but 49596 is for a total defect length over 10 cm.

Codes related to 49592

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