CPT code 49593: Abdominal hernia repair, initial, reducible, 3–10 cm2026 Medicare rate & RVUs

Medicare pays $525.06 for 49593 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 49593 covers

Code 49593 describes initial repair of an anterior abdominal hernia, such as a ventral, incisional, umbilical, or epigastric hernia. A surgeon may perform the operation open, laparoscopically, or robotically; the approach does not change code selection. Mesh or another prosthesis may be used as part of the repair and is included in this service.

Select the code when the hernia is reducible and the total length of the defect or defects is 3–10 cm. The operative report should support the hernia site, initial-repair status, reducibility, and measured defect length. CMS assigns a 0-day global period, so same-day preoperative and postoperative care is included. When multiple procedures occur in the same session, the highest-valued procedure is paid in full and other procedures are subject to the standard 50% reduction. Modifier 50 is inappropriate. Assistant-at-surgery payment may be made; 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 49593 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

49593 rates by state

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

How the 49593 rate is calculated

Each of 49593’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 49593

The CMS indicators that decide how 49593 is paid alongside other services.

What modifiers do to the payment

When to use modifier 51

49593 compared with similar codes

How to choose

49591Hernia repairInitial, under 3 cm, reducible

Both are for initial, reducible anterior abdominal hernia repairs. Use 49591 when the total defect length is under 3 cm; use 49593 for 3–10 cm.

49594Hernia repairInitial, 3–10 cm, incarcerated

This is the 3–10 cm counterpart for an incarcerated or strangulated hernia. Code 49593 is for a reducible hernia in that size range.

49595Abdominal hernia repairInitial, over 10 cm, reducible

Both are for initial, reducible repairs, but 49595 applies when the total defect length is greater than 10 cm.

49592Abdominal hernia repairIncarcerated or strangulated, under 3 cm

This code covers an initial hernia repair under 3 cm when the hernia is incarcerated or strangulated; 49593 is for a 3–10 cm reducible hernia.

Codes related to 49593

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