CPT code 49596: Abdominal hernia repair, initial, over 10 cm, incarcerated2026 Medicare rate & RVUs in Connecticut

In Connecticut, Medicare pays $995.04 for 49596 in a facility. There’s no office rate.

Check a contract rate as a % of Medicare · 49596 nationwide

Medicare allowed amount for participating (non-QP) physicians, before deductible, coinsurance and claim adjustments. Not a patient’s bill or a hospital charge.

What 49596 covers

This code covers initial repair of an anterior abdominal hernia, such as a ventral, incisional, umbilical, or epigastric hernia, when the hernia is incarcerated or strangulated and the defect exceeds 10 cm. General surgeons commonly perform the repair in a hospital or ambulatory surgical setting. The code includes open, laparoscopic, and robotic approaches, and includes mesh or another prosthesis when used.

Select the code from the operative findings: document that the repair is initial, the hernia’s incarcerated or strangulated status, and the defect measurement. When multiple defects are repaired, document their measurements to support the applicable size category. Same-day preoperative and postoperative care is included in the 0-day global period. In a same-session multiple-procedure claim, the highest-valued procedure is paid in full and other procedures are subject to the standard 50% reduction. Modifier 50 is inappropriate. An assistant at surgery may be paid; co-surgeons require 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 Connecticut compares for 49596

Across 109 of 109 payment localities, the facility rate for 49596 runs from $820.07 in Wisconsin to $1,185.12 in Miami, FL. Connecticut pays $995.04. The RVUs are the same everywhere; the geographic indexes change the dollars.

Every other payment area

49596 rates by state

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

See 49596 in every payment locality

How the 49596 rate is calculated

Each of 49596’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 49596

The CMS indicators that decide how 49596 is paid alongside other services.

What modifiers do to the payment

When to use modifier 51

Codes related to 49596

Related codes aren’t interchangeable: bill the code that matches the service performed.

How 49596 has changed in Connecticut

Price 49596 for an earlier date of service

Where the Connecticut rate applies

Connecticut is a Medicare payment area, not a city. Our Census mapping connects it to 215 cities and communities in Connecticut. Some span more than one payment area; confirm with the service ZIP.

• Ansonia
• Ball Pond
• Baltic
• Bantam
• Bethel
• Bethlehem Village
• Bigelow Corners
• Blue Hills

Browse all communities in Connecticut

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