CPT code 49613: Abdominal hernia repair, recurrent, reducible, under 3 cm2026 Medicare rate & RVUs in Indiana

In Indiana, Medicare pays $349.09 for 49613 in a facility. There’s no office rate.

Check a contract rate as a % of Medicare · 49613 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 49613 covers

This code describes repair of a previously repaired anterior abdominal hernia that is reducible and has a total defect length under 3 cm. These repairs are commonly performed by general surgeons in a hospital or ambulatory surgery setting. The code covers recognized anterior abdominal hernia sites, such as incisional, ventral, umbilical, epigastric, and Spigelian hernias, and includes mesh or other prosthesis implantation when performed. The repair may use an open, laparoscopic, or robotic approach.

Select the code using the hernia’s recurrence status, reducibility, and total length of the defect or defects repaired. The operative report should establish the prior repair, reducibility, measured defect length, and repair performed. CMS assigns a 0-day global period, so same-day preoperative and postoperative care is included. When multiple procedures occur in one session, the highest-valued procedure is paid in full and other procedures are subject to the standard multiple-procedure reduction. Modifier 50 is inappropriate. Assistant-at-surgery payment may be available; 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 Indiana compares for 49613

Across 109 of 109 payment localities, the facility rate for 49613 runs from $340.62 in Wisconsin to $485.53 in Miami, FL. Indiana pays $349.09. The RVUs are the same everywhere; the geographic indexes change the dollars.

Every other payment area

49613 rates by state

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

See 49613 in every payment locality

How the 49613 rate is calculated

Each of 49613’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 49613

The CMS indicators that decide how 49613 is paid alongside other services.

What modifiers do to the payment

When to use modifier 51

Codes related to 49613

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

How 49613 has changed in Indiana

Price 49613 for an earlier date of service

Where the Indiana rate applies

Indiana is a Medicare payment area, not a city. Our Census mapping connects it to 974 cities and communities in Indiana. Some span more than one payment area; confirm with the service ZIP.

• Aberdeen
• Abington
• Adams
• Adams Lake
• Advance
• Akron
• Alamo
• Albany

Browse all communities in Indiana

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