CPT code 49617: Abdominal hernia repair, recurrent, over 10 cm, reducible2026 Medicare rate & RVUs in Missouri
Reports operative repair of a recurrent, reducible anterior abdominal hernia when the total defect length is greater than 10 cm.
CMS doesn’t publish an office rate for 49617 in Missouri.
Medicare allowed amount for participating (non-QP) physicians, before deductible, coinsurance and claim adjustments. Not a patient’s bill or a hospital charge.
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What 49617 covers
A surgeon repairs a recurrent hernia of the anterior abdominal wall, such as a recurrent ventral or incisional hernia. The defect is reducible and its total length is greater than 10 cm. Repair may be performed through an open, laparoscopic, or robotic approach. These operations are typically performed in a hospital or ambulatory surgery facility by a general surgeon or another surgeon who treats abdominal wall hernias.
Choose this code based on the documented recurrence, reducibility, and total defect length—not the size of the hernia sac. The operative report should support the prior repair, the defect measurement, and whether the contents could be reduced. Mesh or another prosthesis used in the repair is included in the hernia repair service. Medicare 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 other procedures are subject to the standard 50% reduction. Assistant-at-surgery payment may be made; co-surgeons require supporting documentation, and team surgery is not permitted. Modifier 50 is inappropriate for this code.
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 49617 pays more and less in Missouri
The same RVUs, adjusted for each area’s costs. Open a locality for its calculation, history and nearby areas.
| Payment locality | Office | Facility |
|---|---|---|
| Metropolitan Kansas City, MO | Unavailable | $795.92 |
| Metropolitan St. Louis, MO | Unavailable | $801.24 |
| Rest of Missouri | Unavailable | $783.76 |
How the 49617 rate is calculated
Each of 49617’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 · 49617
RVUs × geographic indexes × conversion factor
Work15.63
15.63 RVUs× 1.000 GPCI
Practice expense4.57
4.57 RVUs× 1.000 GPCI
Malpractice4.00
4.00 RVUs× 1.000 GPCI
Adjusted RVUs
24.2000
Conversion factor
$33.4009
Medicare rate
$808.30
Every GPCI starts at 1.000, the national rate. Enter a ZIP or drag a slider.
Payment rules and modifiers for 49617
The CMS indicators that decide how 49617 is paid alongside other services.
CMS payment indicators · 49617
Abdominal hernia repair, recurrent, over 10 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
49617 without 51 · national facility
$808.30
Abdominal hernia repair, recurrent, over 10 cm, reducible
49617-51 · Second procedure: 50%
$404.15
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%).
49617 compared with similar codes
Compare codes · National
4 codes, side by side
How to choose
- 49618Abdominal hernia repairRecurrent, over 10 cm
- Use 49618 for a recurrent defect over 10 cm that is incarcerated or strangulated; 49617 is for a reducible defect.
- 49595Abdominal hernia repairInitial, over 10 cm, reducible
- Both cover a reducible defect over 10 cm. Use 49595 for an initial repair and 49617 for a recurrent repair.
- 49615Hernia repairRecurrent, 3–10 cm, reducible
- Both describe recurrent, reducible repair, but 49615 is for a defect in the 3–10 cm group rather than one over 10 cm.
49617 billing questions
How is this code distinguished from 49618?
Both describe recurrent anterior abdominal hernia repair for a defect over 10 cm. Use 49617 when the hernia is reducible and 49618 when it is incarcerated or strangulated.
Does the defect measurement refer to the hernia sac?
No. Selection is based on the total length of the abdominal wall defect, not the size of the sac. The operative report should document the measurement supporting the level.
Can mesh placement be billed separately?
Mesh or another prosthesis used as part of this hernia repair is included in the repair service.
Can modifier 50 be used for bilateral repair?
No. Modifier 50 is inappropriate for this code's anatomy and descriptor.
What documentation supports reporting recurrent repair?
The operative report should establish that the hernia has recurred after a prior repair, describe reducibility, and document a total defect length greater than 10 cm.
How are other procedures in the same session paid?
When multiple procedures are performed in the same session, Medicare pays the highest-valued procedure in full and applies the standard 50% reduction to the others.
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
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