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CPT code 49618: Abdominal hernia repair, recurrent, over 10 cm2026 Medicare rate & RVUs

Repair a recurrent anterior abdominal hernia with a total defect length over 10 cm when the hernia is incarcerated or strangulated.

CMS RVU26DEffective Oct 1, 2026109 payment localities3K Medicare services in 2024

Medicare pays $1,131.62 for 49618 nationally in a facility.

Medicare rate · 49618

Abdominal hernia repair, recurrent, over 10 cm

Office or facility?

Work RVUs
22.1
Total RVUs
33.88
Global days
000

National rate · 2026

$1,131.62

Facility setting, before claim adjustments.

See every locality for 49618 →Billed by an NP, PA or therapist? →

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

Your location

Medicare pays by the payment locality where the service is performed.

On this page 10 sections
  1. Medicare rate
  2. What 49618 covers
  3. By payment locality
  4. Rate map
  5. How it’s calculated
  6. Payment rules
  7. Similar codes
  8. Related codes
  9. Billing questions
  10. Sources

What 49618 covers

This code represents operative repair of a recurrent anterior abdominal wall hernia when the total length of the defect or defects is greater than 10 cm and the hernia is incarcerated or strangulated. General and acute care surgeons commonly perform the repair in a hospital operating room, using an open, laparoscopic, or robotic approach. Mesh or another prosthesis may be implanted as part of the repair.

Choose the code from the operative findings: the hernia must be recurrent, the total defect length must exceed 10 cm, and the hernia must be incarcerated or strangulated. Documentation should establish the prior repair, defect measurement, and clinical status, along with the repair performed. Mesh placement is included in the hernia repair. 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 49618 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

49618 office and facility rates by payment locality
Payment localityOfficeFacility
AlabamaUnavailable$1,023.71
AlaskaUnavailable$1,428.59
ArizonaUnavailable$1,097.95
ArkansasUnavailable$1,010.77
Atlanta, GAUnavailable$1,175.29
Austin, TXUnavailable$1,123.23
Bakersfield, CAUnavailable$1,090.87
Baltimore area, MDUnavailable$1,203.32
Beaumont, TXUnavailable$1,099.82
Brazoria, TXUnavailable$1,093.89

49618 rates by state

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

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Local rates. Clear comparisons.

Hover or focus a tile to see its rate range. Select it to open the state’s fee schedule.

View every state and territory as a table
49618 office rate range by state
State / territoryOffice rate rangeLocalities
AKNo published base rate1
ALNo published base rate1
ARNo published base rate1
AZNo published base rate1
CANo published base rate29
CONo published base rate1
CTNo published base rate1
DCNo published base rate1
DENo published base rate1
FLNo published base rate3
GANo published base rate2
GUNo published base rate1
HINo published base rate1
IANo published base rate1
IDNo published base rate1
ILNo published base rate4
INNo published base rate1
KSNo published base rate1
KYNo published base rate1
LANo published base rate2
MANo published base rate2
MDNo published base rate3
MENo published base rate2
MINo published base rate2
MNNo published base rate1
MONo published base rate3
MSNo published base rate1
MTNo published base rate1
NCNo published base rate1
NDNo published base rate1
NENo published base rate1
NHNo published base rate1
NJNo published base rate2
NMNo published base rate1
NVNo published base rate1
NYNo published base rate5
OHNo published base rate1
OKNo published base rate1
ORNo published base rate2
PANo published base rate2
PRNo published base rate1
RINo published base rate1
SCNo published base rate1
SDNo published base rate1
TNNo published base rate1
TXNo published base rate8
UTNo published base rate1
VANo published base rate2
VINo published base rate1
VTNo published base rate1
WANo published base rate2
WINo published base rate1
WVNo published base rate1
WYNo published base rate1

How the 49618 rate is calculated

Each of 49618’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 · 49618

RVUs × geographic indexes × conversion factor

Office or facility?

Work22.10

22.10 RVUs× 1.000 GPCI

Practice expense6.09

6.09 RVUs× 1.000 GPCI

Malpractice5.69

5.69 RVUs× 1.000 GPCI

Adjusted RVUs

33.8800

Conversion factor

$33.4009

Medicare rate

$1,131.62

Every GPCI starts at 1.000, the national rate. Enter a ZIP or drag a slider.

Payment rules and modifiers for 49618

The CMS indicators that decide how 49618 is paid alongside other services.

CMS payment indicators · 49618

Abdominal hernia repair, recurrent, over 10 cm

RuleCMS valueWhat it means
Global period000Same-day global: pre- and post-op care on the day of the procedure is included.
Multiple procedures2Standard reduction: highest-valued procedure at 100%, others at 50%.
Bilateral (modifier 50)0The 150% bilateral adjustment doesn’t apply.
Assistant at surgery (80/81/82/AS)2Paid.
Co-surgeons (62)1Permitted with supporting documentation.
Team surgery (66)0Not permitted.
Professional/technical0Physician service: no professional/technical split.

What modifiers do to the payment

Modifier 51 · payment effect

With and without the modifier

49618 without 51 · national facility

$1,131.62

Abdominal hernia repair, recurrent, over 10 cm

49618-51 · Second procedure: 50%

$565.81

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%).

When to use modifier 51

49618 compared with similar codes

Compare codes · National

4 codes, side by side

Office or facility?

  • 49618

    Abdominal hernia repair, recurrent, over 10 cm22.1 wRVU

    Not priced

  • 49617

    Abdominal hernia repair, recurrent, over 10 cm, reducible15.63 wRVU

    Not priced

  • 49616

    Hernia repair, recurrent, 3-10 cm, incarcerated15.16 wRVU

    Not priced

  • 49596

    Abdominal hernia repair, initial, over 10 cm, incarcerated18.2 wRVU

    Not priced

How to choose

49617Abdominal hernia repairRecurrent, over 10 cm, reducible
Both are for recurrent defects over 10 cm. 49617 applies when the hernia is reducible; 49618 applies when it is incarcerated or strangulated.
49616Hernia repairRecurrent, 3-10 cm, incarcerated
Both describe recurrent incarcerated or strangulated hernias, but 49616 is for a total defect length of 3 to 10 cm; 49618 is for over 10 cm.
49596Abdominal hernia repairInitial, over 10 cm, incarcerated
This code is for an initial anterior abdominal hernia over 10 cm that is incarcerated or strangulated. Use 49618 when the hernia is recurrent.

Codes related to 49618

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

Codes related to 49618
CodeHow it relatesNational office range
Same family
49617Abdominal hernia repair, recurrent, over 10 cm, reducibleRecurrent defect over 10 cm when reducible.No office rate
49616Hernia repair, recurrent, 3-10 cm, incarceratedRecurrent incarcerated or strangulated defect measuring 3 to 10 cm.No office rate
49614Hernia repair, recurrent, under 3 cmRecurrent incarcerated or strangulated defect measuring less than 3 cm.No office rate
Used instead
49596Abdominal hernia repair, initial, over 10 cm, incarceratedUse for an initial, rather than recurrent, large incarcerated or strangulated anterior abdominal hernia.No office rate

49618 billing questions

How does this code differ from 49617?

Both describe repair of a recurrent anterior abdominal hernia with a total defect length over 10 cm. Use 49618 when the hernia is incarcerated or strangulated; 49617 is for a reducible hernia.

Is mesh separately reportable with this repair?

Mesh or another prosthesis placed as part of the hernia repair is included in the code. The repair should not be split into separate hernia-repair and mesh-placement charges.

What documentation supports the size level?

Document the total length of the defect or defects and the operative findings supporting that the hernia is recurrent and incarcerated or strangulated.

Should modifier 50 be appended for more than one defect?

No. CMS identifies modifier 50 as inappropriate for this code; multiple defects are considered in the total defect length used to select the code.

How are other procedures in the same session paid?

Under the standard multiple-procedure reduction, the highest-valued procedure is paid in full and other procedures are subject to a 50% reduction. The code has a 0-day global period, which includes same-day preoperative and postoperative care.

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

Show the CMS file lines behind this rate
RVUs for 49618PPRRVU2026_Oct_nonQPP.csv, line 5,853 (RVU26D)

Open CMS sourceHow we calculate rates

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