CPT code 49622: Parastomal hernia repair, incarcerated or strangulated2026 Medicare rate & RVUs in California
Repair an incarcerated or strangulated hernia at a stoma site; select this code rather than the reducible parastomal hernia repair code.
CMS doesn’t publish an office rate for 49622 in California.
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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On this page 9 sections
What 49622 covers
This code covers operative repair of a parastomal hernia when the hernia is incarcerated or strangulated. The defect is in the abdominal wall around a stoma, such as a colostomy or ileostomy. General or colorectal surgeons commonly perform the repair in a hospital or other surgical facility. The code applies to the hernia repair whether the surgeon uses an open or minimally invasive approach; mesh may be used to reinforce the repair.
Choose this code based on the hernia’s parastomal location and incarcerated or strangulated status, not on the approach. A reducible parastomal hernia is reported with 49621. Document the stoma site and the finding that the hernia is incarcerated or strangulated. CMS assigns a 0-day global period, so same-day preoperative and postoperative care is included. When multiple procedures are performed in one session, the highest-valued procedure is paid in full and the others at 50%. 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 49622 pays more and less in California
The same RVUs, adjusted for each area’s costs. Open a locality for its calculation, history and nearby areas.
29 of 29 payment localities
| Payment locality | Office | Facility |
|---|---|---|
| Bakersfield, CA | Unavailable | $821.83 |
| Chico, CA | Unavailable | $810.72 |
| El Centro, CA | Unavailable | $811.41 |
| Fresno, CA | Unavailable | $810.72 |
| Hanford, CA | Unavailable | $810.72 |
| Los Angeles, CA | Unavailable | $855.27 |
| Madera, CA | Unavailable | $810.72 |
| Marin County, CA | Unavailable | $892.90 |
| Merced, CA | Unavailable | $810.72 |
| Modesto, CA | Unavailable | $810.72 |
| Napa, CA | Unavailable | $867.36 |
| Oxnard, CA | Unavailable | $842.28 |
| Redding, CA | Unavailable | $810.72 |
| Rest of California | Unavailable | $810.72 |
| Riverside, CA | Unavailable | $854.69 |
| Sacramento, CA | Unavailable | $831.82 |
| Salinas, CA | Unavailable | $828.41 |
| San Benito County, CA | Unavailable | $916.81 |
| San Diego, CA | Unavailable | $834.50 |
| San Francisco, CA | Unavailable | $888.25 |
| San Luis Obispo, CA | Unavailable | $817.49 |
| Santa Clara County, CA | Unavailable | $897.78 |
| Santa Cruz, CA | Unavailable | $831.67 |
| Santa Maria, CA | Unavailable | $827.84 |
| Santa Rosa, CA | Unavailable | $838.71 |
| Stockton, CA | Unavailable | $810.72 |
| Vallejo, CA | Unavailable | $860.65 |
| Visalia, CA | Unavailable | $810.72 |
| Yuba City, CA | Unavailable | $810.72 |
How the 49622 rate is calculated
Each of 49622’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 · 49622
RVUs × geographic indexes × conversion factor
Work16.63
16.63 RVUs× 1.000 GPCI
Practice expense4.71
4.71 RVUs× 1.000 GPCI
Malpractice4.10
4.10 RVUs× 1.000 GPCI
Adjusted RVUs
25.4400
Conversion factor
$33.4009
Medicare rate
$849.72
Every GPCI starts at 1.000, the national rate. Enter a ZIP or drag a slider.
Payment rules and modifiers for 49622
The CMS indicators that decide how 49622 is paid alongside other services.
CMS payment indicators · 49622
Parastomal hernia repair, incarcerated or strangulated
| 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
49622 without 51 · national facility
$849.72
Parastomal hernia repair, incarcerated or strangulated
49622-51 · Second procedure: 50%
$424.86
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%).
49622 compared with similar codes
Compare codes · National
4 codes, side by side
How to choose
- 49621Hernia repairReducible parastomal hernia
- Both codes describe parastomal hernia repair. Choose 49622 for an incarcerated or strangulated hernia and 49621 for a reducible one.
- 49623Mesh removalDuring hernia repair
- This add-on addresses removal of noninfected mesh during a hernia repair; it does not replace the primary repair code.
- 49616Hernia repairRecurrent, 3-10 cm, incarcerated
- This code is for a qualifying anterior abdominal hernia, not a defect around a stoma. Use 49622 when the repaired hernia is parastomal and incarcerated or strangulated.
49622 billing questions
When should 49622 be chosen over 49621?
Use 49622 for a parastomal hernia that is incarcerated or strangulated. Use 49621 when the parastomal hernia is reducible.
Is mesh placement separately reported?
Mesh used to reinforce the hernia repair is included in the repair code. Noninfected mesh removal at the time of repair may be reported with add-on code 49623 when applicable.
Can modifier 50 be reported?
No. The parastomal anatomy makes bilateral adjustment and modifier 50 inappropriate.
Does this code have a postoperative global period?
It has a 0-day global period. Same-day preoperative and postoperative care is included.
How are other procedures in the same session paid?
CMS pays the highest-valued procedure in full and the other procedures at 50% when performed in the same session.
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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