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CPT code 49659: Laparoscopic hernia procedure, unlisted service2026 Medicare rate & RVUs

Reports a laparoscopic hernia operation when no specific CPT code describes the procedure performed, with Medicare payment determined by the contractor.

CMS RVU26DEffective Oct 1, 2026109 payment localities2K Medicare services in 2024

Medicare rate · 49659

Laparoscopic hernia procedure, unlisted service

Office or facility?

Work RVUs
0
Total RVUs
0.00
Global days
YYY

National rate · 2026

—

Not priced in the facility setting.

See every locality for 49659 →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 49659 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 49659 covers

49659 is an unlisted laparoscopic code for a hernia operation that has no dedicated CPT code matching the procedure performed. A surgeon may report it for laparoscopic hernia repair when the anatomy and work do not fit a more specific listed code. It is used for operative treatment, typically in a hospital or ambulatory surgery setting. The operative report should identify the hernia site, laparoscopic approach, work performed, and why a named code does not represent the service.

For Medicare, status C means CMS publishes no national physician fee schedule payment; the Medicare Administrative Contractor sets payment for each claim and determines the global period. When multiple procedures are performed in one session, the highest-valued procedure is paid in full and the others are subject to the standard multiple-procedure reduction. Modifier 50 invokes the bilateral payment rule. Include a clear operative narrative to support the unlisted service and contractor review.

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 49659 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

49659 office and facility rates by payment locality
Payment localityOfficeFacility
AlabamaUnavailableUnavailable
AlaskaUnavailableUnavailable
ArizonaUnavailableUnavailable
ArkansasUnavailableUnavailable
Atlanta, GAUnavailableUnavailable
Austin, TXUnavailableUnavailable
Bakersfield, CAUnavailableUnavailable
Baltimore area, MDUnavailableUnavailable
Beaumont, TXUnavailableUnavailable
Brazoria, TXUnavailableUnavailable

49659 rates by state

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

MEWIVTNHMTNDMNMINYMARIWAIDWYSDIAILINOHPANJCTORNVUTCONEMOKYWVVAMDDECAAZNMKSOKARTNNCSCDCTXLAMSALGAFLAKHI

Explore a state

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
49659 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 49659 rate is calculated

Each of 49659’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 · 49659

RVUs × geographic indexes × conversion factor

Office or facility?

Work0.00

0.00 RVUs× 1.000 GPCI

Practice expense0.00

0.00 RVUs× 1.000 GPCI

Malpractice0.00

0.00 RVUs× 1.000 GPCI

Adjusted RVUs

0.0000

Conversion factor

$33.4009

Medicare rate

$0.00

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

Payment rules and modifiers for 49659

The CMS indicators that decide how 49659 is paid alongside other services.

CMS payment indicators · 49659

Laparoscopic hernia procedure, unlisted service

RuleCMS valueWhat it means
Global periodYYYThe Medicare contractor sets the global period.
Multiple procedures2Standard reduction: highest-valued procedure at 100%, others at 50%.
Bilateral (modifier 50)1Bilateral with modifier 50 pays 150% of the fee schedule amount.
Assistant at surgery (80/81/82/AS)2Paid.
Co-surgeons (62)1Permitted with supporting documentation.
Team surgery (66)1Permitted with supporting documentation.
Professional/technical0Physician service: no professional/technical split.

What modifiers do to the payment

Modifier 50 · payment effect

With and without the modifier

49659 without 50 · national facility

$0.00

Laparoscopic hernia procedure, unlisted service

49659-50 · Bilateral: 150%

$0.00

Both sides on one line with modifier 50 are paid at 150% of the fee schedule amount (subject to multiple-procedure rules with other procedures).

When to use modifier 50

49659 compared with similar codes

Compare codes · National

5 codes, side by side

Office or facility?

  • 49659

    Laparoscopic hernia procedure, unlisted service0 wRVU

    Not priced

  • 49650

    Inguinal hernia repair, laparoscopic, initial6.2 wRVU

    Not priced

  • 49651

    Inguinal hernia repair, laparoscopic, recurrent8.17 wRVU

    Not priced

  • 49613

    Abdominal hernia repair, recurrent, reducible, under 3 cm7.23 wRVU

    Not priced

  • 49615

    Hernia repair, recurrent, 3–10 cm, reducible11.17 wRVU

    Not priced

How to choose

49650Inguinal hernia repairLaparoscopic, initial
49650 describes an initial laparoscopic inguinal hernia repair. Choose 49659 only when the procedure performed is not represented by a specific listed code.
49651Inguinal hernia repairLaparoscopic, recurrent
49651 describes a recurrent laparoscopic inguinal hernia repair. It is the listed choice when that specific service is performed.
49613Abdominal hernia repairRecurrent, reducible, under 3 cm
49613 identifies a qualifying recurrent anterior abdominal hernia repair with a reducible defect under 3 cm. Use the specific code when the repair meets its criteria rather than reporting an unlisted service.
49615Hernia repairRecurrent, 3–10 cm, reducible
49615 identifies a qualifying recurrent anterior abdominal hernia repair with a reducible defect from 3 to 10 cm. Use it when applicable; 49659 is for a procedure without a fitting specific code.

Codes related to 49659

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

Codes related to 49659
CodeHow it relatesNational office range
Used instead
49650Inguinal hernia repair, laparoscopic, initialUse for a listed initial laparoscopic inguinal hernia repair.No office rate
49651Inguinal hernia repair, laparoscopic, recurrentUse for a listed recurrent laparoscopic inguinal hernia repair.No office rate
49613Abdominal hernia repair, recurrent, reducible, under 3 cmSpecific code for qualifying recurrent anterior abdominal hernia repair with a reducible defect under 3 cm.No office rate
49615Hernia repair, recurrent, 3–10 cm, reducibleSpecific code for qualifying recurrent anterior abdominal hernia repair with a reducible defect from 3 to 10 cm.No office rate

49659 billing questions

When should 49659 be used instead of 49650?

Use 49650 for a listed initial laparoscopic inguinal hernia repair. Use 49659 only when no specific CPT code describes the laparoscopic hernia procedure performed.

What should the operative documentation include?

Describe the hernia site, laparoscopic approach, repair performed, and relevant operative work. Explain why a specific listed code does not represent the procedure.

How does Medicare price 49659?

Status C means there is no national physician fee schedule payment; the Medicare Administrative Contractor sets payment for each claim.

How are bilateral procedures and multiple procedures treated?

Modifier 50 invokes the bilateral payment rule. For multiple procedures in the same session, the highest-valued procedure is paid in full and the others are subject to the standard reduction.

Who sets the global period?

The Medicare contractor sets the global period for this code.

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

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