CPT code 49659: Laparoscopic hernia procedure, unlisted service2026 Medicare rate & RVUs in Washington, DC area

CMS doesn’t publish a rate for 49659 in Washington, DC area.

Check a contract rate as a % of Medicare · 49659 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 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.

How Washington, DC area compares for 49659

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49659 rates by state

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

See 49659 in every payment locality

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.

Payment rules and modifiers for 49659

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

What modifiers do to the payment

When to use modifier 50

Codes related to 49659

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

How 49659 has changed in Washington, DC area

Price 49659 for an earlier date of service

Where the Washington, DC area rate applies

Washington, DC area is a Medicare payment area, not a city. Our Census mapping connects it to 1 cities and communities in District of Columbia. Some span more than one payment area; confirm with the service ZIP.

• Washington

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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