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CPT code 49900: Abdominal wall repair, incision disruption or evisceration2026 Medicare rate & RVUs

Reports operative reclosure of an abdominal incision after wound separation or evisceration, rather than repair of an abdominal hernia.

CMS RVU26DEffective Oct 1, 2026109 payment localities920 Medicare services in 2024

Medicare pays $800.29 for 49900 nationally in a facility.

Medicare rate · 49900

Abdominal wall repair, incision disruption or evisceration

Office or facility?

Work RVUs
12.1
Total RVUs
23.96
Global days
090

National rate · 2026

$800.29

Facility setting, before claim adjustments.

See every locality for 49900 →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 49900 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 49900 covers

CPT 49900 describes operative reclosure of an abdominal incision when the abdominal wall has separated, including cases with evisceration. A surgeon typically performs the repair in an operating room, often after a patient returns following recent abdominal surgery. The operative report should identify the wound disruption and describe the repair of the abdominal wall; routine dressing care or superficial skin closure alone does not establish this service.

Report 49900 when the surgeon repairs the disrupted abdominal wall, not when the procedure is an incisional hernia repair. The code has a 90-day global period: the day-before preoperative visit and 90 days of related postoperative care are 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. Modifier 50 is inappropriate. Assistant-at-surgery payment may be available; 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 49900 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

49900 office and facility rates by payment locality
Payment localityOfficeFacility
AlabamaUnavailable$719.39
AlaskaUnavailable$975.92
ArizonaUnavailable$776.53
ArkansasUnavailable$709.50
Atlanta, GAUnavailable$826.62
Austin, TXUnavailable$806.61
Bakersfield, CAUnavailable$796.54
Baltimore area, MDUnavailable$852.32
Beaumont, TXUnavailable$766.56
Brazoria, TXUnavailable$778.53

49900 rates by state

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

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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
49900 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 49900 rate is calculated

Each of 49900’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 · 49900

RVUs × geographic indexes × conversion factor

Office or facility?

Work12.10

12.10 RVUs× 1.000 GPCI

Practice expense8.82

8.82 RVUs× 1.000 GPCI

Malpractice3.04

3.04 RVUs× 1.000 GPCI

Adjusted RVUs

23.9600

Conversion factor

$33.4009

Medicare rate

$800.29

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

Payment rules and modifiers for 49900

49900 has a 90-day global period: related visits in that window are included in the surgery payment.

CMS payment indicators · 49900

Abdominal wall repair, incision disruption or evisceration

RuleCMS valueWhat it means
Global period090Major surgery: the day before, the day of, and 90 days after are 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.
Split (54/55/56)0.09/0.81/0.10Share of the payment for pre-op, the procedure itself, and post-op care.

Global surgery period · 49900

Abdominal wall repair, incision disruption or evisceration

90-day global period ends

Dec 30, 2026

Covers Sep 30, 2026 through Dec 30, 2026 (92 days, including the day before surgery).

Visit on Oct 31, 2026

Day 30 of the 90-day post-op period: related follow-up care is included in the surgical payment.

  • 24Unrelated E/M visit by the same physician
  • 79Unrelated procedure (starts its own global period)
  • 58Staged, more extensive, or therapy procedure that was planned
  • 78Unplanned return to the operating room for a related complication
SurgeryVisit
Sep 23, 2026Jan 10, 2027

Pre-op dayGlobal period

What modifiers do to the payment

Modifier 51 · payment effect

With and without the modifier

49900 without 51 · national facility

$800.29

Abdominal wall repair, incision disruption or evisceration

49900-51 · Second procedure: 50%

$400.15

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%).

When to use modifier 51

49900 compared with similar codes

Compare codes · National

4 codes, side by side

Office or facility?

  • 49900

    Abdominal wall repair, incision disruption or evisceration12.1 wRVU

    Not priced

  • 49002

    Abdominal reoperation, recent laparotomy17.19 wRVU

    Not priced

  • 49591

    Hernia repair, initial, under 3 cm, reducible5.81 wRVU

    Not priced

  • 49999

    Unlisted abdominal procedure, abdomen, peritoneum, omentum0 wRVU

    Not priced

How to choose

49002Abdominal reoperationRecent laparotomy
49002 represents reopening a recent laparotomy. Report 49900 for the abdominal wall repair when the incision has disrupted; both services may be relevant when both procedures are performed.
49591Hernia repairInitial, under 3 cm, reducible
49591 is for repair of a qualifying anterior abdominal hernia. Use 49900 for reclosure of a disrupted abdominal incision, not a hernia repair.
49999Unlisted abdominal procedureAbdomen, peritoneum, omentum
49999 is an unlisted abdominal procedure code for a service without a specific code. Use 49900 when the service is the described repair of a disrupted abdominal wall.

Codes related to 49900

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

Codes related to 49900
CodeHow it relatesNational office range
Often billed with
49002Abdominal reoperation, recent laparotomyMay describe reopening a recent laparotomy when the disrupted incision is re-entered for repair.No office rate
Used instead
49591Hernia repair, initial, under 3 cm, reducibleFor repair of a qualifying anterior abdominal hernia, rather than acute incision disruption.No office rate
49999Unlisted abdominal procedure, abdomen, peritoneum, omentumUnlisted abdominal procedure code when no specific code describes the procedure performed.No office rate

49900 billing questions

When should 49900 be chosen instead of an abdominal hernia repair code?

Use 49900 for operative repair of a disrupted abdominal incision, such as fascial separation or evisceration. Use a hernia repair code when the operative service repairs a hernia.

Can 49900 be reported with 49002?

49002 describes reopening a recent laparotomy, while 49900 describes repair of the disrupted abdominal wall. Both may be relevant when the surgeon reopens the incision and performs a distinct repair; the operative report should support each service.

Is modifier 50 appropriate for bilateral repair?

No. The abdominal wall repair is not reported with a bilateral adjustment under the CMS rule for this code.

What postoperative care is included?

The 90-day global period includes the day-before preoperative visit and 90 days of related postoperative care.

Can an assistant or co-surgeon be reported?

Assistant-at-surgery payment may be available. Co-surgeon payment requires supporting documentation; team surgery is not permitted.

What should the operative note document?

Document the abdominal wound disruption, whether evisceration occurred, and the operative repair performed on the abdominal wall. This helps distinguish the service from superficial wound care or hernia repair.

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 49900PPRRVU2026_Oct_nonQPP.csv, line 5,860 (RVU26D)

Open CMS sourceHow we calculate rates

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