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Billing code 39541: Diaphragm repairMedicare rate & RVUs

Repair a traumatic diaphragmatic hernia through a thoracic approach, typically when abdominal contents have displaced into the chest after injury.

CMS RVU26DEffective Oct 1, 2026109 payment localities108 Medicare services in 2024

Medicare pays $888.13 for 39541 nationally in a facility.

Medicare rate · 39541

Diaphragm repair

Work RVUs
15.36
Total RVUs
26.59
Global days
090

National rate · 2026

$888.13

Facility setting, before claim adjustments.

See every locality for 39541 →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.

On this page 10 sections
  1. Medicare rate
  2. What 39541 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 39541 covers

This service repairs a traumatic opening in the diaphragm through the chest. The surgeon returns displaced abdominal contents to the abdomen and closes or reconstructs the defect as needed. It is typically performed by a thoracic or general surgeon in an operating room, often during treatment of blunt or penetrating chest or abdominal trauma. The thoracic approach distinguishes this service from the abdominal approach used for the related repair code.

Report the code when the operative record supports repair of a traumatic diaphragmatic hernia by the thoracic route; document the injury, hernia, approach, and repair performed. The service has a 90-day global period, including the day-before preoperative visit and 90 days of related postoperative care. When multiple procedures are performed in the same session, the highest-valued procedure is paid in full and other procedures are subject to the standard 50% reduction. An assistant at surgery may be paid. 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 39541 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

39541 office and facility rates by payment locality
Payment localityOfficeFacility
AlabamaUnavailable$800.17
Alaska*Unavailable$1,100.70
ArizonaUnavailable$861.48
ArkansasUnavailable$789.51
AtlantaUnavailable$920.26
AustinUnavailable$888.05
BakersfieldUnavailable$869.15
Baltimore/Surr. CntysUnavailable$945.52
BeaumontUnavailable$856.90
BrazoriaUnavailable$860.81

39541 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
39541 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 39541 rate is calculated

Each of 39541’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 · 39541

RVUs × geographic indexes × conversion factor

Work15.36

15.36 RVUs× 1.000 GPCI

Practice expense7.25

7.25 RVUs× 1.000 GPCI

Malpractice3.98

3.98 RVUs× 1.000 GPCI

Adjusted RVUs

26.5900

Conversion factor

$33.4009

Medicare rate

$888.13

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

Payment rules and modifiers for 39541

39541 has a 90-day global period: related visits in that window are included in the surgery payment.

CMS payment indicators · 39541

Diaphragm repair

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)0.09/0.84/0.07Share of the payment for pre-op, the procedure itself, and post-op care.

Global surgery period · 39541

Diaphragm repair

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

39541 without 51 · national facility

$888.13

Diaphragm repair

39541-51 · Second procedure: 50%

$444.07

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

39541 compared with similar codes

Compare codes · National

4 codes, side by side

  • 39541

    Diaphragm repair15.36 wRVU

    Not priced

  • 39540

    Diaphragm hernia repair14.21 wRVU

    Not priced

  • 39503

    Diaphragm hernia repair106.19 wRVU

    Not priced

  • 39501

    Diaphragm repair13.63 wRVU

    Not priced

How to choose

39540Diaphragm hernia repair
The key distinction is the operative route: 39541 is the thoracic approach, while 39540 is the abdominal approach for traumatic diaphragmatic hernia repair.
39503Diaphragm hernia repair
39503 is for congenital diaphragmatic hernia repair in a neonatal patient; 39541 describes traumatic hernia repair through a thoracic approach.
39501Diaphragm repair
39501 addresses repair of a traumatic diaphragm laceration. Use 39541 when the condition being repaired is a traumatic diaphragmatic hernia.

Codes related to 39541

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

Codes related to 39541
CodeHow it relatesNational office range
Same family
39540Diaphragm hernia repairRepair of a traumatic diaphragmatic hernia by the abdominal approach.No office rate
Used instead
39503Diaphragm hernia repairUsed for congenital diaphragmatic hernia repair in a neonatal patient.No office rate
39501Diaphragm repairRepair of a traumatic diaphragm laceration rather than a diaphragmatic hernia.No office rate

39541 billing questions

How is 39541 distinguished from 39540?

Both describe repair of a traumatic diaphragmatic hernia in a non-neonatal patient. Select 39541 for the thoracic approach and 39540 for the abdominal approach.

What operative documentation supports 39541?

Document the traumatic hernia, the thoracic route, and the repair performed. The operative report should make the approach clear enough to distinguish it from an abdominal repair.

Are related postoperative visits separately reported during the global period?

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

Can an assistant or co-surgeon be reported?

An assistant at surgery may be paid. Co-surgeon payment requires supporting documentation; team surgery is not permitted.

How does the multiple-procedure reduction affect same-session services?

When other procedures are performed in the same session, the highest-valued procedure is paid in full and the others are subject to the standard 50% reduction.

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 39541PPRRVU2026_Oct_nonQPP.csv, line 4,784 (RVU26D)

Open CMS sourceHow we calculate rates

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