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Billing code 49250: Umbilical excisionMedicare rate & RVUs

Reports surgical removal of the umbilicus for localized disease or as a distinct operative service, rather than routine umbilical hernia repair.

CMS RVU26DEffective Oct 1, 2026109 payment localities135 Medicare services in 2024

Medicare pays $568.15 for 49250 nationally in a facility.

Medicare rate · 49250

Umbilical excision

Swap in your local Medicare rate.

Work RVUs
8.78
Total RVUs
17.01
Global days
090

National rate · 2026

$568.15

Facility setting, before claim adjustments.

See every locality for 49250 → · 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 49250 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 49250 covers

This code describes removal of the navel itself by a surgeon, commonly during an open abdominal operation or to treat disease centered in the umbilicus. The procedure may be performed by a general, gynecologic, or oncologic surgeon. The operative note should identify the condition prompting removal and document that the umbilicus was excised, not merely used as an access point or affected incidentally during another procedure.

The code is designated a separate procedure, so report it separately when the excision is distinct rather than integral to a more extensive operation. Documentation should make the operative work and its relationship to other procedures clear. Medicare assigns a 90-day global period, including the day-before preoperative visit and 90 days of related postoperative care. When multiple procedures occur 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 for excision of this single anatomic structure. Medicare does not pay an assistant at surgery for this code; 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 49250 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

49250 office and facility rates by payment locality
Payment localityOfficeFacility
AlabamaUnavailable$512.11
Alaska*Unavailable$696.59
ArizonaUnavailable$551.70
ArkansasUnavailable$505.26
AtlantaUnavailable$586.40
AustinUnavailable$572.62
BakersfieldUnavailable$565.95
Baltimore/Surr. CntysUnavailable$604.41
BeaumontUnavailable$544.74
BrazoriaUnavailable$553.22

49250 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
49250 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 49250 rate is calculated

Each of 49250’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 · 49250

RVUs × geographic indexes × conversion factor

Swap in your local Medicare rate.

Work 8.78Practice expense 6.13Malpractice 2.10

17.0100 adjusted RVUs×$33.4009 conversion factor=$568.15

All indexes start at 1.000 (the national rate). Enter a ZIP or drag a slider.

Payment rules and modifiers for 49250

49250 has a 90-day global period: related visits in that window are included in the surgery payment.

CMS payment indicators · 49250

Umbilical excision

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)1Not paid (statutory restriction).
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 · 49250

Umbilical excision

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.

  • 24 Unrelated E/M visit by the same physician
  • 79 Unrelated procedure (starts its own global period)
  • 58 Staged, more extensive, or therapy procedure that was planned
  • 78 Unplanned 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

49250 without 51 · national facility

$568.15

Umbilical excision

49250-51 · Second procedure: 50%

$284.08

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

49250 compared with similar codes

Compare codes

49250 vs 22902 vs 22903 vs 49591: national Medicare rates

Swap in your local Medicare rate.

  • 49250
    Umbilical excision · 8.78 wRVU
    —
  • 22902
    Abdominal wall excision · 4.31 wRVU
    $517.38
  • 22903
    Tumor excision · 6.23 wRVU
    —
  • 49591
    Hernia repair · 5.81 wRVU
    —

How to choose

22902Abdominal wall excision
Use for qualifying subcutaneous soft-tissue tumor excision of the abdominal wall. This code is for removal of the umbilicus itself.
22903Tumor excision
This code describes qualifying deeper abdominal-wall soft-tissue tumor excision; it does not describe removal of the navel.
49591Hernia repair
Use for the specified initial reducible anterior abdominal hernia repair. It does not describe excision of the umbilicus.

Codes related to 49250

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

Codes related to 49250
CodeHow it relatesNational office range
Used instead
22902Abdominal wall excisionConsider for excision of a subcutaneous abdominal-wall soft-tissue tumor rather than removal of the umbilicus.$452.43–$665.89
22903Tumor excisionDescribes excision of a deeper abdominal-wall soft-tissue tumor, not excision of the navel itself.No office rate
49591Hernia repairDescribes repair of a qualifying initial reducible anterior abdominal hernia, not umbilical excision.No office rate

49250 billing questions

When is this code appropriate instead of an umbilical hernia repair code?

Use this code for surgical removal of the umbilicus itself. A hernia repair code describes repair of the defect and is not a substitute when the navel is excised.

Can it be reported with another abdominal procedure?

It is designated a separate procedure, so do not separately report it when the excision is integral to a more extensive operation. The operative note should show when it represents distinct work.

Should modifier 50 be used?

No. The service concerns the single umbilicus, so modifier 50 is inappropriate.

What postoperative care is included?

Medicare assigns a 90-day global period. It includes the day-before preoperative visit and 90 days of related postoperative care.

How are other procedures in the same session paid?

The highest-valued procedure is paid in full, and other procedures are subject to the standard multiple procedure reduction. Medicare does not pay an assistant at surgery 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

Show the CMS file lines behind this rate
RVUs for 49250PPRRVU2026_Oct_nonQPP.csv, line 5,781 (RVU26D)

Open CMS sourceHow we calculate rates

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