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Billing code 49505: Inguinal hernia repairMedicare rate & RVUs

Open repair of a first-time, reducible inguinal hernia in a patient age five or older, typically performed by a surgeon in an operating room.

CMS RVU26DEffective Oct 1, 2026109 payment localities39.2K Medicare services in 2024

Medicare pays $508.03 for 49505 nationally in a facility.

Medicare rate · 49505

Inguinal hernia repair

Work RVUs
7.76
Total RVUs
15.21
Global days
090

National rate · 2026

$508.03

Facility setting, before claim adjustments.

See every locality for 49505 →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 49505 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 49505 covers

This code represents open surgery for a primary inguinal hernia that is reducible in a patient age five or older. The surgeon exposes the groin, addresses the hernia contents, and repairs the inguinal defect. General surgeons commonly perform the operation in an operating room for adults and older children with a first-time, reducible groin hernia.

Select the code based on the patient’s age, inguinal site, initial-repair status, and reducibility. Document these details and the operative findings. CMS assigns a 90-day global period, including the day-before preoperative visit and 90 days of related postoperative care. When multiple procedures occur in the same session, the highest-valued procedure is paid in full and the others at 50%. Bilateral reporting with modifier 50 is paid at 150%. An assistant at surgery may be paid; co-surgeons require 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 49505 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

49505 office and facility rates by payment locality
Payment localityOfficeFacility
AlabamaUnavailable$455.77
Alaska*Unavailable$618.60
ArizonaUnavailable$492.58
ArkansasUnavailable$449.39
AtlantaUnavailable$525.45
AustinUnavailable$511.20
BakersfieldUnavailable$503.49
Baltimore/Surr. CntysUnavailable$541.57
BeaumontUnavailable$486.93
BrazoriaUnavailable$493.41

49505 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
49505 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 49505 rate is calculated

Each of 49505’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 · 49505

RVUs × geographic indexes × conversion factor

Work7.76

7.76 RVUs× 1.000 GPCI

Practice expense5.40

5.40 RVUs× 1.000 GPCI

Malpractice2.05

2.05 RVUs× 1.000 GPCI

Adjusted RVUs

15.2100

Conversion factor

$33.4009

Medicare rate

$508.03

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

Payment rules and modifiers for 49505

49505 has a 90-day global period: related visits in that window are included in the surgery payment.

CMS payment indicators · 49505

Inguinal hernia 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)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)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 · 49505

Inguinal hernia 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 50 · payment effect

With and without the modifier

49505 without 50 · national facility

$508.03

Inguinal hernia repair

49505-50 · Bilateral: 150%

$762.05

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

49505 compared with similar codes

Compare codes · National

4 codes, side by side

  • 49505

    Inguinal hernia repair7.76 wRVU

    Not priced

  • 49500

    Inguinal hernia repair5.69 wRVU

    Not priced

  • 49507

    Inguinal hernia repair8.86 wRVU

    Not priced

  • 49520

    Inguinal hernia repair9.74 wRVU

    Not priced

How to choose

49500Inguinal hernia repair
Both describe initial reducible inguinal hernia repair; 49500 is for a patient younger than five, while 49505 is for a patient age five or older.
49507Inguinal hernia repair
This code is for a reducible initial hernia in a patient age five or older. Code 49507 describes an initial hernia that is incarcerated or strangulated in that age group.
49520Inguinal hernia repair
Use 49505 for an initial reducible inguinal hernia. Code 49520 is for repair of a recurrent, reducible inguinal hernia.

Codes related to 49505

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

Codes related to 49505
CodeHow it relatesNational office range
Same family
49500Inguinal hernia repairInitial reducible inguinal hernia repair for a patient younger than five.No office rate
49507Inguinal hernia repairInitial incarcerated or strangulated inguinal hernia repair for a patient age five or older.No office rate
Used instead
49520Inguinal hernia repairFor a recurrent, reducible inguinal hernia rather than an initial repair.No office rate
49525Inguinal hernia repairFor repair of a sliding inguinal hernia.No office rate

49505 billing questions

When is this code appropriate instead of 49500?

Use this code for an initial, reducible inguinal hernia in a patient age five or older. Code 49500 is the corresponding initial reducible repair for a younger child.

How does an incarcerated hernia change code selection?

For an initial inguinal hernia in a patient age five or older that is incarcerated or strangulated rather than reducible, compare code 49507.

Are related postoperative visits separately reported?

Related postoperative care for 90 days is included in the global period. The day-before preoperative visit is also included.

How is a bilateral repair reported?

Report modifier 50 for a bilateral procedure. CMS pays the bilateral service at 150%.

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.

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 49505PPRRVU2026_Oct_nonQPP.csv, line 5,827 (RVU26D)

Open CMS sourceHow we calculate rates

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