Billing code 49525: Inguinal hernia repairMedicare rate & RVUs

Medicare pays $554.45 for 49525 nationally in a facility.

Medicare allowed amount for participating (non-QP) physicians, before deductible, coinsurance and claim adjustments. Not a patient’s bill or a hospital charge.

What 49525 covers

A sliding inguinal hernia has an organ wall, commonly colon or bladder, forming part of the hernia sac. A surgeon repairs the hernia through an open operation, carefully identifying and managing the organ that contributes to the sac. These repairs are generally performed in an operating room, most often by a general surgeon.

Select this code when the operative findings establish sliding anatomy, rather than choosing an ordinary inguinal hernia code based only on reducibility or recurrence. The operative report should identify the side, the organ or tissue forming part of the sac when known, and the repair performed. CMS assigns a 90-day global period, including the day-before preoperative visit and 90 days of related postoperative care. For multiple procedures in one session, the highest-valued procedure is paid in full and others at 50%. Bilateral repair with modifier 50 is paid at 150%. Assistant-at-surgery payment may be available; co-surgeon payment requires supporting documentation, and team-surgery payment 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 49525 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

49525 rates by state

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

How the 49525 rate is calculated

Each of 49525’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 49525

49525 has a 90-day global period: related visits in that window are included in the surgery payment.

What modifiers do to the payment

When to use modifier 50

49525 compared with similar codes

How to choose

49505Inguinal hernia repair

49505 describes an initial, reducible inguinal hernia in a patient age five or older. Choose 49525 when the operative findings establish a sliding hernia.

49507Inguinal hernia repair

49507 is for an initial incarcerated or strangulated inguinal hernia in a patient age five or older. Sliding anatomy is the defining feature for 49525.

49520Inguinal hernia repair

49520 describes repair of a recurrent, reducible inguinal hernia. Use 49525 when the hernia is documented as sliding rather than coding by recurrence and reducibility alone.

49521Inguinal hernia repair

49521 is for a recurrent incarcerated or strangulated inguinal hernia. 49525 identifies the sliding anatomy of the hernia.

Codes related to 49525

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

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