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Billing code 49593: Abdominal hernia repairMedicare rate & RVUs

Reports initial repair of a reducible anterior abdominal hernia when the total defect length is 3–10 cm, regardless of surgical approach.

CMS RVU26DEffective Oct 1, 2026109 payment localities18.4K Medicare services in 2024

Medicare pays $525.06 for 49593 nationally in a facility.

Medicare rate · 49593

Abdominal hernia repair

Swap in your local Medicare rate.

Work RVUs
10
Total RVUs
15.72
Global days
000

National rate · 2026

$525.06

Facility setting, before claim adjustments.

See every locality for 49593 → · 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 49593 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 49593 covers

Code 49593 describes initial repair of an anterior abdominal hernia, such as a ventral, incisional, umbilical, or epigastric hernia. A surgeon may perform the operation open, laparoscopically, or robotically; the approach does not change code selection. Mesh or another prosthesis may be used as part of the repair and is included in this service.

Select the code when the hernia is reducible and the total length of the defect or defects is 3–10 cm. The operative report should support the hernia site, initial-repair status, reducibility, and measured defect length. CMS assigns a 0-day global period, so same-day preoperative and postoperative care is included. When multiple procedures occur in the same 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 made; 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 49593 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

49593 office and facility rates by payment locality
Payment localityOfficeFacility
AlabamaUnavailable$474.24
Alaska*Unavailable$659.68
ArizonaUnavailable$509.29
ArkansasUnavailable$468.13
AtlantaUnavailable$545.25
AustinUnavailable$521.82
BakersfieldUnavailable$507.29
Baltimore/Surr. CntysUnavailable$558.65
BeaumontUnavailable$509.52
BrazoriaUnavailable$507.62

49593 rates by state

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

MEWIVTNHMTNDMNMINYMARIWAIDWYSDIAILINOHPANJCTORNVUTCONEMOKYWVVAMDDECAAZNMKSOKARTNNCSCDCTXLAMSALGAFLAKHI

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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
49593 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 49593 rate is calculated

Each of 49593’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 · 49593

RVUs × geographic indexes × conversion factor

Swap in your local Medicare rate.

Work 10.00Practice expense 3.11Malpractice 2.61

15.7200 adjusted RVUs×$33.4009 conversion factor=$525.06

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

Payment rules and modifiers for 49593

The CMS indicators that decide how 49593 is paid alongside other services.

CMS payment indicators · 49593

Abdominal hernia repair

RuleCMS valueWhat it means
Global period000Same-day global: pre- and post-op care on the day of the procedure is 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.

What modifiers do to the payment

Modifier 51 · payment effect

With and without the modifier

49593 without 51 · national facility

$525.06

Abdominal hernia repair

49593-51 · Second procedure: 50%

$262.53

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

49593 compared with similar codes

Compare codes

49593 vs 49591 vs 49594 vs 49595 vs 49592: national Medicare rates

Swap in your local Medicare rate.

  • 49593
    Abdominal hernia repair · 10 wRVU
    —
  • 49591
    Hernia repair · 5.81 wRVU
    —
  • 49594
    Hernia repair · 13.12 wRVU
    —
  • 49595
    Abdominal hernia repair · 13.59 wRVU
    —
  • 49592
    Abdominal hernia repair · 8.25 wRVU
    —

How to choose

49591Hernia repair
Both are for initial, reducible anterior abdominal hernia repairs. Use 49591 when the total defect length is under 3 cm; use 49593 for 3–10 cm.
49594Hernia repair
This is the 3–10 cm counterpart for an incarcerated or strangulated hernia. Code 49593 is for a reducible hernia in that size range.
49595Abdominal hernia repair
Both are for initial, reducible repairs, but 49595 applies when the total defect length is greater than 10 cm.
49592Abdominal hernia repair
This code covers an initial hernia repair under 3 cm when the hernia is incarcerated or strangulated; 49593 is for a 3–10 cm reducible hernia.

Codes related to 49593

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

Codes related to 49593
CodeHow it relatesNational office range
Same family
49591Hernia repairInitial reducible anterior abdominal hernia repair for a total defect length under 3 cm.No office rate
49592Abdominal hernia repairInitial repair under 3 cm when the hernia is incarcerated or strangulated.No office rate
49594Hernia repairInitial repair for a 3–10 cm defect when the hernia is incarcerated or strangulated.No office rate
49595Abdominal hernia repairInitial reducible repair when the total defect length is greater than 10 cm.No office rate
49596Abdominal hernia repairInitial repair over 10 cm when the hernia is incarcerated or strangulated.No office rate

49593 billing questions

How does 49593 differ from 49594?

Both describe an initial anterior abdominal hernia repair for a total defect length of 3–10 cm. Report 49593 for a reducible hernia and 49594 for an incarcerated or strangulated hernia.

Does the surgical approach determine whether to report 49593?

No. The code covers open, laparoscopic, and robotic approaches; select it based on initial status, reducibility, and total defect length.

Can mesh placement be billed separately?

Mesh or another prosthesis used in the repair is included in 49593. The code does not separately report the implant placement as an additional hernia-repair service.

What documentation supports the 3–10 cm level?

Document the total length of the hernia defect or defects and the operative findings that establish reducibility and initial-repair status. The recorded defect size should support the selected size range.

How does the 0-day global period affect same-day care?

Same-day preoperative and postoperative care is included in the procedure. For other procedures performed in the same session, CMS pays the highest-valued procedure in full and applies the standard multiple-procedure reduction to the others.

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 49593PPRRVU2026_Oct_nonQPP.csv, line 5,839 (RVU26D)

Open CMS sourceHow we calculate rates

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