No office rate
Both codes cover recurrent anterior abdominal hernias under 3 cm. Choose 49614 for incarceration or strangulation and 49613 when the hernia is reducible.
On this page
CMS RVU26D · Effective 2026-10-01
49614 Hernia repair Medicare reimbursement rates
Reports repair of a recurrent anterior abdominal hernia with a defect under 3 cm when incarcerated or strangulated, regardless of operative approach. Compare 49614 office and facility rates across CMS payment localities.
Amounts below use the non-QP conversion factor for participating physicians. These are base physician payments before claim-level adjustments, not patient costs or total hospital charges.
What does Medicare pay for 49614?
The service location and office or facility setting determine which base rate applies. These are the supported base rates for the 109 payment areas shown below, using the same CMS release.
Office / nonfacility
No supported rate
These are locality ranges, not averages or address-specific quotes. A facility-setting amount covers the physician service; it does not include a hospital’s separate bill. Choose a locality below to inspect its calculation, compare other payment areas, or price a percentage of Medicare.
Where 49614 pays more and less
General surgery
About 49614: Recurrent incarcerated small abdominal hernia repair
Reports repair of a recurrent anterior abdominal hernia with a defect under 3 cm when incarcerated or strangulated, regardless of operative approach.
This code represents operative repair of a recurrent hernia in the anterior abdominal wall, such as an incisional, ventral, umbilical, epigastric, or Spigelian hernia. It applies when the total defect length is under 3 cm and the hernia is incarcerated or strangulated. A general surgeon typically performs the repair in a hospital operating room, using an open, laparoscopic, or robotic approach. Mesh placement, when performed as part of the repair, is included in the hernia service.
Choose the code from the operative findings: document the prior repair at the same site, the total defect length, and incarceration or strangulation. The approach does not change code selection. Medicare assigns a 0-day global period, so same-day preoperative and postoperative care is included. When multiple procedures are performed in one session, the highest-valued procedure is paid in full and other procedures are subject to the standard 50% multiple-procedure reduction. Modifier 50 is inappropriate. Assistant-at-surgery payment may be available; co-surgeon payment requires supporting documentation, and team surgery is not permitted.
CMS billing rules for 49614
- Global period
- Minor procedure with a 0-day global period: same-day preoperative and postoperative care is included.
- Multiple procedures
- Standard multiple procedure reduction: the highest-valued procedure is paid in full and others at 50% when performed in the same session.
- Bilateral procedures
- Bilateral adjustment does not apply; the descriptor or anatomy makes modifier 50 inappropriate.
- Assistant at surgery
- Assistant at surgery may be paid.
- Co-surgeons
- Co-surgeons paid only with supporting documentation.
- Team surgery
- Team surgery not permitted.
Where the value comes from
- Work RVU9.99 · 64%
- Practice expense (office) RVU3.09 · 20%
- Malpractice RVU2.61 · 17%
905
Medicare services in 2024 · #3037 by national volume
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.
49614 compared with similar codes
Office rate ranges across all CMS payment localities, from the same CMS release.
No office rate
Both cover recurrent incarcerated or strangulated hernias. 49616 is for a total defect length of 3–10 cm; 49614 is for under 3 cm.
No office rate
Both cover recurrent incarcerated or strangulated hernias. 49618 applies when the defect is over 10 cm, rather than under 3 cm.
No office rate
49622 is for repair of a parastomal hernia with incarceration or strangulation. Use 49614 for the specified recurrent anterior abdominal hernia outside that parastomal category.
See how rates vary across the country
49614 · Office / nonfacility · Non-QP. Choose a state to explore its payment localities. A range means the amount varies within that state.
Explore a state
Local rates. Clear comparisons.
Hover or focus a tile to see its rate range. Select it to open the state’s fee schedule.
View all state and territory rates as a table
| State / territory | Rate range | Localities |
|---|---|---|
| AK | No published base rate | 1 |
| AL | No published base rate | 1 |
| AR | No published base rate | 1 |
| AZ | No published base rate | 1 |
| CA | No published base rate | 29 |
| CO | No published base rate | 1 |
| CT | No published base rate | 1 |
| DC | No published base rate | 1 |
| DE | No published base rate | 1 |
| FL | No published base rate | 3 |
| GA | No published base rate | 2 |
| GU | No published base rate | 1 |
| HI | No published base rate | 1 |
| IA | No published base rate | 1 |
| ID | No published base rate | 1 |
| IL | No published base rate | 4 |
| IN | No published base rate | 1 |
| KS | No published base rate | 1 |
| KY | No published base rate | 1 |
| LA | No published base rate | 2 |
| MA | No published base rate | 2 |
| MD | No published base rate | 3 |
| ME | No published base rate | 2 |
| MI | No published base rate | 2 |
| MN | No published base rate | 1 |
| MO | No published base rate | 3 |
| MS | No published base rate | 1 |
| MT | No published base rate | 1 |
| NC | No published base rate | 1 |
| ND | No published base rate | 1 |
| NE | No published base rate | 1 |
| NH | No published base rate | 1 |
| NJ | No published base rate | 2 |
| NM | No published base rate | 1 |
| NV | No published base rate | 1 |
| NY | No published base rate | 5 |
| OH | No published base rate | 1 |
| OK | No published base rate | 1 |
| OR | No published base rate | 2 |
| PA | No published base rate | 2 |
| PR | No published base rate | 1 |
| RI | No published base rate | 1 |
| SC | No published base rate | 1 |
| SD | No published base rate | 1 |
| TN | No published base rate | 1 |
| TX | No published base rate | 8 |
| UT | No published base rate | 1 |
| VA | No published base rate | 2 |
| VI | No published base rate | 1 |
| VT | No published base rate | 1 |
| WA | No published base rate | 2 |
| WI | No published base rate | 1 |
| WV | No published base rate | 1 |
| WY | No published base rate | 1 |
Compare 49614 by payment locality
Find the payment area for your service address, then open its rate page for calculation inputs, release history and the percentage-of-Medicare tool. A city may cross payment-area boundaries; the ZIP lookup above helps resolve the location.
109 of 109 payment localities
| Payment locality | Office | Facility |
|---|---|---|
| Alabama | Office Unavailable | Facility $473.32 |
| Alaska* | Office Unavailable | Facility $658.46 |
| Arizona | Office Unavailable | Facility $508.31 |
| Arkansas | Office Unavailable | Facility $467.23 |
| Atlanta | Office Unavailable | Facility $544.23 |
| Austin | Office Unavailable | Facility $520.78 |
| Bakersfield | Office Unavailable | Facility $506.22 |
| Baltimore/Surr. Cntys | Office Unavailable | Facility $557.59 |
| Beaumont | Office Unavailable | Facility $508.58 |
| Brazoria | Office Unavailable | Facility $506.62 |
| Chicago | Office Unavailable | Facility $639.81 |
| Chico | Office Unavailable | Facility $499.19 |
| Colorado | Office Unavailable | Facility $515.58 |
| Connecticut | Office Unavailable | Facility $556.99 |
| Dallas | Office Unavailable | Facility $514.27 |
| Dc + Md/Va Suburbs | Office Unavailable | Facility $570.30 |
| Delaware | Office Unavailable | Facility $515.69 |
| Detroit | Office Unavailable | Facility $580.25 |
| East St. Louis | Office Unavailable | Facility $604.20 |
| El Centro | Office Unavailable | Facility $499.63 |
| Fort Lauderdale | Office Unavailable | Facility $595.84 |
| Fort Worth | Office Unavailable | Facility $514.37 |
| Fresno | Office Unavailable | Facility $499.19 |
| Galveston | Office Unavailable | Facility $511.01 |
| Hanford-Corcoran | Office Unavailable | Facility $499.19 |
| Hawaii, Guam | Office Unavailable | Facility $501.50 |
| Houston | Office Unavailable | Facility $558.79 |
| Idaho | Office Unavailable | Facility $469.86 |
| Indiana | Office Unavailable | Facility $471.72 |
| Iowa | Office Unavailable | Facility $462.72 |
| Kansas | Office Unavailable | Facility $470.91 |
| Kentucky | Office Unavailable | Facility $505.19 |
| Los Angeles-Long Beach-Anaheim (Los Angeles/Orange Cnty) | Office Unavailable | Facility $527.34 |
| Madera | Office Unavailable | Facility $499.19 |
| Manhattan | Office Unavailable | Facility $613.22 |
| Merced | Office Unavailable | Facility $499.19 |
| Metropolitan Boston | Office Unavailable | Facility $548.17 |
| Metropolitan Kansas City | Office Unavailable | Facility $515.76 |
| Metropolitan Philadelphia | Office Unavailable | Facility $551.12 |
| Metropolitan St. Louis | Office Unavailable | Facility $519.28 |
| Miami | Office Unavailable | Facility $661.58 |
| Minnesota | Office Unavailable | Facility $465.68 |
| Mississippi | Office Unavailable | Facility $486.96 |
| Modesto | Office Unavailable | Facility $499.19 |
| Montana** | Office Unavailable | Facility $523.89 |
| Napa | Office Unavailable | Facility $535.01 |
| Nebraska | Office Unavailable | Facility $461.89 |
| Nevada** | Office Unavailable | Facility $509.60 |
| New Hampshire | Office Unavailable | Facility $517.39 |
| New Mexico | Office Unavailable | Facility $533.02 |
| New Orleans | Office Unavailable | Facility $529.83 |
| North Carolina | Office Unavailable | Facility $485.67 |
| North Dakota** | Office Unavailable | Facility $472.28 |
| Northern Nj | Office Unavailable | Facility $567.52 |
| Nyc Suburbs/Long Island | Office Unavailable | Facility $639.63 |
| Ohio | Office Unavailable | Facility $515.78 |
| Oklahoma | Office Unavailable | Facility $493.58 |
| Oxnard-Thousand Oaks-Ventura | Office Unavailable | Facility $519.32 |
| Portland | Office Unavailable | Facility $518.54 |
| Poughkpsie/N Nyc Suburbs | Office Unavailable | Facility $567.19 |
| Puerto Rico | Office Unavailable | Facility $523.89 |
| Queens | Office Unavailable | Facility $602.73 |
| Redding | Office Unavailable | Facility $499.19 |
| Rest Of California | Office Unavailable | Facility $499.19 |
| Rest Of Florida | Office Unavailable | Facility $563.37 |
| Rest Of Georgia | Office Unavailable | Facility $529.65 |
| Rest Of Illinois | Office Unavailable | Facility $564.16 |
| Rest Of Louisiana | Office Unavailable | Facility $508.53 |
| Rest Of Maine | Office Unavailable | Facility $482.85 |
| Rest Of Maryland | Office Unavailable | Facility $521.49 |
| Rest Of Massachusetts | Office Unavailable | Facility $517.17 |
| Rest Of Michigan | Office Unavailable | Facility $526.33 |
| Rest Of Missouri | Office Unavailable | Facility $507.55 |
| Rest Of New Jersey | Office Unavailable | Facility $555.36 |
| Rest Of New York | Office Unavailable | Facility $493.01 |
| Rest Of Oregon | Office Unavailable | Facility $497.76 |
| Rest Of Pennsylvania | Office Unavailable | Facility $510.80 |
| Rest Of Texas | Office Unavailable | Facility $510.34 |
| Rest Of Washington | Office Unavailable | Facility $513.03 |
| Rhode Island | Office Unavailable | Facility $524.39 |
| Riverside-San Bernardino-Ontario | Office Unavailable | Facility $527.16 |
| Sacramento-Roseville-Folsom | Office Unavailable | Facility $512.45 |
| Salinas | Office Unavailable | Facility $510.36 |
| San Diego-Chula Vista-Carlsbad | Office Unavailable | Facility $514.37 |
| San Francisco-Oakland-Berkeley (Marin Cnty) | Office Unavailable | Facility $550.91 |
| San Francisco-Oakland-Berkeley (San Francisco/San Mateo/Alameda/Contra Costa Cnty) | Office Unavailable | Facility $547.95 |
| San Jose-Sunnyvale-Santa Clara (San Benito Cnty) | Office Unavailable | Facility $565.93 |
| San Jose-Sunnyvale-Santa Clara (Santa Clara Cnty) | Office Unavailable | Facility $553.82 |
| San Luis Obispo-Paso Robles | Office Unavailable | Facility $503.63 |
| Santa Cruz-Watsonville | Office Unavailable | Facility $512.81 |
| Santa Maria-Santa Barbara | Office Unavailable | Facility $510.09 |
| Santa Rosa-Petaluma | Office Unavailable | Facility $517.15 |
| Seattle (King Cnty) | Office Unavailable | Facility $548.22 |
| South Carolina | Office Unavailable | Facility $503.14 |
| South Dakota** | Office Unavailable | Facility $466.18 |
| Southern Maine | Office Unavailable | Facility $490.96 |
| Stockton | Office Unavailable | Facility $499.19 |
| Suburban Chicago | Office Unavailable | Facility $596.48 |
| Tennessee | Office Unavailable | Facility $474.31 |
| Utah | Office Unavailable | Facility $508.98 |
| Vallejo | Office Unavailable | Facility $530.74 |
| Vermont | Office Unavailable | Facility $479.96 |
| Virgin Islands | Office Unavailable | Facility $523.89 |
| Virginia | Office Unavailable | Facility $496.68 |
| Visalia | Office Unavailable | Facility $499.19 |
| West Virginia | Office Unavailable | Facility $548.11 |
| Wisconsin | Office Unavailable | Facility $459.40 |
| Wyoming** | Office Unavailable | Facility $501.39 |
| Yuba City | Office Unavailable | Facility $499.19 |
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49614 billing questions
How does this differ from 49613?
Both describe repair of a recurrent anterior abdominal hernia with a defect under 3 cm. Use 49614 when the hernia is incarcerated or strangulated; 49613 is for a reducible hernia.
How is the size category selected?
Use the total length of the hernia defect documented at surgery. This code is for a defect under 3 cm.
Does the operative approach change the code?
No. The code applies whether the repair is open, laparoscopic, or robotic.
Can mesh placement be billed separately?
Mesh placement performed as part of the hernia repair is included in the service; it is not separately reported as a distinct mesh-placement service.
Should modifier 50 be appended?
No. CMS identifies bilateral adjustment as inappropriate for this code.
What same-session payment rule should billers expect?
If multiple procedures are performed in the same session, the highest-valued procedure is paid in full and the other procedures are subject to the standard 50% multiple-procedure 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 indices and the applicable conversion factor. Unavailable or separately priced services are labeled rather than assigned a made-up amount.
Source: RVU26D. Effective 2026-10-01 through the day before 2027-01-01.
5,84649610,,Repair umbilical lesion,A,,10.64,6.36,NA,6.36,,2.84,19.84,19.84,0,090,0.09,0.81,0.10,2,0,2,1,0,9,,33.4009,09,0,99,0.00,0.00,0.00
5,84749611,,Repair umbilical lesion,A,,9.11,6.13,NA,6.13,,2.43,17.67,17.67,0,090,0.09,0.81,0.10,2,0,2,1,0,9,,33.4009,09,0,99,0.00,0.00,0.00
5,84849613,,Rpr aa hrn rcr < 3 rdc,A,,7.23,2.50,NA,2.50,,1.86,11.59,11.59,0,000,0.00,0.00,0.00,2,0,2,1,0,9,,33.4009,09,0,99,0.00,0.00,0.00
5,84949614,,Rpr aa hrn rcr < 3 ncr/strn,A,,9.99,3.09,NA,3.09,,2.61,15.69,15.69,0,000,0.00,0.00,0.00,2,0,2,1,0,9,,33.4009,09,0,99,0.00,0.00,0.00
5,85049615,,Rpr aa hrn rcr 3-10 rdc,A,,11.17,3.40,NA,3.40,,2.91,17.48,17.48,0,000,0.00,0.00,0.00,2,0,2,1,0,9,,33.4009,09,0,99,0.00,0.00,0.00
5,85149616,,Rpr aa hrn rcr 3-10 ncr/strn,A,,15.16,4.34,NA,4.34,,3.95,23.45,23.45,0,000,0.00,0.00,0.00,2,0,2,1,0,9,,33.4009,09,0,99,0.00,0.00,0.00
5,85249617,,Rpr aa hrn rcr > 10 rdc,A,,15.63,4.57,NA,4.57,,4.00,24.20,24.20,0,000,0.00,0.00,0.00,2,0,2,1,0,9,,33.4009,09,0,99,0.00,0.00,0.00