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Billing code 49617: Abdominal hernia repairMedicare rate & RVUs

Reports operative repair of a recurrent, reducible anterior abdominal hernia when the total defect length is greater than 10 cm.

CMS RVU26DEffective Oct 1, 2026109 payment localities1.7K Medicare services in 2024

Medicare pays $808.30 for 49617 nationally in a facility.

Medicare rate · 49617

Abdominal hernia repair

Swap in your local Medicare rate.

Work RVUs
15.63
Total RVUs
24.20
Global days
000

National rate · 2026

$808.30

Facility setting, before claim adjustments.

See every locality for 49617 → · 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 49617 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 49617 covers

A surgeon repairs a recurrent hernia of the anterior abdominal wall, such as a recurrent ventral or incisional hernia. The defect is reducible and its total length is greater than 10 cm. Repair may be performed through an open, laparoscopic, or robotic approach. These operations are typically performed in a hospital or ambulatory surgery facility by a general surgeon or another surgeon who treats abdominal wall hernias.

Choose this code based on the documented recurrence, reducibility, and total defect length—not the size of the hernia sac. The operative report should support the prior repair, the defect measurement, and whether the contents could be reduced. Mesh or another prosthesis used in the repair is included in the hernia repair service. Medicare assigns a 0-day global period, so same-day preoperative and postoperative care is included. For multiple procedures in one session, the highest-valued procedure is paid in full and other procedures are subject to the standard 50% reduction. Assistant-at-surgery payment may be made; co-surgeons require supporting documentation, and team surgery is not permitted. Modifier 50 is inappropriate for this code.

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 49617 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

49617 office and facility rates by payment locality
Payment localityOfficeFacility
AlabamaUnavailable$731.24
Alaska*Unavailable$1,019.26
ArizonaUnavailable$784.33
ArkansasUnavailable$721.98
AtlantaUnavailable$839.16
AustinUnavailable$802.97
BakersfieldUnavailable$780.64
Baltimore/Surr. CntysUnavailable$859.46
BeaumontUnavailable$785.08
BrazoriaUnavailable$781.71

49617 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
49617 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 49617 rate is calculated

Each of 49617’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 · 49617

RVUs × geographic indexes × conversion factor

Swap in your local Medicare rate.

Work 15.63Practice expense 4.57Malpractice 4.00

24.2000 adjusted RVUs×$33.4009 conversion factor=$808.30

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

Payment rules and modifiers for 49617

The CMS indicators that decide how 49617 is paid alongside other services.

CMS payment indicators · 49617

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

49617 without 51 · national facility

$808.30

Abdominal hernia repair

49617-51 · Second procedure: 50%

$404.15

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

49617 compared with similar codes

Compare codes

49617 vs 49618 vs 49595 vs 49615: national Medicare rates

Swap in your local Medicare rate.

  • 49617
    Abdominal hernia repair · 15.63 wRVU
    —
  • 49618
    Abdominal hernia repair · 22.1 wRVU
    —
  • 49595
    Abdominal hernia repair · 13.59 wRVU
    —
  • 49615
    Hernia repair · 11.17 wRVU
    —

How to choose

49618Abdominal hernia repair
Use 49618 for a recurrent defect over 10 cm that is incarcerated or strangulated; 49617 is for a reducible defect.
49595Abdominal hernia repair
Both cover a reducible defect over 10 cm. Use 49595 for an initial repair and 49617 for a recurrent repair.
49615Hernia repair
Both describe recurrent, reducible repair, but 49615 is for a defect in the 3–10 cm group rather than one over 10 cm.

Codes related to 49617

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

Codes related to 49617
CodeHow it relatesNational office range
Same family
49615Hernia repairRecurrent reducible repair for a defect in the 3–10 cm size group.No office rate
49616Hernia repairRecurrent repair for a 3–10 cm defect when incarcerated or strangulated.No office rate
49618Abdominal hernia repairRecurrent repair over 10 cm when incarcerated or strangulated.No office rate
49595Abdominal hernia repairInitial rather than recurrent repair of a reducible defect over 10 cm.No office rate

49617 billing questions

How is this code distinguished from 49618?

Both describe recurrent anterior abdominal hernia repair for a defect over 10 cm. Use 49617 when the hernia is reducible and 49618 when it is incarcerated or strangulated.

Does the defect measurement refer to the hernia sac?

No. Selection is based on the total length of the abdominal wall defect, not the size of the sac. The operative report should document the measurement supporting the level.

Can mesh placement be billed separately?

Mesh or another prosthesis used as part of this hernia repair is included in the repair service.

Can modifier 50 be used for bilateral repair?

No. Modifier 50 is inappropriate for this code's anatomy and descriptor.

What documentation supports reporting recurrent repair?

The operative report should establish that the hernia has recurred after a prior repair, describe reducibility, and document a total defect length greater than 10 cm.

How are other procedures in the same session paid?

When multiple procedures are performed in the same session, Medicare pays the highest-valued procedure in full and applies the standard 50% 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 49617PPRRVU2026_Oct_nonQPP.csv, line 5,852 (RVU26D)

Open CMS sourceHow we calculate rates

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