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Billing code 49622: Parastomal hernia repairMedicare rate & RVUs

Repair an incarcerated or strangulated hernia at a stoma site; select this code rather than the reducible parastomal hernia repair code.

CMS RVU26DEffective Oct 1, 2026109 payment localities1.4K Medicare services in 2024

Medicare pays $849.72 for 49622 nationally in a facility.

Medicare rate · 49622

Parastomal hernia repair

Swap in your local Medicare rate.

Work RVUs
16.63
Total RVUs
25.44
Global days
000

National rate · 2026

$849.72

Facility setting, before claim adjustments.

See every locality for 49622 → · 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 49622 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 49622 covers

This code covers operative repair of a parastomal hernia when the hernia is incarcerated or strangulated. The defect is in the abdominal wall around a stoma, such as a colostomy or ileostomy. General or colorectal surgeons commonly perform the repair in a hospital or other surgical facility. The code applies to the hernia repair whether the surgeon uses an open or minimally invasive approach; mesh may be used to reinforce the repair.

Choose this code based on the hernia’s parastomal location and incarcerated or strangulated status, not on the approach. A reducible parastomal hernia is reported with 49621. Document the stoma site and the finding that the hernia is incarcerated or strangulated. CMS 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 the others at 50%. 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 49622 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

49622 office and facility rates by payment locality
Payment localityOfficeFacility
AlabamaUnavailable$770.62
Alaska*Unavailable$1,076.19
ArizonaUnavailable$825.12
ArkansasUnavailable$761.12
AtlantaUnavailable$881.43
AustinUnavailable$844.34
BakersfieldUnavailable$821.83
Baltimore/Surr. CntysUnavailable$902.55
BeaumontUnavailable$825.84
BrazoriaUnavailable$822.62

49622 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
49622 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 49622 rate is calculated

Each of 49622’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 · 49622

RVUs × geographic indexes × conversion factor

Swap in your local Medicare rate.

Work 16.63Practice expense 4.71Malpractice 4.10

25.4400 adjusted RVUs×$33.4009 conversion factor=$849.72

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

Payment rules and modifiers for 49622

The CMS indicators that decide how 49622 is paid alongside other services.

CMS payment indicators · 49622

Parastomal 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

49622 without 51 · national facility

$849.72

Parastomal hernia repair

49622-51 · Second procedure: 50%

$424.86

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

49622 compared with similar codes

Compare codes

49622 vs 49621 vs 49623 vs 49616: national Medicare rates

Swap in your local Medicare rate.

  • 49622
    Parastomal hernia repair · 16.63 wRVU
    —
  • 49621
    Hernia repair · 13.36 wRVU
    —
  • 49623
    Mesh removal · 3.66 wRVU
    —
  • 49616
    Hernia repair · 15.16 wRVU
    —

How to choose

49621Hernia repair
Both codes describe parastomal hernia repair. Choose 49622 for an incarcerated or strangulated hernia and 49621 for a reducible one.
49623Mesh removal
This add-on addresses removal of noninfected mesh during a hernia repair; it does not replace the primary repair code.
49616Hernia repair
This code is for a qualifying anterior abdominal hernia, not a defect around a stoma. Use 49622 when the repaired hernia is parastomal and incarcerated or strangulated.

Codes related to 49622

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

Codes related to 49622
CodeHow it relatesNational office range
Same family
49621Hernia repairParastomal hernia repair when the hernia is reducible.No office rate
Add-on codes
49623Mesh removalAdd-on for removal of noninfected mesh during hernia repair, when applicable.No office rate
Used instead
49616Hernia repairFor a qualifying anterior abdominal hernia that is not parastomal.No office rate

49622 billing questions

When should 49622 be chosen over 49621?

Use 49622 for a parastomal hernia that is incarcerated or strangulated. Use 49621 when the parastomal hernia is reducible.

Is mesh placement separately reported?

Mesh used to reinforce the hernia repair is included in the repair code. Noninfected mesh removal at the time of repair may be reported with add-on code 49623 when applicable.

Can modifier 50 be reported?

No. The parastomal anatomy makes bilateral adjustment and modifier 50 inappropriate.

Does this code have a postoperative global period?

It has a 0-day global period. Same-day preoperative and postoperative care is included.

How are other procedures in the same session paid?

CMS pays the highest-valued procedure in full and the other procedures at 50% when performed in the same session.

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 49622PPRRVU2026_Oct_nonQPP.csv, line 5,855 (RVU26D)

Open CMS sourceHow we calculate rates

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