FeeBase
Log inGet started
Menu

Billing code 49623: Mesh removalMedicare rate & RVUs

Reports removal of noninfected mesh or another prosthesis during a hernia repair, in addition to the primary repair code.

CMS RVU26DEffective Oct 1, 2026109 payment localities1.9K Medicare services in 2024

Medicare pays $184.04 for 49623 nationally in a facility.

Medicare rate · 49623

Mesh removal

Swap in your local Medicare rate.

Work RVUs
3.66
Total RVUs
5.51
Global days
ZZZ

National rate · 2026

$184.04

Facility setting, before claim adjustments.

See every locality for 49623 → · 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 49623 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 49623 covers

This add-on describes removing noninfected mesh or another prosthesis during a hernia repair, regardless of the surgical approach. A surgeon may encounter prior mesh during an open or laparoscopic repair of a recurrent abdominal, parastomal, or inguinal hernia. The work must involve removal of the prosthesis; simply working around existing mesh as part of the repair does not establish that removal was performed.

Report 49623 with the qualifying primary hernia repair, not as a standalone service. The operative note should identify the prosthesis as noninfected and document its removal during the repair. CMS classifies the code as an add-on and places its payment within the primary procedure’s global period. The primary code identifies the hernia repair; 49623 represents the additional prosthesis-removal work.

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 49623 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

49623 office and facility rates by payment locality
Payment localityOfficeFacility
AlabamaUnavailable$166.51
Alaska*Unavailable$232.87
ArizonaUnavailable$178.54
ArkansasUnavailable$164.41
AtlantaUnavailable$191.26
AustinUnavailable$182.41
BakersfieldUnavailable$176.84
Baltimore/Surr. CntysUnavailable$195.71
BeaumontUnavailable$179.08
BrazoriaUnavailable$177.77

49623 rates by state

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

MEWIVTNHMTNDMNMINYMARIWAIDWYSDIAILINOHPANJCTORNVUTCONEMOKYWVVAMDDECAAZNMKSOKARTNNCSCDCTXLAMSALGAFLAKHI

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 every state and territory as a table
49623 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 49623 rate is calculated

Each of 49623’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 · 49623

RVUs × geographic indexes × conversion factor

Swap in your local Medicare rate.

Work 3.66Practice expense 0.90Malpractice 0.95

5.5100 adjusted RVUs×$33.4009 conversion factor=$184.04

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

Payment rules and modifiers for 49623

The CMS indicators that decide how 49623 is paid alongside other services.

CMS payment indicators · 49623

Mesh removal

RuleCMS valueWhat it means
Global periodZZZAdd-on code: falls within the primary procedure’s global period.
Multiple procedures0No multiple-procedure reduction.
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 80 · payment effect

With and without the modifier

49623 without 80 · national facility

$184.04

Mesh removal

49623-80 · Assistant: 16%

$29.45

A physician assistant at surgery is paid 16% of the surgeon’s fee schedule amount.

When to use modifier 80

49623 compared with similar codes

Compare codes

49623 vs 49621 vs 49650 vs 49651: national Medicare rates

Swap in your local Medicare rate.

  • 49623
    Mesh removal · 3.66 wRVU
    —
  • 49621
    Hernia repair · 13.36 wRVU
    —
  • 49650
    Inguinal hernia repair · 6.2 wRVU
    —
  • 49651
    Inguinal hernia repair · 8.17 wRVU
    —

How to choose

49621Hernia repair
49621 reports the parastomal hernia repair itself. Add 49623 only when noninfected mesh or another prosthesis is also removed during that repair.
49650Inguinal hernia repair
49650 reports an initial laparoscopic inguinal hernia repair. It is a primary procedure, while 49623 reports qualifying prosthesis removal performed during a hernia repair.
49651Inguinal hernia repair
49651 reports a recurrent laparoscopic inguinal hernia repair. It does not by itself represent mesh removal; 49623 is the add-on for qualifying removal.

Codes related to 49623

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

Codes related to 49623
CodeHow it relatesNational office range
Add-on codes
49591Hernia repairPrimary abdominal hernia repair; report 49623 when qualifying noninfected prosthesis removal is performed.No office rate
49613Abdominal hernia repairRecurrent abdominal hernia repair that may be paired with 49623 for prosthesis removal.No office rate
49617Abdominal hernia repairPrimary repair for a large recurrent abdominal hernia; 49623 may represent additional prosthesis removal.No office rate
49621Hernia repairParastomal hernia repair that may serve as the primary procedure.No office rate
49650Inguinal hernia repairInitial laparoscopic inguinal hernia repair; pair with 49623 when qualifying prosthesis removal is performed.No office rate
49651Inguinal hernia repairRecurrent laparoscopic inguinal hernia repair that may be paired with 49623.No office rate

49623 billing questions

Can 49623 be reported by itself?

No. It is an add-on code and must be reported with a qualifying primary hernia repair.

Does the surgeon need to remove mesh, or is dissection around it enough?

The code is for removal of noninfected mesh or another prosthesis. The operative note should document that the prosthesis was removed, not merely encountered or left in place.

Can 49623 be used when the mesh is infected?

No. This code describes removal of a noninfected prosthesis.

Does the surgical approach determine whether 49623 applies?

No. The code covers qualifying prosthesis removal during hernia repair by any approach.

What should the operative note say?

Document the noninfected prosthesis, its removal, and the hernia repair performed during the same operation. The primary repair code must also be reported.

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 49623PPRRVU2026_Oct_nonQPP.csv, line 5,856 (RVU26D)

Open CMS sourceHow we calculate rates

Did this answer your question about what 49623 pays?

Tell us what you were actually trying to work out. We’ll answer you directly, or build the page that does.

Fee sheets

Put 49623 and the rest of your codes on one sheet

Build a fee sheet from your own code list at your locality, put your payer contracts beside Medicare, and see what changed each quarter.

Build my fee sheetOr price your code list free →