FeeBase
Log inGet started
Menu

Billing code 49651: Inguinal hernia repairMedicare rate & RVUs

Reports laparoscopic operative repair of an inguinal hernia that has returned at a previously repaired site, typically by a surgeon in an operating room.

CMS RVU26DEffective Oct 1, 2026109 payment localities9.5K Medicare services in 2024

Medicare pays $550.11 for 49651 nationally in a facility.

Medicare rate · 49651

Inguinal hernia repair

Swap in your local Medicare rate.

Work RVUs
8.17
Total RVUs
16.47
Global days
090

National rate · 2026

$550.11

Facility setting, before claim adjustments.

See every locality for 49651 → · 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 49651 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 49651 covers

This code describes laparoscopic surgery to repair a recurrent inguinal hernia: a hernia that has returned at a site repaired previously. A general surgeon typically uses small abdominal incisions and a camera to access the groin, reduce the hernia, and reinforce the repair, often with mesh. The service is generally performed in a hospital or ambulatory surgery center. The code distinguishes recurrence from an initial inguinal hernia repair; the operative report should establish the prior repair, recurrent site, and laparoscopic approach.

Medicare assigns a 90-day global period, including the day-before preoperative visit and 90 days of related postoperative care. When multiple procedures occur in the same session, the highest-valued is paid in full and others at 50%. For bilateral repair, modifier 50 is paid at 150%. An assistant at surgery may be paid; co-surgeons require 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 49651 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

49651 office and facility rates by payment locality
Payment localityOfficeFacility
AlabamaUnavailable$493.27
Alaska*Unavailable$667.66
ArizonaUnavailable$533.40
ArkansasUnavailable$486.32
AtlantaUnavailable$568.65
AustinUnavailable$554.39
BakersfieldUnavailable$546.94
Baltimore/Surr. CntysUnavailable$586.49
BeaumontUnavailable$526.53
BrazoriaUnavailable$534.65

49651 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
49651 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 49651 rate is calculated

Each of 49651’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 · 49651

RVUs × geographic indexes × conversion factor

Swap in your local Medicare rate.

Work 8.17Practice expense 6.15Malpractice 2.15

16.4700 adjusted RVUs×$33.4009 conversion factor=$550.11

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

Payment rules and modifiers for 49651

49651 has a 90-day global period: related visits in that window are included in the surgery payment.

CMS payment indicators · 49651

Inguinal hernia repair

RuleCMS valueWhat it means
Global period090Major surgery: the day before, the day of, and 90 days after are included.
Multiple procedures2Standard reduction: highest-valued procedure at 100%, others at 50%.
Bilateral (modifier 50)1Bilateral with modifier 50 pays 150% of the fee schedule amount.
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.
Split (54/55/56)0.09/0.81/0.10Share of the payment for pre-op, the procedure itself, and post-op care.

Global surgery period · 49651

Inguinal hernia repair

90-day global period ends

Dec 30, 2026

Covers Sep 30, 2026 through Dec 30, 2026 (92 days, including the day before surgery).

Visit on Oct 31, 2026

Day 30 of the 90-day post-op period: related follow-up care is included in the surgical payment.

  • 24 Unrelated E/M visit by the same physician
  • 79 Unrelated procedure (starts its own global period)
  • 58 Staged, more extensive, or therapy procedure that was planned
  • 78 Unplanned return to the operating room for a related complication
SurgeryVisit
Sep 23, 2026Jan 10, 2027

Pre-op dayGlobal period

What modifiers do to the payment

Modifier 50 · payment effect

With and without the modifier

49651 without 50 · national facility

$550.11

Inguinal hernia repair

49651-50 · Bilateral: 150%

$825.17

Both sides on one line with modifier 50 are paid at 150% of the fee schedule amount (subject to multiple-procedure rules with other procedures).

When to use modifier 50

49651 compared with similar codes

Compare codes

49651 vs 49650 vs 49520 vs 49613: national Medicare rates

Swap in your local Medicare rate.

  • 49651
    Inguinal hernia repair · 8.17 wRVU
    —
  • 49650
    Inguinal hernia repair · 6.2 wRVU
    —
  • 49520
    Inguinal hernia repair · 9.74 wRVU
    —
  • 49613
    Abdominal hernia repair · 7.23 wRVU
    —

How to choose

49650Inguinal hernia repair
Both describe laparoscopic inguinal hernia repair; 49650 is for an initial repair, while 49651 is for recurrence after prior repair.
49520Inguinal hernia repair
This is the open alternative for recurrent, reducible inguinal hernia repair. Use 49651 when the recurrent repair is performed laparoscopically.
49613Abdominal hernia repair
This describes recurrent anterior abdominal hernia repair, not inguinal hernia repair. Select by the hernia's anatomic site.

Codes related to 49651

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

Codes related to 49651
CodeHow it relatesNational office range
Same family
49650Inguinal hernia repairLaparoscopic repair of an initial rather than recurrent inguinal hernia.No office rate
Used instead
49520Inguinal hernia repairOpen repair of a recurrent reducible inguinal hernia rather than laparoscopic repair.No office rate
49659Unlstd laps px hrnap hrnrphyUnlisted laparoscopic hernia procedure when no specific laparoscopic hernia code describes the service.No office rate

49651 billing questions

How is this code different from 49650?

Use 49651 for laparoscopic repair of an inguinal hernia that has recurred after prior repair. Code 49650 is for an initial laparoscopic inguinal hernia repair.

Can mesh placement be billed separately?

Mesh used to reinforce the laparoscopic inguinal hernia repair is part of the repair service. Do not report a separate mesh-placement service for that work.

How is a bilateral repair reported?

Report modifier 50 for bilateral repair. CMS pays the bilateral procedure at 150%.

What documentation supports recurrent rather than initial repair?

The operative report should identify the previously repaired inguinal site, the recurrent hernia, and the laparoscopic approach.

How does the 90-day global period affect follow-up billing?

The day-before preoperative visit and 90 days of related postoperative care are included in the global period.

May an assistant or co-surgeon be reported?

An assistant at surgery may be paid. Co-surgeon payment requires supporting documentation; team surgery is not permitted.

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 49651PPRRVU2026_Oct_nonQPP.csv, line 5,858 (RVU26D)

Open CMS sourceHow we calculate rates

Did this answer your question about what 49651 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 49651 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 →