49600
No office rateUmbilical repair
Use 49600 for a newborn omphalocele in the small size category; 49606 represents the giant category.
On this page
CMS RVU26D · Effective 2026-10-01
49606 in Merced
Office / nonfacility
Not available in this setting
Base rate per service
Facility setting
$1020.62
Base rate per service
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.
Congenital surgery
About 49606: Giant omphalocele repair in a newborn
Reports surgical repair of a giant omphalocele in a newborn, a congenital abdominal wall defect requiring operative closure.
This code identifies operative repair of a giant omphalocele in a newborn. An omphalocele is a congenital abdominal wall defect in which abdominal contents protrude through the umbilical area within a sac. Pediatric or neonatal surgeons perform the repair, typically in an operating room. The operative report should establish that the condition is an omphalocele and describe the defect and repair sufficiently to support the giant category.
Select this code by the omphalocele size category, not by treating the condition as an acquired umbilical hernia or as gastroschisis. The code has a 90-day global period: the day-before preoperative visit and 90 days of related postoperative care are included. When multiple procedures occur in the same session, the highest-valued procedure is paid in full and other procedures are subject to the standard multiple procedure reduction. Modifier 50 is inappropriate for this code. Assistant-at-surgery payment may be made; co-surgeon payment requires supporting documentation, and team surgery is not permitted.
CMS billing rules for 49606
- Global period
- Major surgery with a 90-day global period: the day-before preoperative visit and 90 days of related postoperative care are 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 RVU18.53 · 58%
- Practice expense (office) RVU8.27 · 26%
- Malpractice RVU4.94 · 16%
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.
49606 compared with similar codes
Office rates for Merced, from the same CMS release.
No office rate
Use 49605 for the large omphalocele category. The documented defect category distinguishes it from the giant category reported with 49606.
No office rate
49610 is for gastroschisis repair, not omphalocele repair. Base code selection on the congenital defect documented and treated.
The same code, a different location
How does Merced compare?
49606 across payment areas
Same release and payment basis · bars start at $0
Merced · This locality
Unavailable
Unavailable
No comparable rate is available in this setting.
Unavailable
No comparable rate is available in this setting.
Unavailable
No comparable rate is available in this setting.
Unavailable
No comparable rate is available in this setting.
Unavailable
No comparable rate is available in this setting.
No comparable rate is available in this setting.
Other payment areas listed in California appear first, followed by selected cross-country examples. The chart compares amounts, not distance.
The code’s RVUs stay the same in these comparisons. Geographic adjustments to work, practice expense and malpractice change the dollar amount. A city name alone may not identify the payment area for a service address.
Compare all 108 other payment areas
Madera
California · 49606
Office
Unavailable
Facility
$1020.62
No comparable office rate is available.
Modesto
California · 49606
Office
Unavailable
Facility
$1020.62
No comparable office rate is available.
Napa
California · 49606
Office
Unavailable
Facility
$1105.80
No comparable office rate is available.
Oxnard-Thousand Oaks-Ventura
California · 49606
Office
Unavailable
Facility
$1065.54
No comparable office rate is available.
Redding
California · 49606
Office
Unavailable
Facility
$1020.62
No comparable office rate is available.
Rest Of California
California · 49606
Office
Unavailable
Facility
$1020.62
No comparable office rate is available.
Riverside-San Bernardino-Ontario
California · 49606
Office
Unavailable
Facility
$1073.55
No comparable office rate is available.
Sacramento-Roseville-Folsom
California · 49606
Office
Unavailable
Facility
$1050.89
No comparable office rate is available.
Salinas
California · 49606
Office
Unavailable
Facility
$1046.69
No comparable office rate is available.
San Diego-Chula Vista-Carlsbad
California · 49606
Office
Unavailable
Facility
$1057.28
No comparable office rate is available.
San Francisco-Oakland-Berkeley (Marin Cnty)
California · 49606
Office
Unavailable
Facility
$1142.93
No comparable office rate is available.
San Francisco-Oakland-Berkeley (San Francisco/San Mateo/Alameda/Contra Costa Cnty)
California · 49606
Office
Unavailable
Facility
$1137.32
No comparable office rate is available.
San Jose-Sunnyvale-Santa Clara (San Benito Cnty)
California · 49606
Office
Unavailable
Facility
$1173.76
No comparable office rate is available.
San Jose-Sunnyvale-Santa Clara (Santa Clara Cnty)
California · 49606
Office
Unavailable
Facility
$1150.82
No comparable office rate is available.
San Luis Obispo-Paso Robles
California · 49606
Office
Unavailable
Facility
$1032.50
No comparable office rate is available.
Santa Cruz-Watsonville
California · 49606
Office
Unavailable
Facility
$1055.97
No comparable office rate is available.
Santa Maria-Santa Barbara
California · 49606
Office
Unavailable
Facility
$1046.77
No comparable office rate is available.
Santa Rosa-Petaluma
California · 49606
Office
Unavailable
Facility
$1065.13
No comparable office rate is available.
Stockton
California · 49606
Office
Unavailable
Facility
$1020.62
No comparable office rate is available.
Vallejo
California · 49606
Office
Unavailable
Facility
$1097.71
No comparable office rate is available.
Visalia
California · 49606
Office
Unavailable
Facility
$1020.62
No comparable office rate is available.
Yuba City
California · 49606
Office
Unavailable
Facility
$1020.62
No comparable office rate is available.
Dc + Md/Va Suburbs
District of Columbia · 49606
Office
Unavailable
Facility
$1161.38
No comparable office rate is available.
Miami
Florida · 49606
Office
Unavailable
Facility
$1323.76
No comparable office rate is available.
Chicago
Illinois · 49606
Office
Unavailable
Facility
$1279.53
No comparable office rate is available.
Manhattan
New York · 49606
Office
Unavailable
Facility
$1241.19
No comparable office rate is available.
Alaska*
Alaska · 49606
Office
Unavailable
Facility
$1313.47
No comparable office rate is available.
Alabama
Alabama · 49606
Office
Unavailable
Facility
$954.01
No comparable office rate is available.
Arkansas
Arkansas · 49606
Office
Unavailable
Facility
$941.17
No comparable office rate is available.
Arizona
Arizona · 49606
Office
Unavailable
Facility
$1027.82
No comparable office rate is available.
Colorado
Colorado · 49606
Office
Unavailable
Facility
$1049.11
No comparable office rate is available.
Connecticut
Connecticut · 49606
Office
Unavailable
Facility
$1128.44
No comparable office rate is available.
Delaware
Delaware · 49606
Office
Unavailable
Facility
$1043.26
No comparable office rate is available.
Fort Lauderdale
Florida · 49606
Office
Unavailable
Facility
$1197.06
No comparable office rate is available.
Rest Of Florida
Florida · 49606
Office
Unavailable
Facility
$1130.99
No comparable office rate is available.
Atlanta
Georgia · 49606
Office
Unavailable
Facility
$1099.59
No comparable office rate is available.
Rest Of Georgia
Georgia · 49606
Office
Unavailable
Facility
$1061.99
No comparable office rate is available.
Hawaii, Guam
Hawaii · 49606
Office
Unavailable
Facility
$1028.52
No comparable office rate is available.
Iowa
Iowa · 49606
Office
Unavailable
Facility
$937.17
No comparable office rate is available.
Idaho
Idaho · 49606
Office
Unavailable
Facility
$951.09
No comparable office rate is available.
East St. Louis
Illinois · 49606
Office
Unavailable
Facility
$1205.36
No comparable office rate is available.
Rest Of Illinois
Illinois · 49606
Office
Unavailable
Facility
$1129.01
No comparable office rate is available.
Suburban Chicago
Illinois · 49606
Office
Unavailable
Facility
$1199.32
No comparable office rate is available.
Indiana
Indiana · 49606
Office
Unavailable
Facility
$955.17
No comparable office rate is available.
Kansas
Kansas · 49606
Office
Unavailable
Facility
$951.79
No comparable office rate is available.
Kentucky
Kentucky · 49606
Office
Unavailable
Facility
$1015.46
No comparable office rate is available.
New Orleans
Louisiana · 49606
Office
Unavailable
Facility
$1066.29
No comparable office rate is available.
Rest Of Louisiana
Louisiana · 49606
Office
Unavailable
Facility
$1021.45
No comparable office rate is available.
Metropolitan Boston
Massachusetts · 49606
Office
Unavailable
Facility
$1120.96
No comparable office rate is available.
Rest Of Massachusetts
Massachusetts · 49606
Office
Unavailable
Facility
$1051.19
No comparable office rate is available.
Baltimore/Surr. Cntys
Maryland · 49606
Office
Unavailable
Facility
$1129.32
No comparable office rate is available.
Rest Of Maryland
Maryland · 49606
Office
Unavailable
Facility
$1056.12
No comparable office rate is available.
Rest Of Maine
Maine · 49606
Office
Unavailable
Facility
$975.68
No comparable office rate is available.
Southern Maine
Maine · 49606
Office
Unavailable
Facility
$996.77
No comparable office rate is available.
Detroit
Michigan · 49606
Office
Unavailable
Facility
$1163.67
No comparable office rate is available.
Rest Of Michigan
Michigan · 49606
Office
Unavailable
Facility
$1057.40
No comparable office rate is available.
Minnesota
Minnesota · 49606
Office
Unavailable
Facility
$951.99
No comparable office rate is available.
Metropolitan Kansas City
Missouri · 49606
Office
Unavailable
Facility
$1039.50
No comparable office rate is available.
Metropolitan St. Louis
Missouri · 49606
Office
Unavailable
Facility
$1047.22
No comparable office rate is available.
Rest Of Missouri
Missouri · 49606
Office
Unavailable
Facility
$1017.74
No comparable office rate is available.
Mississippi
Mississippi · 49606
Office
Unavailable
Facility
$978.68
No comparable office rate is available.
Montana**
Montana · 49606
Office
Unavailable
Facility
$1059.81
No comparable office rate is available.
North Carolina
North Carolina · 49606
Office
Unavailable
Facility
$982.07
No comparable office rate is available.
North Dakota**
North Dakota · 49606
Office
Unavailable
Facility
$962.13
No comparable office rate is available.
Nebraska
Nebraska · 49606
Office
Unavailable
Facility
$936.24
No comparable office rate is available.
New Hampshire
New Hampshire · 49606
Office
Unavailable
Facility
$1050.84
No comparable office rate is available.
Northern Nj
New Jersey · 49606
Office
Unavailable
Facility
$1154.55
No comparable office rate is available.
Rest Of New Jersey
New Jersey · 49606
Office
Unavailable
Facility
$1126.32
No comparable office rate is available.
New Mexico
New Mexico · 49606
Office
Unavailable
Facility
$1070.38
No comparable office rate is available.
Nevada**
Nevada · 49606
Office
Unavailable
Facility
$1032.87
No comparable office rate is available.
Nyc Suburbs/Long Island
New York · 49606
Office
Unavailable
Facility
$1293.37
No comparable office rate is available.
Poughkpsie/N Nyc Suburbs
New York · 49606
Office
Unavailable
Facility
$1148.89
No comparable office rate is available.
Queens
New York · 49606
Office
Unavailable
Facility
$1222.96
No comparable office rate is available.
Rest Of New York
New York · 49606
Office
Unavailable
Facility
$997.33
No comparable office rate is available.
Ohio
Ohio · 49606
Office
Unavailable
Facility
$1037.43
No comparable office rate is available.
Oklahoma
Oklahoma · 49606
Office
Unavailable
Facility
$993.79
No comparable office rate is available.
Portland
Oregon · 49606
Office
Unavailable
Facility
$1058.47
No comparable office rate is available.
Rest Of Oregon
Oregon · 49606
Office
Unavailable
Facility
$1010.03
No comparable office rate is available.
Metropolitan Philadelphia
Pennsylvania · 49606
Office
Unavailable
Facility
$1114.46
No comparable office rate is available.
Rest Of Pennsylvania
Pennsylvania · 49606
Office
Unavailable
Facility
$1028.42
No comparable office rate is available.
Puerto Rico
Puerto Rico · 49606
Office
Unavailable
Facility
$1060.71
No comparable office rate is available.
Rhode Island
Rhode Island · 49606
Office
Unavailable
Facility
$1063.20
No comparable office rate is available.
South Carolina
South Carolina · 49606
Office
Unavailable
Facility
$1014.40
No comparable office rate is available.
South Dakota**
South Dakota · 49606
Office
Unavailable
Facility
$950.58
No comparable office rate is available.
Tennessee
Tennessee · 49606
Office
Unavailable
Facility
$958.61
No comparable office rate is available.
Austin
Texas · 49606
Office
Unavailable
Facility
$1058.59
No comparable office rate is available.
Beaumont
Texas · 49606
Office
Unavailable
Facility
$1023.57
No comparable office rate is available.
Brazoria
Texas · 49606
Office
Unavailable
Facility
$1026.31
No comparable office rate is available.
Dallas
Texas · 49606
Office
Unavailable
Facility
$1041.18
No comparable office rate is available.
Fort Worth
Texas · 49606
Office
Unavailable
Facility
$1040.56
No comparable office rate is available.
Galveston
Texas · 49606
Office
Unavailable
Facility
$1034.78
No comparable office rate is available.
Houston
Texas · 49606
Office
Unavailable
Facility
$1125.20
No comparable office rate is available.
Rest Of Texas
Texas · 49606
Office
Unavailable
Facility
$1030.05
No comparable office rate is available.
Utah
Utah · 49606
Office
Unavailable
Facility
$1026.74
No comparable office rate is available.
Virginia
Virginia · 49606
Office
Unavailable
Facility
$1006.94
No comparable office rate is available.
Virgin Islands
United States Virgin Islands · 49606
Office
Unavailable
Facility
$1060.71
No comparable office rate is available.
Vermont
Vermont · 49606
Office
Unavailable
Facility
$975.87
No comparable office rate is available.
Rest Of Washington
Washington · 49606
Office
Unavailable
Facility
$1043.40
No comparable office rate is available.
Seattle (King Cnty)
Washington · 49606
Office
Unavailable
Facility
$1123.60
No comparable office rate is available.
Wisconsin
Wisconsin · 49606
Office
Unavailable
Facility
$934.36
No comparable office rate is available.
West Virginia
West Virginia · 49606
Office
Unavailable
Facility
$1095.07
No comparable office rate is available.
Wyoming**
Wyoming · 49606
Office
Unavailable
Facility
$1017.24
No comparable office rate is available.
See how rates vary across the country
49606 · 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 |
Where does this rate apply?
Merced is a Medicare payment area. Our Census mapping connects it to 24 cities and communities in California, including the examples shown here.
Some communities span more than one payment area. Follow a city link to compare all of its mapped areas, or check the service-location ZIP above for an address-level starting point.
Use this rate
What is a percentage of Medicare worth?
Turn a percentage into dollars for 49606 in Merced. This uses the base rate on this page, so the locality and release stay consistent.
Reference amount per service
$1122.68
$1020.62 × 110% = $1122.68
A contract may specify another Medicare year or additional adjustments. This is percentage arithmetic on the displayed base rate, not a claim adjudication.
Working with a whole code list?
Compare an offer across your annual code mix, including an older Medicare schedule or flat per-code rates.
How this local rate is calculated
Each RVU component is multiplied by its own geographic practice cost index (GPCI). The three adjusted components are added, then multiplied by the conversion factor. These are the inputs used for 49606 in Merced.
PPRRVU2026_Oct_nonQPP.csv
5,845
- Code
- 49606
- Physician work
- 18.53
- Practice expense
- 8.27
- Malpractice
- 4.94
GPCI2026.csv
15
- Locality
- Merced
- Physician work
- 1.017
- Practice expense
- 1.096
- Malpractice
- 0.536
| Component | RVU | Locality factor | Adjusted |
|---|---|---|---|
| Physician work | 18.53 | × 1.017 | 18.8450 |
| Practice expense | 8.27 | × 1.096 | 9.0639 |
| Malpractice | 4.94 | × 0.536 | 2.6478 |
| Total RVUs | 30.5568 | ||
| Conversion factor | × 33.4009 | ||
Facility rate, Merced$1020.62
Open 49606 in the RVU calculator →
Explore RVUs, geographic factors and the full formula
Facility
| Component | RVU | Local GPCI |
|---|---|---|
| Work | 18.53 | 1.017 |
| Practice expense | 8.27 | 1.096 |
| Malpractice | 4.94 | 0.536 |
(18.53 × 1.017 + 8.27 × 1.096 + 4.94 × 0.536) × $33.4009 = $1020.62
The office and facility calculations use their respective practice-expense RVUs. The facility amount here is the physician fee, not a separate hospital or facility bill.
How this rate has changed
49606 · Office / nonfacility
Rate unavailable
Effective 2026-10-01
A rate is unavailable in one of these releases, so a change cannot be calculated.
One bar per available release, ordered by effective date. Missing rates remain gaps. These comparisons hold the code, setting and locality identifiers constant; they do not isolate which policy or input caused a change.
What changed, release by release
Explore release dates and calculate this code in an earlier period →
Each row uses the accepted CMS release effective on that date and the same contractor and locality identifiers. Missing rates stay visible. Historical boundaries may differ; verify the service address for an older claim.
Inspect every release and its CMS source
| Effective from | Office / nonfacility | Facility | CMS release |
|---|---|---|---|
| 2026-10-01 | Not available in this setting | $1020.62 | RVU26D |
| 2026-07-01 | Not available in this setting | $1020.62 | RVU26C |
| 2026-04-01 | Not available in this setting | $1020.62 | RVU26B |
| 2026-01-01 | Not available in this setting | $1020.62 | RVU26A |
| 2025-10-01 | Not available in this setting | $1081.20 | RVU25D |
| 2025-07-01 | Not available in this setting | $1081.20 | RVU25C |
| 2025-04-01 | Not available in this setting | $1081.20 | RVU25B |
| 2025-01-01 | Not available in this setting | $1081.20 | RVU25A |
49606 billing questions
How is 49606 distinguished from 49600 and 49605?
These codes distinguish omphalocele repairs by the size category documented for the newborn’s defect. Use 49606 for the giant category, not the small or large categories.
Is an omphalocele the same as gastroschisis for coding?
No. An omphalocele and gastroschisis are distinct congenital abdominal wall defects; this code is for giant omphalocele repair.
Does the 90-day global period include related postoperative care?
Yes. The day-before preoperative visit and 90 days of related postoperative care are included in the global period.
Can modifier 50 be reported for a bilateral repair?
No. Bilateral adjustment is not appropriate for this code.
Can an assistant or co-surgeon be reported?
Assistant-at-surgery payment may be made. Co-surgeon payment requires supporting documentation; team surgery is not permitted.
What happens when another procedure is performed in the same session?
The highest-valued procedure is paid in full, and other procedures are subject to the standard 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.
5,84249596,,Rpr aa hrn 1st > 10 ncr/strn,A,,18.20,5.11,NA,5.11,,4.73,28.04,28.04,0,000,0.00,0.00,0.00,2,0,2,1,0,9,,33.4009,09,0,99,0.00,0.00,0.00
5,84349600,,Repair umbilical lesion,A,,11.26,6.80,NA,6.80,,3.01,21.07,21.07,0,090,0.09,0.81,0.10,2,0,2,1,0,9,,33.4009,09,0,99,0.00,0.00,0.00
5,84449605,,Repair umbilical lesion,A,,84.91,26.81,NA,26.81,,22.74,134.46,134.46,0,090,0.09,0.81,0.10,2,0,2,1,0,9,,33.4009,09,0,99,0.00,0.00,0.00
5,84549606,,Repair umbilical lesion,A,,18.53,8.27,NA,8.27,,4.94,31.74,31.74,0,090,0.09,0.81,0.10,2,0,2,1,0,9,,33.4009,09,0,99,0.00,0.00,0.00
5,84649610,,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
1201112,CA,57,HANFORD-CORCORAN,1.017,1.096,0.536
1301182,CA,18,LOS ANGELES-LONG BEACH-ANAHEIM (LOS ANGELES/ORANGE CNTY),1.041,1.183,0.664
1401112,CA,58,MADERA,1.017,1.096,0.536
1501112,CA,59,MERCED,1.017,1.096,0.536
1601112,CA,60,MODESTO,1.017,1.096,0.536
1701112,CA,51,NAPA,1.063,1.318,0.508
1801182,CA,17,OXNARD-THOUSAND OAKS-VENTURA,1.028,1.182,0.623