Billing code 49610: Gastroschisis repairMedicare rate & RVUs in Alaska
Reports operative repair of gastroschisis in a newborn when the abdominal contents are reduced and the abdominal wall is closed in a primary repair.
CMS doesn’t publish an office rate for 49610 in Alaska.
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 9 sections
What 49610 covers
This code describes operative treatment of gastroschisis in a newborn: the surgeon returns the exposed abdominal contents to the abdomen and closes the abdominal wall defect. Pediatric surgeons typically perform the repair in a hospital operating room shortly after birth. A primary closure is used when the defect can be closed at the initial repair; staged management uses a different code.
Report the code when the operative record supports primary repair of gastroschisis, including the newborn’s diagnosis and the closure performed. The 90-day global period includes the day-before preoperative visit and related postoperative care during the following 90 days. When multiple procedures occur in the same session, the highest-valued procedure is paid in full and other procedures are subject to the standard 50% reduction. Modifier 50 is inappropriate for this midline defect. Assistant-at-surgery payment may be available; 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.
49610 in Alaska*
| Payment locality | Office | Facility |
|---|---|---|
| Alaska* | Unavailable | $811.58 |
How the 49610 rate is calculated
Each of 49610’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 · 49610
RVUs × geographic indexes × conversion factor
Swap in your local Medicare rate.
Work 10.64Practice expense 6.36Malpractice 2.84
All indexes start at 1.000 (the national rate). Enter a ZIP or drag a slider.
Payment rules and modifiers for 49610
49610 has a 90-day global period: related visits in that window are included in the surgery payment.
CMS payment indicators · 49610
Gastroschisis repair
| Rule | CMS value | What it means |
|---|---|---|
| Global period | 090 | Major surgery: the day before, the day of, and 90 days after are included. |
| Multiple procedures | 2 | Standard reduction: highest-valued procedure at 100%, others at 50%. |
| Bilateral (modifier 50) | 0 | The 150% bilateral adjustment doesn’t apply. |
| Assistant at surgery (80/81/82/AS) | 2 | Paid. |
| Co-surgeons (62) | 1 | Permitted with supporting documentation. |
| Team surgery (66) | 0 | Not permitted. |
| Professional/technical | 0 | Physician service: no professional/technical split. |
| Split (54/55/56) | 0.09/0.81/0.10 | Share of the payment for pre-op, the procedure itself, and post-op care. |
Global surgery period · 49610
Gastroschisis 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.
Pre-op dayGlobal period
What modifiers do to the payment
Modifier 51 · payment effect
With and without the modifier
49610 without 51 · national facility
$662.67
Gastroschisis repair
49610-51 · Second procedure: 50%
$331.34
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%).
49610 compared with similar codes
Compare codes
49610 vs 49611 vs 49600: national Medicare rates
Swap in your local Medicare rate.
How to choose
49610 billing questions
How does this differ from 49611?
Use 49610 for primary repair of gastroschisis. Use 49611 when the operative treatment is a staged closure.
Is this the code for omphalocele repair?
No. Gastroschisis and omphalocele are distinct congenital abdominal wall defects; codes 49600, 49605, and 49606 are in the omphalocele repair group.
What documentation supports reporting 49610?
Document the newborn’s gastroschisis and the operative reduction and primary abdominal wall closure. The record should make clear that the procedure was not a staged closure.
Can modifier 50 be used?
No. The defect is midline, so modifier 50 is inappropriate.
How are other procedures in the same session paid?
The highest-valued procedure is paid in full, with other procedures subject to the standard multiple-procedure reduction.
Can an assistant or co-surgeon be reported?
Assistant-at-surgery payment may be available. 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
Fee sheets
Put 49610 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 →