Billing code 49621: Hernia repairMedicare rate & RVUs in Delaware
Repair a reducible hernia surrounding a stoma, using an open or minimally invasive approach, with mesh implantation included when performed.
CMS doesn’t publish an office rate for 49621 in Delaware.
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 49621 covers
This service repairs a hernia at the abdominal opening where a colostomy, ileostomy, or other stoma passes through the abdominal wall. The surgeon returns the hernia contents and repairs the defect; the hernia is reducible when its contents can be returned. The code covers open, laparoscopic, and robotic approaches, and includes mesh or another prosthesis when implanted. It is generally performed by a general or colorectal surgeon in an operating room.
Report this code for a reducible parastomal hernia, not a hernia at another abdominal site or an incarcerated or strangulated parastomal hernia. The operative note should identify the stoma site, describe the hernia and its reducibility, and document the repair approach and any prosthesis. The 0-day global period includes same-day preoperative and postoperative care. When multiple procedures occur in one session, the highest-valued procedure is paid in full and other procedures are subject to the standard 50% multiple-procedure reduction. 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.
49621 in Delaware
| Payment locality | Office | Facility |
|---|---|---|
| Delaware | Unavailable | $673.37 |
How the 49621 rate is calculated
Each of 49621’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 · 49621
RVUs × geographic indexes × conversion factor
Swap in your local Medicare rate.
Work 13.36Practice expense 3.94Malpractice 3.16
All indexes start at 1.000 (the national rate). Enter a ZIP or drag a slider.
Payment rules and modifiers for 49621
The CMS indicators that decide how 49621 is paid alongside other services.
CMS payment indicators · 49621
Hernia repair
| Rule | CMS value | What it means |
|---|---|---|
| Global period | 000 | Same-day global: pre- and post-op care on the day of the procedure is 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. |
What modifiers do to the payment
Modifier 51 · payment effect
With and without the modifier
49621 without 51 · national facility
$683.38
Hernia repair
49621-51 · Second procedure: 50%
$341.69
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%).
49621 compared with similar codes
Compare codes
49621 vs 49622 vs 49613 vs 49615: national Medicare rates
Swap in your local Medicare rate.
How to choose
- 49622Parastomal hernia repair
- Choose 49621 for a reducible parastomal hernia. Choose 49622 when the parastomal hernia is incarcerated or strangulated.
- 49613Abdominal hernia repair
- 49613 is for a qualifying anterior abdominal hernia under 3 cm, not a hernia around a stoma.
- 49615Hernia repair
- 49615 is for a qualifying anterior abdominal hernia 3–10 cm. A hernia at the stoma site is classified with the parastomal hernia codes instead.
49621 billing questions
How does this code differ from 49622?
49621 is for a reducible parastomal hernia. Use 49622 when the parastomal hernia is incarcerated or strangulated.
Does the code include mesh placement?
Yes. Mesh or another prosthesis is included when implanted as part of the parastomal hernia repair.
Can modifier 50 be used for a parastomal hernia?
No. The CMS bilateral adjustment does not apply to this code, and modifier 50 is inappropriate.
What should the operative note document?
Document the stoma site, the parastomal hernia and its reducibility, the repair performed, and any implanted prosthesis.
How are other procedures in the same session paid?
The highest-valued procedure is paid in full; other procedures performed in the same session are subject to the standard 50% multiple-procedure reduction.
Is assistant-at-surgery payment available?
CMS indicates that assistant-at-surgery payment may be made. Co-surgeon payment requires supporting documentation.
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 49621 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 →