CPT code 49623: Mesh removal2026 Medicare rate & RVUs in Delaware
Reports removal of noninfected mesh or another prosthesis during a hernia repair, in addition to the primary repair code.
CMS doesn’t publish an office rate for 49623 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 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.
49623 in Delaware
| Payment locality | Office | Facility |
|---|---|---|
| Delaware | Unavailable | $181.08 |
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
Work3.66
3.66 RVUs× 1.000 GPCI
Practice expense0.90
0.90 RVUs× 1.000 GPCI
Malpractice0.95
0.95 RVUs× 1.000 GPCI
Adjusted RVUs
5.5100
Conversion factor
$33.4009
Medicare rate
$184.04
Every GPCI starts 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
| Rule | CMS value | What it means |
|---|---|---|
| Global period | ZZZ | Add-on code: falls within the primary procedure’s global period. |
| Multiple procedures | 0 | No multiple-procedure reduction. |
| 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 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.
49623 compared with similar codes
Compare codes · National
4 codes, side by side
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.
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
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