Billing code 49501: Inguinal hernia repairMedicare rate & RVUs in Florida
Reports initial surgical repair of an incarcerated or strangulated inguinal hernia in a child aged 6 months to younger than 5 years.
CMS doesn’t publish an office rate for 49501 in Florida.
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 49501 covers
This code describes initial surgical repair of an inguinal hernia that is incarcerated or strangulated in a child aged 6 months to younger than 5 years. A pediatric or general surgeon typically performs the repair in an operating room, addressing the hernia and its contents through a surgical approach. The defining distinctions are the child’s age, an initial rather than recurrent repair, and documentation that the hernia is incarcerated or strangulated rather than reducible.
The operative report should support the hernia’s location and status, the patient’s age, and that this is the first repair. CMS assigns a 90-day global period, including the day-before preoperative visit and 90 days of related postoperative care. When multiple procedures are performed in the same session, the highest-valued procedure is paid in full and other procedures at 50%. For bilateral repair reported with modifier 50, CMS pays at 150%. Assistant-at-surgery services may be paid; 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.
Where 49501 pays more and less in Florida
The same RVUs, adjusted for each area’s costs. Open a locality for its calculation, history and nearby areas.
| Payment locality | Office | Facility |
|---|---|---|
| Fort Lauderdale | Unavailable | $654.97 |
| Miami | Unavailable | $719.33 |
| Rest Of Florida | Unavailable | $618.71 |
How the 49501 rate is calculated
Each of 49501’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 · 49501
RVUs × geographic indexes × conversion factor
Swap in your local Medicare rate.
Work 9.13Practice expense 5.99Malpractice 2.44
All indexes start at 1.000 (the national rate). Enter a ZIP or drag a slider.
Payment rules and modifiers for 49501
49501 has a 90-day global period: related visits in that window are included in the surgery payment.
CMS payment indicators · 49501
Inguinal hernia 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) | 1 | Bilateral with modifier 50 pays 150% of the fee schedule amount. |
| 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 · 49501
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.
Pre-op dayGlobal period
What modifiers do to the payment
Modifier 50 · payment effect
With and without the modifier
49501 without 50 · national facility
$586.52
Inguinal hernia repair
49501-50 · Bilateral: 150%
$879.78
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).
49501 compared with similar codes
Compare codes
49501 vs 49500 vs 49507 vs 49521: national Medicare rates
Swap in your local Medicare rate.
How to choose
- 49500Inguinal hernia repair
- Use 49500 for an initial reducible inguinal hernia in a child under 5. Use 49501 when the hernia is incarcerated or strangulated.
- 49507Inguinal hernia repair
- Both codes describe an initial incarcerated or strangulated inguinal hernia repair; 49507 is for patients aged 5 years or older, while 49501 is for children aged 6 months to younger than 5 years.
- 49521Inguinal hernia repair
- 49521 describes repair of a recurrent incarcerated inguinal hernia. Choose 49501 when the incarcerated or strangulated hernia is being repaired for the first time in a child under 5.
49501 billing questions
How does this code differ from 49500?
Both describe an initial inguinal hernia repair in a child younger than 5 years. Use 49501 when the hernia is incarcerated or strangulated; 49500 is for a reducible hernia.
When is 49507 used instead?
49507 describes an initial incarcerated or strangulated inguinal hernia repair in a patient aged 5 years or older. This code is for a child aged 6 months to younger than 5 years.
What documentation supports reporting 49501?
The operative record should identify the inguinal hernia as incarcerated or strangulated, establish that the repair is initial, and support the patient’s age.
How are bilateral repairs handled?
For bilateral repair reported with modifier 50, CMS pays at 150%. The record should support repair on both sides.
What postoperative care is included?
The 90-day global period includes the day-before preoperative visit and 90 days of related postoperative care.
Can an assistant or co-surgeon be reported?
Assistant-at-surgery services may be paid. Co-surgeon payment requires supporting documentation; CMS does not permit team-surgery payment for this code.
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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