Billing code 49592: Abdominal hernia repairMedicare rate & RVUs in Florida
Reports initial repair of an anterior abdominal hernia under 3 cm when its contents cannot be reduced or the hernia is strangulated.
CMS doesn’t publish an office rate for 49592 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 49592 covers
A surgeon uses this code for the first repair of an anterior abdominal hernia, such as an umbilical, epigastric, ventral, incisional, or Spigelian hernia, when the contents cannot be returned to the abdomen or the hernia is strangulated and the defect is under 3 cm. The repair may be open, laparoscopic, or robotic. Mesh or another prosthesis is included when placed. These cases are commonly performed in an operating room for a painful or obstructed abdominal-wall bulge.
Select the code based on initial versus recurrent repair, reducibility or strangulation, and total transverse defect length. When multiple defects are repaired, add their lengths under the family rules. The operative report should support the hernia site, clinical condition, measurements, approach, and prosthesis use. CMS assigns a 0-day global period, so same-day preoperative and postoperative care is included. For multiple procedures in one session, the highest-valued procedure is paid in full and others at 50%. Modifier 50 is inappropriate. An assistant at surgery 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 49592 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 | $496.34 |
| Miami | Unavailable | $550.85 |
| Rest Of Florida | Unavailable | $469.25 |
How the 49592 rate is calculated
Each of 49592’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 · 49592
RVUs × geographic indexes × conversion factor
Swap in your local Medicare rate.
Work 8.25Practice expense 2.67Malpractice 2.16
All indexes start at 1.000 (the national rate). Enter a ZIP or drag a slider.
Payment rules and modifiers for 49592
The CMS indicators that decide how 49592 is paid alongside other services.
CMS payment indicators · 49592
Abdominal 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
49592 without 51 · national facility
$436.88
Abdominal hernia repair
49592-51 · Second procedure: 50%
$218.44
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%).
49592 compared with similar codes
Compare codes
49592 vs 49591 vs 49594 vs 49596: national Medicare rates
Swap in your local Medicare rate.
How to choose
- 49591Hernia repair
- This code applies when the under-3-cm hernia is incarcerated or strangulated. Use 49591 for the same size and initial-repair category when the hernia is reducible.
- 49594Hernia repair
- Both cover initial incarcerated or strangulated repairs, but 49594 is for a total defect length from 3 cm through 10 cm; this code is for under 3 cm.
- 49596Abdominal hernia repair
- Both cover initial incarcerated or strangulated repairs, but 49596 is for a total defect length over 10 cm.
49592 billing questions
How does this code differ from 49591?
Both describe an initial anterior abdominal hernia repair with a defect under 3 cm. Use 49592 when the hernia is incarcerated or strangulated; 49591 is for a reducible hernia.
Is mesh reported separately?
Mesh or another prosthesis is included in this repair code when used. Document its placement in the operative report.
How are multiple repaired defects measured?
Use the total transverse length of the defects repaired, adding their lengths when multiple hernias are repaired under the family rules.
Can modifier 50 be appended?
No. CMS identifies bilateral adjustment as inappropriate for this code.
What same-day payment rules affect this code?
It has a 0-day global period, so same-day preoperative and postoperative care is included. When multiple procedures are performed in the same session, the highest-valued procedure is paid in full and others at 50%.
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 49592 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 →