No office rate
49002 represents reopening a recent laparotomy. Report 49900 for the abdominal wall repair when the incision has disrupted; both services may be relevant when both procedures are performed.
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CMS RVU26D · Effective 2026-10-01
49900 Abdominal wall repair Medicare reimbursement rates in Idaho
Reports operative reclosure of an abdominal incision after wound separation or evisceration, rather than repair of an abdominal hernia. Compare 49900 office and facility rates across CMS payment localities in Idaho.
Amounts below use the non-QP conversion factor for participating physicians. These are base physician payments before claim-level adjustments, not patient costs or total hospital charges.
What does Medicare pay for 49900 in Idaho?
Idaho has 1 payment locality in this comparison. Use the service location to choose the applicable amount. These are the supported base rates for the payment area shown below, using the same CMS release.
Office / nonfacility
No supported rate
Facility setting
$723.21
1 of 1 localities have a supported rate.
Payment area: Idaho
One mapped payment locality.
These are locality ranges, not averages or address-specific quotes. A facility-setting amount covers the physician service; it does not include a hospital’s separate bill. Choose a locality below to inspect its calculation, compare other payment areas, or price a percentage of Medicare.
General surgery
About 49900: Secondary abdominal wall closure
Reports operative reclosure of an abdominal incision after wound separation or evisceration, rather than repair of an abdominal hernia.
CPT 49900 describes operative reclosure of an abdominal incision when the abdominal wall has separated, including cases with evisceration. A surgeon typically performs the repair in an operating room, often after a patient returns following recent abdominal surgery. The operative report should identify the wound disruption and describe the repair of the abdominal wall; routine dressing care or superficial skin closure alone does not establish this service.
Report 49900 when the surgeon repairs the disrupted abdominal wall, not when the procedure is an incisional hernia repair. The code has a 90-day global period: the day-before preoperative visit and 90 days of related postoperative care are included. For multiple procedures in one session, the highest-valued procedure is paid in full and other procedures are subject to the standard 50% reduction. Modifier 50 is inappropriate. Assistant-at-surgery payment may be available; co-surgeon payment requires supporting documentation, and team surgery is not permitted.
CMS billing rules for 49900
- Global period
- Major surgery with a 90-day global period: the day-before preoperative visit and 90 days of related postoperative care are included.
- Multiple procedures
- Standard multiple procedure reduction: the highest-valued procedure is paid in full and others at 50% when performed in the same session.
- Bilateral procedures
- Bilateral adjustment does not apply; the descriptor or anatomy makes modifier 50 inappropriate.
- Assistant at surgery
- Assistant at surgery may be paid.
- Co-surgeons
- Co-surgeons paid only with supporting documentation.
- Team surgery
- Team surgery not permitted.
Where the value comes from
- Work RVU12.10 · 51%
- Practice expense (office) RVU8.82 · 37%
- Malpractice RVU3.04 · 13%
920
Medicare services in 2024 · #3031 by national volume
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.
49900 compared with similar codes
Office rates for Idaho, from the same CMS release.
No office rate
49591 is for repair of a qualifying anterior abdominal hernia. Use 49900 for reclosure of a disrupted abdominal incision, not a hernia repair.
49999
No office rateUnlisted px abd pertm&omn
49999 is an unlisted abdominal procedure code for a service without a specific code. Use 49900 when the service is the described repair of a disrupted abdominal wall.
Compare 49900 by payment locality
Find the payment area for your service address, then open its rate page for calculation inputs, release history and the percentage-of-Medicare tool. A city may cross payment-area boundaries; the ZIP lookup above helps resolve the location.
1 of 1 payment localities
Idaho →
Office / nonfacility
Unavailable
Facility
$723.21
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How this local rate is calculated
Each RVU component is multiplied by its own geographic practice cost index (GPCI). The three adjusted components are added, then multiplied by the conversion factor. These are the inputs used for 49900 in Idaho.
PPRRVU2026_Oct_nonQPP.csv
5,860
- Code
- 49900
- Physician work
- 12.10
- Practice expense
- 8.82
- Malpractice
- 3.04
GPCI2026.csv
47
- Locality
- Idaho
- Physician work
- 1.000
- Practice expense
- 0.920
- Malpractice
- 0.473
| Component | RVU | Locality factor | Adjusted |
|---|---|---|---|
| Physician work | 12.10 | × 1.000 | 12.1000 |
| Practice expense | 8.82 | × 0.920 | 8.1144 |
| Malpractice | 3.04 | × 0.473 | 1.4379 |
| Total RVUs | 21.6523 | ||
| Conversion factor | × 33.4009 | ||
Facility rate, Idaho$723.21
Explore RVUs, geographic factors and the full formula
Facility
| Component | RVU | Local GPCI |
|---|---|---|
| Work | 12.1 | 1 |
| Practice expense | 8.82 | 0.92 |
| Malpractice | 3.04 | 0.473 |
(12.1 × 1 + 8.82 × 0.92 + 3.04 × 0.473) × $33.4009 = $723.21
The office and facility calculations use their respective practice-expense RVUs. The facility amount here is the physician fee, not a separate hospital or facility bill.
49900 billing questions
When should 49900 be chosen instead of an abdominal hernia repair code?
Use 49900 for operative repair of a disrupted abdominal incision, such as fascial separation or evisceration. Use a hernia repair code when the operative service repairs a hernia.
Can 49900 be reported with 49002?
49002 describes reopening a recent laparotomy, while 49900 describes repair of the disrupted abdominal wall. Both may be relevant when the surgeon reopens the incision and performs a distinct repair; the operative report should support each service.
Is modifier 50 appropriate for bilateral repair?
No. The abdominal wall repair is not reported with a bilateral adjustment under the CMS rule for this code.
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 payment may be available. Co-surgeon payment requires supporting documentation; team surgery is not permitted.
What should the operative note document?
Document the abdominal wound disruption, whether evisceration occurred, and the operative repair performed on the abdominal wall. This helps distinguish the service from superficial wound care or hernia repair.
Where these rates come from
FeeBase calculates base physician payments from CMS work, practice-expense, and malpractice RVUs, adjusted by each locality’s geographic indices and the applicable conversion factor. Unavailable or separately priced services are labeled rather than assigned a made-up amount.
Source: RVU26D. Effective 2026-10-01 through the day before 2027-01-01.
5,85749650,,Lap ing hernia repair init,A,,6.20,4.87,NA,4.87,,1.63,12.70,12.70,0,090,0.09,0.81,0.10,2,1,2,1,0,9,,33.4009,09,0,99,0.00,0.00,0.00
5,85849651,,Lap ing hernia repair recur,A,,8.17,6.15,NA,6.15,,2.15,16.47,16.47,0,090,0.09,0.81,0.10,2,1,2,1,0,9,,33.4009,09,0,99,0.00,0.00,0.00
5,85949659,,Unlstd laps px hrnap hrnrphy,C,,0.00,0.00,,0.00,,0.00,0.00,0.00,0,YYY,0.00,0.00,0.00,2,1,2,1,1,9,,33.4009,09,0,99,0.00,0.00,0.00
5,86049900,,Repair of abdominal wall,A,,12.10,8.82,NA,8.82,,3.04,23.96,23.96,0,090,0.09,0.81,0.10,2,0,2,1,0,9,,33.4009,09,0,99,0.00,0.00,0.00
5,86149904,,Omental flap extra-abdom,A,,21.79,11.77,NA,11.77,,5.01,38.57,38.57,0,090,0.10,0.80,0.10,2,0,1,1,1,9,,33.4009,09,0,99,0.00,0.00,0.00
5,86249905,,Omental flap intra-abdom,A,,6.38,1.57,NA,1.57,,1.48,9.43,9.43,0,ZZZ,0.00,0.00,0.00,0,0,2,2,0,9,,33.4009,09,0,99,0.00,0.00,0.00
5,86349906,,Free omental flap microvasc,C,,0.00,0.00,,0.00,,0.00,0.00,0.00,0,090,0.09,0.81,0.10,2,0,1,1,0,9,,33.4009,09,0,99,0.00,0.00,0.00
4410212,GA,01,ATLANTA,1.003,1.016,1.201
4510212,GA,99,REST OF GEORGIA,1.000,0.892,1.192
4601212,HI,01,"HAWAII, GUAM",1.000,1.137,0.579
4702202,ID,00,IDAHO,1.000,0.920,0.473
4806102,IL,16,CHICAGO,1.007,1.005,2.295
4906102,IL,12,EAST ST. LOUIS,1.000,0.920,2.014
5006102,IL,15,SUBURBAN CHICAGO,1.007,1.027,1.772