CPT code 49553: Femoral hernia repair2026 Medicare rate & RVUs in Illinois
Repair a first-time femoral hernia when the hernia is incarcerated or strangulated, with operative treatment of the trapped contents and femoral defect.
CMS doesn’t publish an office rate for 49553 in Illinois.
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 49553 covers
This code describes surgical repair of a femoral hernia that is incarcerated or strangulated and has not been repaired previously. The surgeon addresses the hernia at the femoral canal, reduces the trapped contents when possible, assesses the involved tissue, and repairs the defect. These repairs are commonly performed in a hospital or other surgical facility, including when a patient presents with a painful, nonreducible groin mass or concern for compromised bowel.
Report this code when the operative record supports both the femoral location and incarcerated or strangulated status, and identifies the repair as the initial repair rather than a recurrence. The day-before preoperative visit and 90 days of related postoperative care are included in the 90-day global period. For bilateral repair, modifier 50 is paid at 150%. When multiple procedures are performed in the same session, the highest-valued procedure is paid in full and the others at 50%. 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 49553 pays more and less in Illinois
The same RVUs, adjusted for each area’s costs. Open a locality for its calculation, history and nearby areas.
| Payment locality | Office | Facility |
|---|---|---|
| Chicago | Unavailable | $721.17 |
| East St. Louis | Unavailable | $678.11 |
| Rest Of Illinois | Unavailable | $638.73 |
| Suburban Chicago | Unavailable | $681.59 |
How the 49553 rate is calculated
Each of 49553’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 · 49553
RVUs × geographic indexes × conversion factor
Work9.67
9.67 RVUs× 1.000 GPCI
Practice expense6.04
6.04 RVUs× 1.000 GPCI
Malpractice2.52
2.52 RVUs× 1.000 GPCI
Adjusted RVUs
18.2300
Conversion factor
$33.4009
Medicare rate
$608.90
Every GPCI starts at 1.000, the national rate. Enter a ZIP or drag a slider.
Payment rules and modifiers for 49553
49553 has a 90-day global period: related visits in that window are included in the surgery payment.
CMS payment indicators · 49553
Femoral 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 · 49553
Femoral 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
49553 without 50 · national facility
$608.90
Femoral hernia repair
49553-50 · Bilateral: 150%
$913.35
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).
49553 compared with similar codes
Compare codes · National
5 codes, side by side
How to choose
- 49550Femoral hernia repair
- Both are initial femoral hernia repairs. Choose 49553 for an incarcerated or strangulated hernia and 49550 for a reducible one.
- 49555Femoral hernia repair
- This is for a recurrent, reducible femoral hernia. 49553 is for an initial repair when the hernia is incarcerated or strangulated.
- 49557Femoral hernia repair
- Both describe incarcerated or strangulated femoral hernia repair; 49557 is for a recurrence, while 49553 is for an initial repair.
- 49501Inguinal hernia repair
- This describes an initial incarcerated or strangulated inguinal hernia repair. Use 49553 when the operative diagnosis and findings identify a femoral hernia.
49553 billing questions
How does this differ from 49550?
Both codes describe an initial femoral hernia repair. Use 49553 when the hernia is incarcerated or strangulated; 49550 is for a reducible femoral hernia.
Can this code be used for a recurrent femoral hernia?
No. This code is for an initial repair. A recurrent incarcerated or strangulated femoral hernia is represented by 49557.
What documentation supports reporting 49553?
The operative record should identify the femoral hernia, document its incarcerated or strangulated status, and support that this is the initial repair.
How is a bilateral repair handled?
For bilateral repair, report modifier 50; CMS pays the bilateral procedure at 150%.
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 paid?
An assistant at surgery may be paid. Co-surgeons are paid only with supporting documentation; team surgery is not permitted.
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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