Billing code 49555: Femoral hernia repairMedicare rate & RVUs in Illinois
Reports operative repair of a recurrent femoral hernia when the hernia is reducible, rather than an initial or nonreducible femoral hernia.
CMS doesn’t publish an office rate for 49555 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 49555 covers
This service repairs a femoral hernia that has returned after an earlier repair and can be reduced. A surgeon treats the defect in an operative setting, addressing the hernia contents and repairing the weakened area. The femoral location distinguishes this service from repair of an inguinal hernia, even when the clinical presentation is similar.
Report the code when the operative record supports both a prior femoral hernia repair and a recurrent, reducible hernia. Use the nonreducible recurrent femoral hernia code when the hernia is documented as incarcerated or strangulated. Medicare assigns a 90-day global period, including the day-before preoperative visit and related postoperative care. For multiple procedures in one session, the highest-valued procedure is paid in full and other procedures are subject to the standard 50% reduction. Bilateral reporting with modifier 50 is paid at 150%. Assistant-at-surgery payment may be made; 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 49555 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 | $693.04 |
| East St. Louis | Unavailable | $651.20 |
| Rest Of Illinois | Unavailable | $612.77 |
| Suburban Chicago | Unavailable | $654.36 |
How the 49555 rate is calculated
Each of 49555’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 · 49555
RVUs × geographic indexes × conversion factor
Swap in your local Medicare rate.
Work 9.16Practice expense 5.85Malpractice 2.46
All indexes start at 1.000 (the national rate). Enter a ZIP or drag a slider.
Payment rules and modifiers for 49555
49555 has a 90-day global period: related visits in that window are included in the surgery payment.
CMS payment indicators · 49555
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 · 49555
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
49555 without 50 · national facility
$583.51
Femoral hernia repair
49555-50 · Bilateral: 150%
$875.27
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).
49555 compared with similar codes
Compare codes
49555 vs 49550 vs 49553 vs 49557 vs 49520: national Medicare rates
Swap in your local Medicare rate.
How to choose
- 49550Femoral hernia repair
- Both describe reducible femoral hernia repair; 49550 is for an initial repair, while this code is for a recurrence after prior repair.
- 49553Femoral hernia repair
- This code is for a recurrent, reducible femoral hernia. 49553 describes an initial femoral hernia repair when the hernia is incarcerated or strangulated.
- 49557Femoral hernia repair
- Both describe repair of a recurrent femoral hernia. Use 49557 when the hernia is incarcerated or strangulated rather than reducible.
- 49520Inguinal hernia repair
- 49520 describes recurrent reducible inguinal hernia repair. Choose the femoral code when the defect is in the femoral region.
49555 billing questions
How does this differ from an initial femoral hernia repair?
This code is for a femoral hernia that has recurred after a prior repair. Use the initial-repair code when there has been no earlier repair of that femoral hernia.
When should the nonreducible recurrent femoral hernia code be used?
Use the nonreducible recurrent code when the operative documentation describes the recurrent femoral hernia as incarcerated or strangulated, rather than reducible.
What documentation supports reporting this code?
Document the femoral location, the history of prior repair, and the reducible status of the recurrent hernia, along with the operative repair performed.
How is bilateral repair reported?
Report modifier 50 for bilateral repair. CMS pays the bilateral procedure at 150%.
How do multiple-procedure and assistant-surgery rules affect payment?
When performed with other procedures in the same session, the highest-valued procedure is paid in full and the others are subject to the standard 50% reduction. Assistant-at-surgery payment may be made; co-surgeon payment requires supporting documentation.
What care is included in the global period?
The 90-day global period includes the day-before preoperative visit and 90 days of related postoperative care.
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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