No office rate
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.
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CMS RVU26D · Effective 2026-10-01
49592 Abdominal hernia repair Medicare reimbursement rates in Illinois
Reports initial repair of an anterior abdominal hernia under 3 cm when its contents cannot be reduced or the hernia is strangulated. Compare 49592 office and facility rates across CMS payment localities in Illinois.
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 49592 in Illinois?
Illinois has 4 payment localities in this comparison. Use the service location to choose the applicable amount. These are the supported base rates for the 4 payment areas shown below, using the same CMS release.
Office / nonfacility
No supported rate
Facility setting
$469.74–$532.69
4 of 4 localities have a supported rate.
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.
Where 49592 pays more and less in Illinois
Hernia repair
About 49592: Initial small incarcerated abdominal hernia repair
Reports initial repair of an anterior abdominal hernia under 3 cm when its contents cannot be reduced or the hernia is strangulated.
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.
CMS billing rules for 49592
- Global period
- Minor procedure with a 0-day global period: same-day preoperative and postoperative care is 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 RVU8.25 · 63%
- Practice expense (office) RVU2.67 · 20%
- Malpractice RVU2.16 · 17%
13.1K
Medicare services in 2024 · #1336 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.
49592 compared with similar codes
Office rates for Illinois, from the same CMS release.
No office rate
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.
No office rate
Both cover initial incarcerated or strangulated repairs, but 49596 is for a total defect length over 10 cm.
Compare 49592 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.
4 of 4 payment localities
Chicago →
Office / nonfacility
Unavailable
Facility
$532.69
East St. Louis →
Office / nonfacility
Unavailable
Facility
$502.91
Rest Of Illinois →
Office / nonfacility
Unavailable
Facility
$469.74
Suburban Chicago →
Office / nonfacility
Unavailable
Facility
$496.92
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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 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.
5,83549555,,Rerepair fem hernia reduce,A,,9.16,5.85,NA,5.85,,2.46,17.47,17.47,0,090,0.09,0.81,0.10,2,1,2,1,0,9,,33.4009,09,0,99,0.00,0.00,0.00
5,83649557,,Rerepair fem hernia blocked,A,,11.33,6.45,NA,6.45,,2.95,20.73,20.73,0,090,0.09,0.81,0.10,2,1,2,1,0,9,,33.4009,09,0,99,0.00,0.00,0.00
5,83749591,,Rpr aa hrn 1st < 3 cm rdc,A,,5.81,2.15,NA,2.15,,1.49,9.45,9.45,0,000,0.00,0.00,0.00,2,0,2,1,0,9,,33.4009,09,0,99,0.00,0.00,0.00
5,83849592,,Rpr aa hrn 1st < 3 ncr/strn,A,,8.25,2.67,NA,2.67,,2.16,13.08,13.08,0,000,0.00,0.00,0.00,2,0,2,1,0,9,,33.4009,09,0,99,0.00,0.00,0.00
5,83949593,,Rpr aa hrn 1st 3-10 rdc,A,,10.00,3.11,NA,3.11,,2.61,15.72,15.72,0,000,0.00,0.00,0.00,2,0,2,1,0,9,,33.4009,09,0,99,0.00,0.00,0.00
5,84049594,,Rpr aa hrn 1st 3-10 ncr/strn,A,,13.12,3.86,NA,3.86,,3.45,20.43,20.43,0,000,0.00,0.00,0.00,2,0,2,1,0,9,,33.4009,09,0,99,0.00,0.00,0.00
5,84149595,,Rpr aa hrn 1st > 10 rdc,A,,13.59,4.03,NA,4.03,,3.47,21.09,21.09,0,000,0.00,0.00,0.00,2,0,2,1,0,9,,33.4009,09,0,99,0.00,0.00,0.00