No office rate
Use 49618 for a recurrent defect over 10 cm that is incarcerated or strangulated; 49617 is for a reducible defect.
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CMS RVU26D · Effective 2026-10-01
49617 Abdominal hernia repair Medicare reimbursement rates in Iowa
Reports operative repair of a recurrent, reducible anterior abdominal hernia when the total defect length is greater than 10 cm. Compare 49617 office and facility rates across CMS payment localities in Iowa.
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 49617 in Iowa?
Iowa 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
$714.76
1 of 1 localities have a supported rate.
Payment area: Iowa
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 49617: Recurrent large reducible abdominal hernia repair
Reports operative repair of a recurrent, reducible anterior abdominal hernia when the total defect length is greater than 10 cm.
A surgeon repairs a recurrent hernia of the anterior abdominal wall, such as a recurrent ventral or incisional hernia. The defect is reducible and its total length is greater than 10 cm. Repair may be performed through an open, laparoscopic, or robotic approach. These operations are typically performed in a hospital or ambulatory surgery facility by a general surgeon or another surgeon who treats abdominal wall hernias.
Choose this code based on the documented recurrence, reducibility, and total defect length—not the size of the hernia sac. The operative report should support the prior repair, the defect measurement, and whether the contents could be reduced. Mesh or another prosthesis used in the repair is included in the hernia repair service. Medicare 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 other procedures are subject to the standard 50% reduction. Assistant-at-surgery payment may be made; co-surgeons require supporting documentation, and team surgery is not permitted. Modifier 50 is inappropriate for this code.
CMS billing rules for 49617
- 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 RVU15.63 · 65%
- Practice expense (office) RVU4.57 · 19%
- Malpractice RVU4.00 · 17%
1.7K
Medicare services in 2024 · #2595 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.
49617 compared with similar codes
Office rates for Iowa, from the same CMS release.
No office rate
Both cover a reducible defect over 10 cm. Use 49595 for an initial repair and 49617 for a recurrent repair.
No office rate
Both describe recurrent, reducible repair, but 49615 is for a defect in the 3–10 cm group rather than one over 10 cm.
Compare 49617 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
Iowa →
Office / nonfacility
Unavailable
Facility
$714.76
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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 49617 in Iowa.
PPRRVU2026_Oct_nonQPP.csv
5,852
- Code
- 49617
- Physician work
- 15.63
- Practice expense
- 4.57
- Malpractice
- 4.00
GPCI2026.csv
53
- Locality
- Iowa
- Physician work
- 1.000
- Practice expense
- 0.915
- Malpractice
- 0.397
| Component | RVU | Locality factor | Adjusted |
|---|---|---|---|
| Physician work | 15.63 | × 1.000 | 15.6300 |
| Practice expense | 4.57 | × 0.915 | 4.1816 |
| Malpractice | 4.00 | × 0.397 | 1.5880 |
| Total RVUs | 21.3996 | ||
| Conversion factor | × 33.4009 | ||
Facility rate, Iowa$714.76
Explore RVUs, geographic factors and the full formula
Facility
| Component | RVU | Local GPCI |
|---|---|---|
| Work | 15.63 | 1 |
| Practice expense | 4.57 | 0.915 |
| Malpractice | 4 | 0.397 |
(15.63 × 1 + 4.57 × 0.915 + 4 × 0.397) × $33.4009 = $714.76
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.
49617 billing questions
How is this code distinguished from 49618?
Both describe recurrent anterior abdominal hernia repair for a defect over 10 cm. Use 49617 when the hernia is reducible and 49618 when it is incarcerated or strangulated.
Does the defect measurement refer to the hernia sac?
No. Selection is based on the total length of the abdominal wall defect, not the size of the sac. The operative report should document the measurement supporting the level.
Can mesh placement be billed separately?
Mesh or another prosthesis used as part of this hernia repair is included in the repair service.
Can modifier 50 be used for bilateral repair?
No. Modifier 50 is inappropriate for this code's anatomy and descriptor.
What documentation supports reporting recurrent repair?
The operative report should establish that the hernia has recurred after a prior repair, describe reducibility, and document a total defect length greater than 10 cm.
How are other procedures in the same session paid?
When multiple procedures are performed in the same session, Medicare pays the highest-valued procedure in full and applies the standard 50% reduction to the others.
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.
5,84949614,,Rpr aa hrn rcr < 3 ncr/strn,A,,9.99,3.09,NA,3.09,,2.61,15.69,15.69,0,000,0.00,0.00,0.00,2,0,2,1,0,9,,33.4009,09,0,99,0.00,0.00,0.00
5,85049615,,Rpr aa hrn rcr 3-10 rdc,A,,11.17,3.40,NA,3.40,,2.91,17.48,17.48,0,000,0.00,0.00,0.00,2,0,2,1,0,9,,33.4009,09,0,99,0.00,0.00,0.00
5,85149616,,Rpr aa hrn rcr 3-10 ncr/strn,A,,15.16,4.34,NA,4.34,,3.95,23.45,23.45,0,000,0.00,0.00,0.00,2,0,2,1,0,9,,33.4009,09,0,99,0.00,0.00,0.00
5,85249617,,Rpr aa hrn rcr > 10 rdc,A,,15.63,4.57,NA,4.57,,4.00,24.20,24.20,0,000,0.00,0.00,0.00,2,0,2,1,0,9,,33.4009,09,0,99,0.00,0.00,0.00
5,85349618,,Rpr aa hrn rcr > 10 ncr/strn,A,,22.10,6.09,NA,6.09,,5.69,33.88,33.88,0,000,0.00,0.00,0.00,2,0,2,1,0,9,,33.4009,09,0,99,0.00,0.00,0.00
5,85449621,,Rpr parastomal hernia rdc,A,,13.36,3.94,NA,3.94,,3.16,20.46,20.46,0,000,0.00,0.00,0.00,2,0,2,1,0,9,,33.4009,09,0,99,0.00,0.00,0.00
5,85549622,,Rpr parastomal hrna ncr/strn,A,,16.63,4.71,NA,4.71,,4.10,25.44,25.44,0,000,0.00,0.00,0.00,2,0,2,1,0,9,,33.4009,09,0,99,0.00,0.00,0.00
5006102,IL,15,SUBURBAN CHICAGO,1.007,1.027,1.772
5106102,IL,99,REST OF ILLINOIS,1.000,0.913,1.563
5208102,IN,00,INDIANA,1.000,0.927,0.486
5305102,IA,00,IOWA,1.000,0.915,0.397
5405202,KS,00,KANSAS,1.000,0.904,0.504
5515102,KY,00,KENTUCKY,1.000,0.889,0.915
5607202,LA,01,NEW ORLEANS,1.000,0.941,1.136