No office rate
The key distinction is the operative route: 39541 is the thoracic approach, while 39540 is the abdominal approach for traumatic diaphragmatic hernia repair.
On this page
CMS RVU26D · Effective 2026-10-01
39541 Diaphragm repair Medicare reimbursement rates in Kentucky
Repair a traumatic diaphragmatic hernia through a thoracic approach, typically when abdominal contents have displaced into the chest after injury. Compare 39541 office and facility rates across CMS payment localities in Kentucky.
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 39541 in Kentucky?
Kentucky 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
$849.95
1 of 1 localities have a supported rate.
Payment area: Kentucky
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.
Thoracic surgery
About 39541: Traumatic diaphragmatic hernia repair, thoracic approach
Repair a traumatic diaphragmatic hernia through a thoracic approach, typically when abdominal contents have displaced into the chest after injury.
This service repairs a traumatic opening in the diaphragm through the chest. The surgeon returns displaced abdominal contents to the abdomen and closes or reconstructs the defect as needed. It is typically performed by a thoracic or general surgeon in an operating room, often during treatment of blunt or penetrating chest or abdominal trauma. The thoracic approach distinguishes this service from the abdominal approach used for the related repair code.
Report the code when the operative record supports repair of a traumatic diaphragmatic hernia by the thoracic route; document the injury, hernia, approach, and repair performed. The service has a 90-day global period, including the day-before preoperative visit and 90 days of related postoperative care. When multiple procedures are performed in the same session, the highest-valued procedure is paid in full and other procedures are subject to the standard 50% reduction. An assistant at surgery may be paid. Co-surgeon payment requires supporting documentation, and team surgery is not permitted.
CMS billing rules for 39541
- 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 RVU15.36 · 58%
- Practice expense (office) RVU7.25 · 27%
- Malpractice RVU3.98 · 15%
108
Medicare services in 2024 · #4821 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.
39541 compared with similar codes
Office rates for Kentucky, from the same CMS release.
No office rate
39503 is for congenital diaphragmatic hernia repair in a neonatal patient; 39541 describes traumatic hernia repair through a thoracic approach.
No office rate
39501 addresses repair of a traumatic diaphragm laceration. Use 39541 when the condition being repaired is a traumatic diaphragmatic hernia.
Compare 39541 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
Kentucky →
Office / nonfacility
Unavailable
Facility
$849.95
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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 39541 in Kentucky.
PPRRVU2026_Oct_nonQPP.csv
4,784
- Code
- 39541
- Physician work
- 15.36
- Practice expense
- 7.25
- Malpractice
- 3.98
GPCI2026.csv
55
- Locality
- Kentucky
- Physician work
- 1.000
- Practice expense
- 0.889
- Malpractice
- 0.915
| Component | RVU | Locality factor | Adjusted |
|---|---|---|---|
| Physician work | 15.36 | × 1.000 | 15.3600 |
| Practice expense | 7.25 | × 0.889 | 6.4452 |
| Malpractice | 3.98 | × 0.915 | 3.6417 |
| Total RVUs | 25.4470 | ||
| Conversion factor | × 33.4009 | ||
Facility rate, Kentucky$849.95
Explore RVUs, geographic factors and the full formula
Facility
| Component | RVU | Local GPCI |
|---|---|---|
| Work | 15.36 | 1 |
| Practice expense | 7.25 | 0.889 |
| Malpractice | 3.98 | 0.915 |
(15.36 × 1 + 7.25 × 0.889 + 3.98 × 0.915) × $33.4009 = $849.95
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.
39541 billing questions
How is 39541 distinguished from 39540?
Both describe repair of a traumatic diaphragmatic hernia in a non-neonatal patient. Select 39541 for the thoracic approach and 39540 for the abdominal approach.
What operative documentation supports 39541?
Document the traumatic hernia, the thoracic route, and the repair performed. The operative report should make the approach clear enough to distinguish it from an abdominal repair.
Are related postoperative visits separately reported during the global period?
The day-before preoperative visit and 90 days of related postoperative care are included in the global period.
Can an assistant or co-surgeon be reported?
An assistant at surgery may be paid. Co-surgeon payment requires supporting documentation; team surgery is not permitted.
How does the multiple-procedure reduction affect same-session services?
When other procedures are performed in the same session, the highest-valued procedure is paid in full and the others are subject to the standard 50% reduction.
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.
4,78139501,,Repair diaphragm laceration,A,,13.63,7.31,NA,7.31,,3.31,24.25,24.25,0,090,0.09,0.84,0.07,2,0,2,1,0,9,,33.4009,09,0,99,0.00,0.00,0.00
4,78239503,,Repair of diaphragm hernia,A,,106.19,27.29,NA,27.29,,26.77,160.25,160.25,0,090,0.09,0.84,0.07,2,0,2,1,0,9,,33.4009,09,0,99,0.00,0.00,0.00
4,78339540,,Repair of diaphragm hernia,A,,14.21,6.68,NA,6.68,,3.61,24.50,24.50,0,090,0.09,0.84,0.07,2,0,2,1,0,9,,33.4009,09,0,99,0.00,0.00,0.00
4,78439541,,Repair of diaphragm hernia,A,,15.36,7.25,NA,7.25,,3.98,26.59,26.59,0,090,0.09,0.84,0.07,2,0,2,1,0,9,,33.4009,09,0,99,0.00,0.00,0.00
4,78539545,,Revision of diaphragm,A,,14.30,8.24,NA,8.24,,3.59,26.13,26.13,0,090,0.09,0.84,0.07,2,0,2,1,0,9,,33.4009,09,0,99,0.00,0.00,0.00
4,78639560,,Resect diaphragm simple,A,,12.73,6.96,NA,6.96,,3.03,22.72,22.72,0,090,0.09,0.84,0.07,2,0,2,1,0,9,,33.4009,09,0,99,0.00,0.00,0.00
4,78739561,,Resect diaphragm complex,A,,19.49,12.01,NA,12.01,,4.96,36.46,36.46,0,090,0.09,0.84,0.07,2,0,2,1,0,9,,33.4009,09,0,99,0.00,0.00,0.00
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
5707202,LA,99,REST OF LOUISIANA,1.000,0.885,0.958
5814112,ME,03,SOUTHERN MAINE,1.000,0.991,0.631