No office rate
39501 describes repair of a diaphragm laceration. Use 39545 when the operation revises the diaphragm rather than repairing a laceration.
On this page
CMS RVU26D · Effective 2026-10-01
39545 Diaphragm surgery Medicare reimbursement rates in Kentucky
Reports an operation to revise the diaphragm, rather than an initial repair of a traumatic laceration or diaphragmatic hernia. Compare 39545 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 39545 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
$832.02
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 39545: Surgical revision of the diaphragm
Reports an operation to revise the diaphragm, rather than an initial repair of a traumatic laceration or diaphragmatic hernia.
Code 39545 represents an operation to revise the diaphragm itself, rather than an initial repair of an acute tear or a hernia repair. A thoracic or other surgeon may revise previously operated diaphragm tissue to correct its prior reconstruction or anatomy. The service is generally performed in an operating room; the code does not specify a particular access route or material.
Select 39545 when the operative report identifies diaphragm revision as the procedure performed. Document the condition prompting revision and the work done on the diaphragm; use a dedicated repair or resection code when that better describes the operation. CMS assigns a 90-day global period, including the day-before preoperative visit and 90 days of related postoperative care. In a same-session multiple-procedure claim, the highest-valued procedure is paid in full and others at 50%. Modifier 50 is inappropriate. Assistant-at-surgery payment may be made; co-surgeon payment requires supporting documentation, and team surgery is not permitted.
CMS billing rules for 39545
- 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 RVU14.30 · 55%
- Practice expense (office) RVU8.24 · 32%
- Malpractice RVU3.59 · 14%
322
Medicare services in 2024 · #3944 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.
39545 compared with similar codes
Office rates for Kentucky, from the same CMS release.
No office rate
39540 is for repair of a chronic traumatic diaphragmatic hernia. Choose 39545 when the documented procedure is revision of the diaphragm.
No office rate
39560 applies when diaphragm tissue is resected and the resulting defect receives a simple repair. 39545 describes revision without specifying resection.
No office rate
39561 applies to diaphragm resection with complex repair. Use 39545 when the operation is a diaphragm revision rather than resection with complex repair.
Compare 39545 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
$832.02
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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 39545 in Kentucky.
PPRRVU2026_Oct_nonQPP.csv
4,785
- Code
- 39545
- Physician work
- 14.30
- Practice expense
- 8.24
- Malpractice
- 3.59
GPCI2026.csv
55
- Locality
- Kentucky
- Physician work
- 1.000
- Practice expense
- 0.889
- Malpractice
- 0.915
| Component | RVU | Locality factor | Adjusted |
|---|---|---|---|
| Physician work | 14.30 | × 1.000 | 14.3000 |
| Practice expense | 8.24 | × 0.889 | 7.3254 |
| Malpractice | 3.59 | × 0.915 | 3.2849 |
| Total RVUs | 24.9102 | ||
| Conversion factor | × 33.4009 | ||
Facility rate, Kentucky$832.02
Explore RVUs, geographic factors and the full formula
Facility
| Component | RVU | Local GPCI |
|---|---|---|
| Work | 14.3 | 1 |
| Practice expense | 8.24 | 0.889 |
| Malpractice | 3.59 | 0.915 |
(14.3 × 1 + 8.24 × 0.889 + 3.59 × 0.915) × $33.4009 = $832.02
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.
39545 billing questions
How is diaphragm revision different from repair of a traumatic laceration?
Use 39545 for revision of the diaphragm. Code 39501 describes repair of a diaphragm laceration, rather than revision.
Does 39545 include postoperative visits?
The 90-day global period includes the day-before preoperative visit and 90 days of related postoperative care.
Can modifier 50 be reported for bilateral diaphragm revision?
No. CMS identifies bilateral adjustment as inappropriate for this code, so modifier 50 should not be used.
Can an assistant or co-surgeon be paid?
Assistant-at-surgery may be paid. Co-surgeons are paid only when supporting documentation is provided; team surgery is not permitted.
How does the multiple-procedure rule affect 39545?
When multiple procedures are performed in the same session, the highest-valued procedure is paid in full and the 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.
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
4,78839599,,Unlisted px diaphragm,C,,0.00,0.00,,0.00,,0.00,0.00,0.00,0,YYY,0.00,0.00,0.00,2,0,2,1,1,9,,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