No office rate
Both describe laparoscopic inguinal hernia repair; 49650 is for an initial repair, while 49651 is for recurrence after prior repair.
On this page
CMS RVU26D · Effective 2026-10-01
49651 Inguinal hernia repair Medicare reimbursement rates in Minnesota
Reports laparoscopic operative repair of an inguinal hernia that has returned at a previously repaired site, typically by a surgeon in an operating room. Compare 49651 office and facility rates across CMS payment localities in Minnesota.
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 49651 in Minnesota?
Minnesota 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
$505.51
1 of 1 localities have a supported rate.
Payment area: Minnesota
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 49651: Laparoscopic recurrent inguinal hernia repair
Reports laparoscopic operative repair of an inguinal hernia that has returned at a previously repaired site, typically by a surgeon in an operating room.
This code describes laparoscopic surgery to repair a recurrent inguinal hernia: a hernia that has returned at a site repaired previously. A general surgeon typically uses small abdominal incisions and a camera to access the groin, reduce the hernia, and reinforce the repair, often with mesh. The service is generally performed in a hospital or ambulatory surgery center. The code distinguishes recurrence from an initial inguinal hernia repair; the operative report should establish the prior repair, recurrent site, and laparoscopic approach.
Medicare assigns a 90-day global period, including the day-before preoperative visit and 90 days of related postoperative care. When multiple procedures occur in the same session, the highest-valued is paid in full and others at 50%. For bilateral repair, modifier 50 is paid at 150%. An assistant at surgery may be paid; co-surgeons require supporting documentation, and team surgery is not permitted.
CMS billing rules for 49651
- 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 procedure with modifier 50 is paid at 150%.
- 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 RVU8.17 · 50%
- Practice expense (office) RVU6.15 · 37%
- Malpractice RVU2.15 · 13%
9.5K
Medicare services in 2024 · #1500 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.
49651 compared with similar codes
Office rates for Minnesota, from the same CMS release.
No office rate
This is the open alternative for recurrent, reducible inguinal hernia repair. Use 49651 when the recurrent repair is performed laparoscopically.
No office rate
This describes recurrent anterior abdominal hernia repair, not inguinal hernia repair. Select by the hernia's anatomic site.
Compare 49651 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
Minnesota →
Office / nonfacility
Unavailable
Facility
$505.51
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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 49651 in Minnesota.
PPRRVU2026_Oct_nonQPP.csv
5,858
- Code
- 49651
- Physician work
- 8.17
- Practice expense
- 6.15
- Malpractice
- 2.15
GPCI2026.csv
66
- Locality
- Minnesota
- Physician work
- 1.000
- Practice expense
- 1.029
- Malpractice
- 0.296
| Component | RVU | Locality factor | Adjusted |
|---|---|---|---|
| Physician work | 8.17 | × 1.000 | 8.1700 |
| Practice expense | 6.15 | × 1.029 | 6.3283 |
| Malpractice | 2.15 | × 0.296 | 0.6364 |
| Total RVUs | 15.1347 | ||
| Conversion factor | × 33.4009 | ||
Facility rate, Minnesota$505.51
Explore RVUs, geographic factors and the full formula
Facility
| Component | RVU | Local GPCI |
|---|---|---|
| Work | 8.17 | 1 |
| Practice expense | 6.15 | 1.029 |
| Malpractice | 2.15 | 0.296 |
(8.17 × 1 + 6.15 × 1.029 + 2.15 × 0.296) × $33.4009 = $505.51
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.
49651 billing questions
How is this code different from 49650?
Use 49651 for laparoscopic repair of an inguinal hernia that has recurred after prior repair. Code 49650 is for an initial laparoscopic inguinal hernia repair.
Can mesh placement be billed separately?
Mesh used to reinforce the laparoscopic inguinal hernia repair is part of the repair service. Do not report a separate mesh-placement service for that work.
How is a bilateral repair reported?
Report modifier 50 for bilateral repair. CMS pays the bilateral procedure at 150%.
What documentation supports recurrent rather than initial repair?
The operative report should identify the previously repaired inguinal site, the recurrent hernia, and the laparoscopic approach.
How does the 90-day global period affect follow-up billing?
The day-before preoperative visit and 90 days of related postoperative care are included in the global period.
May 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.
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.
5,85549622,,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
5,85649623,,Rmvl ninfct mesh hernia rpr,A,,3.66,0.90,NA,0.90,,0.95,5.51,5.51,0,ZZZ,0.00,0.00,0.00,0,0,2,1,0,9,,33.4009,09,0,99,0.00,0.00,0.00
5,85749650,,Lap ing hernia repair init,A,,6.20,4.87,NA,4.87,,1.63,12.70,12.70,0,090,0.09,0.81,0.10,2,1,2,1,0,9,,33.4009,09,0,99,0.00,0.00,0.00
5,85849651,,Lap ing hernia repair recur,A,,8.17,6.15,NA,6.15,,2.15,16.47,16.47,0,090,0.09,0.81,0.10,2,1,2,1,0,9,,33.4009,09,0,99,0.00,0.00,0.00
5,85949659,,Unlstd laps px hrnap hrnrphy,C,,0.00,0.00,,0.00,,0.00,0.00,0.00,0,YYY,0.00,0.00,0.00,2,1,2,1,1,9,,33.4009,09,0,99,0.00,0.00,0.00
5,86049900,,Repair of abdominal wall,A,,12.10,8.82,NA,8.82,,3.04,23.96,23.96,0,090,0.09,0.81,0.10,2,0,2,1,0,9,,33.4009,09,0,99,0.00,0.00,0.00
5,86149904,,Omental flap extra-abdom,A,,21.79,11.77,NA,11.77,,5.01,38.57,38.57,0,090,0.10,0.80,0.10,2,0,1,1,1,9,,33.4009,09,0,99,0.00,0.00,0.00
6314212,MA,99,REST OF MASSACHUSETTS,1.016,1.053,0.797
6408202,MI,01,DETROIT,1.000,0.965,1.686
6508202,MI,99,REST OF MICHIGAN,1.000,0.913,1.129
6606202,MN,00,MINNESOTA,1.000,1.029,0.296
6707302,MS,00,MISSISSIPPI,1.000,0.861,0.739
6805302,MO,02,METROPOLITAN KANSAS CITY,1.000,0.939,0.977
6905302,MO,01,METROPOLITAN ST. LOUIS,1.000,0.952,1.002