Billing code 49900: Abdominal wall repairMedicare rate & RVUs in Missouri
Reports operative reclosure of an abdominal incision after wound separation or evisceration, rather than repair of an abdominal hernia.
CMS doesn’t publish an office rate for 49900 in Missouri.
Medicare allowed amount for participating (non-QP) physicians, before deductible, coinsurance and claim adjustments. Not a patient’s bill or a hospital charge.
On this page 9 sections
What 49900 covers
billing code 49900 describes operative reclosure of an abdominal incision when the abdominal wall has separated, including cases with evisceration. A surgeon typically performs the repair in an operating room, often after a patient returns following recent abdominal surgery. The operative report should identify the wound disruption and describe the repair of the abdominal wall; routine dressing care or superficial skin closure alone does not establish this service.
Report 49900 when the surgeon repairs the disrupted abdominal wall, not when the procedure is an incisional hernia repair. The code has a 90-day global period: the day-before preoperative visit and 90 days of related postoperative care are 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. Modifier 50 is inappropriate. Assistant-at-surgery payment may be available; co-surgeon payment requires supporting documentation, and team surgery is not permitted.
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.
Where 49900 pays more and less in Missouri
The same RVUs, adjusted for each area’s costs. Open a locality for its calculation, history and nearby areas.
| Payment locality | Office | Facility |
|---|---|---|
| Metropolitan Kansas City | Unavailable | $779.98 |
| Metropolitan St. Louis | Unavailable | $786.35 |
| Rest Of Missouri | Unavailable | $756.99 |
How the 49900 rate is calculated
Each of 49900’s three RVUs is multiplied by a geographic index (GPCI) for the payment locality, added up, and multiplied by the conversion factor. Drag the indexes or enter a ZIP to see what moves the rate.
How the rate is built · 49900
RVUs × geographic indexes × conversion factor
Work12.10
12.10 RVUs× 1.000 GPCI
Practice expense8.82
8.82 RVUs× 1.000 GPCI
Malpractice3.04
3.04 RVUs× 1.000 GPCI
Adjusted RVUs
23.9600
Conversion factor
$33.4009
Medicare rate
$800.29
Every GPCI starts at 1.000, the national rate. Enter a ZIP or drag a slider.
Payment rules and modifiers for 49900
49900 has a 90-day global period: related visits in that window are included in the surgery payment.
CMS payment indicators · 49900
Abdominal wall repair
| Rule | CMS value | What it means |
|---|---|---|
| Global period | 090 | Major surgery: the day before, the day of, and 90 days after are included. |
| Multiple procedures | 2 | Standard reduction: highest-valued procedure at 100%, others at 50%. |
| Bilateral (modifier 50) | 0 | The 150% bilateral adjustment doesn’t apply. |
| Assistant at surgery (80/81/82/AS) | 2 | Paid. |
| Co-surgeons (62) | 1 | Permitted with supporting documentation. |
| Team surgery (66) | 0 | Not permitted. |
| Professional/technical | 0 | Physician service: no professional/technical split. |
| Split (54/55/56) | 0.09/0.81/0.10 | Share of the payment for pre-op, the procedure itself, and post-op care. |
Global surgery period · 49900
Abdominal wall repair
90-day global period ends
Dec 30, 2026
Covers Sep 30, 2026 through Dec 30, 2026 (92 days, including the day before surgery).
Visit on Oct 31, 2026
Day 30 of the 90-day post-op period: related follow-up care is included in the surgical payment.
Pre-op dayGlobal period
What modifiers do to the payment
Modifier 51 · payment effect
With and without the modifier
49900 without 51 · national facility
$800.29
Abdominal wall repair
49900-51 · Second procedure: 50%
$400.15
When this isn’t the highest-valued procedure in the session, Medicare pays 50% of its fee schedule amount (the highest is paid at 100%).
49900 compared with similar codes
Compare codes · National
4 codes, side by side
How to choose
- 49002Abdominal reoperation
- 49002 represents reopening a recent laparotomy. Report 49900 for the abdominal wall repair when the incision has disrupted; both services may be relevant when both procedures are performed.
- 49591Hernia repair
- 49591 is for repair of a qualifying anterior abdominal hernia. Use 49900 for reclosure of a disrupted abdominal incision, not a hernia repair.
- 49999Unlisted px abd pertm&omn
- 49999 is an unlisted abdominal procedure code for a service without a specific code. Use 49900 when the service is the described repair of a disrupted abdominal wall.
49900 billing questions
When should 49900 be chosen instead of an abdominal hernia repair code?
Use 49900 for operative repair of a disrupted abdominal incision, such as fascial separation or evisceration. Use a hernia repair code when the operative service repairs a hernia.
Can 49900 be reported with 49002?
49002 describes reopening a recent laparotomy, while 49900 describes repair of the disrupted abdominal wall. Both may be relevant when the surgeon reopens the incision and performs a distinct repair; the operative report should support each service.
Is modifier 50 appropriate for bilateral repair?
No. The abdominal wall repair is not reported with a bilateral adjustment under the CMS rule for this code.
What postoperative care is included?
The 90-day global period includes the day-before preoperative visit and 90 days of related postoperative care.
Can an assistant or co-surgeon be reported?
Assistant-at-surgery payment may be available. Co-surgeon payment requires supporting documentation; team surgery is not permitted.
What should the operative note document?
Document the abdominal wound disruption, whether evisceration occurred, and the operative repair performed on the abdominal wall. This helps distinguish the service from superficial wound care or hernia repair.
Where these rates come from
FeeBase calculates base physician payments from CMS work, practice-expense and malpractice RVUs, adjusted by each locality’s geographic indexes and the conversion factor. Services without a published rate are labeled, never given a made-up amount. Amounts are Medicare allowed amounts before claim adjustments: not a patient’s bill or a commercial rate.
CMS RVU26D · effective Oct 1, 2026 through the day before Jan 1, 2027
Show the CMS file lines behind this rate
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