Billing code 49611: Umbilical hernia repairMedicare rate & RVUs in Nevada
Reports operative repair of an umbilical hernia, with code selection supported by the documented hernia and the repair performed.
CMS doesn’t publish an office rate for 49611 in Nevada.
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 49611 covers
This service is an operative repair of a hernia at the umbilicus, performed by a surgeon in an operating room or another setting equipped for surgery. The operation addresses the hernia defect; the operative report should identify the umbilical location and describe the repair. The code is specific to the umbilical hernia service, rather than a general abdominal-wall repair or a repair at another hernia site.
Select this code only when the documented service meets its billing code-specific criteria; do not infer those criteria from the anatomic site alone. The record should describe the hernia and the operative work sufficiently to distinguish this code from nearby hernia-repair options. 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 procedure is paid in full and other procedures are subject to the standard 50% multiple-procedure reduction. Modifier 50 is inappropriate for this code. Assistant-at-surgery payment may be made; 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.
49611 in Nevada**
| Payment locality | Office | Facility |
|---|---|---|
| Nevada** | Unavailable | $576.84 |
How the 49611 rate is calculated
Each of 49611’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 · 49611
RVUs × geographic indexes × conversion factor
Swap in your local Medicare rate.
Work 9.11Practice expense 6.13Malpractice 2.43
All indexes start at 1.000 (the national rate). Enter a ZIP or drag a slider.
Payment rules and modifiers for 49611
49611 has a 90-day global period: related visits in that window are included in the surgery payment.
CMS payment indicators · 49611
Umbilical hernia 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 · 49611
Umbilical hernia 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
49611 without 51 · national facility
$590.19
Umbilical hernia repair
49611-51 · Second procedure: 50%
$295.10
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%).
49611 compared with similar codes
Compare codes
49611 vs 49610 vs 49613 vs 49614: national Medicare rates
Swap in your local Medicare rate.
How to choose
- 49610Gastroschisis repair
- Both are nearby umbilical hernia repair choices. Use the code whose billing code-specific criteria match the operative documentation rather than choosing by site alone.
- 49613Abdominal hernia repair
- This is a separate anterior abdominal hernia repair option. Select it only when the documented service meets its criteria, not simply because the repair involves the abdominal wall.
- 49614Hernia repair
- This is another anterior abdominal hernia repair option with distinct criteria. The operative report should support the selected code rather than relying only on the umbilical location.
49611 billing questions
What documentation supports reporting this code?
Document the umbilical hernia and the operative repair performed. The record should provide enough detail to support this code rather than a nearby hernia-repair option.
Is modifier 50 appropriate for an umbilical hernia repair?
No. CMS identifies bilateral adjustment as inappropriate for this code, so modifier 50 should not be used.
How does the 90-day global period affect postoperative visits?
The global period includes the day-before preoperative visit and 90 days of related postoperative care.
How are other procedures in the same session paid?
The highest-valued procedure is paid in full; other procedures in the session are subject to the standard multiple-procedure reduction, with payment at 50%.
Can an assistant or co-surgeon be reported?
Assistant-at-surgery payment may be made. Co-surgeon payment requires supporting documentation; team surgery is not permitted.
How should this code be distinguished from nearby hernia-repair codes?
Confirm that the documented service meets this code’s billing code-specific criteria. Do not select it solely because the hernia is at the umbilicus; use the operative documentation to distinguish among the related choices.
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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