Billing code 49593: Abdominal hernia repairMedicare rate & RVUs in New Jersey
Reports initial repair of a reducible anterior abdominal hernia when the total defect length is 3–10 cm, regardless of surgical approach.
CMS doesn’t publish an office rate for 49593 in New Jersey.
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 49593 covers
Code 49593 describes initial repair of an anterior abdominal hernia, such as a ventral, incisional, umbilical, or epigastric hernia. A surgeon may perform the operation open, laparoscopically, or robotically; the approach does not change code selection. Mesh or another prosthesis may be used as part of the repair and is included in this service.
Select the code when the hernia is reducible and the total length of the defect or defects is 3–10 cm. The operative report should support the hernia site, initial-repair status, reducibility, and measured defect length. CMS assigns a 0-day global period, so same-day preoperative and postoperative care is included. 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% reduction. Modifier 50 is inappropriate. 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.
Where 49593 pays more and less in New Jersey
| Payment locality | Office | Facility |
|---|---|---|
| Northern Nj | Unavailable | $568.65 |
| Rest Of New Jersey | Unavailable | $556.44 |
How the 49593 rate is calculated
Each of 49593’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 · 49593
RVUs × geographic indexes × conversion factor
Work10.00
10.00 RVUs× 1.000 GPCI
Practice expense3.11
3.11 RVUs× 1.000 GPCI
Malpractice2.61
2.61 RVUs× 1.000 GPCI
Adjusted RVUs
15.7200
Conversion factor
$33.4009
Medicare rate
$525.06
Every GPCI starts at 1.000, the national rate. Enter a ZIP or drag a slider.
Payment rules and modifiers for 49593
The CMS indicators that decide how 49593 is paid alongside other services.
CMS payment indicators · 49593
Abdominal hernia repair
| Rule | CMS value | What it means |
|---|---|---|
| Global period | 000 | Same-day global: pre- and post-op care on the day of the procedure is 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. |
What modifiers do to the payment
Modifier 51 · payment effect
With and without the modifier
49593 without 51 · national facility
$525.06
Abdominal hernia repair
49593-51 · Second procedure: 50%
$262.53
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%).
49593 compared with similar codes
Compare codes · National
5 codes, side by side
How to choose
- 49591Hernia repair
- Both are for initial, reducible anterior abdominal hernia repairs. Use 49591 when the total defect length is under 3 cm; use 49593 for 3–10 cm.
- 49594Hernia repair
- This is the 3–10 cm counterpart for an incarcerated or strangulated hernia. Code 49593 is for a reducible hernia in that size range.
- 49595Abdominal hernia repair
- Both are for initial, reducible repairs, but 49595 applies when the total defect length is greater than 10 cm.
- 49592Abdominal hernia repair
- This code covers an initial hernia repair under 3 cm when the hernia is incarcerated or strangulated; 49593 is for a 3–10 cm reducible hernia.
49593 billing questions
How does 49593 differ from 49594?
Both describe an initial anterior abdominal hernia repair for a total defect length of 3–10 cm. Report 49593 for a reducible hernia and 49594 for an incarcerated or strangulated hernia.
Does the surgical approach determine whether to report 49593?
No. The code covers open, laparoscopic, and robotic approaches; select it based on initial status, reducibility, and total defect length.
Can mesh placement be billed separately?
Mesh or another prosthesis used in the repair is included in 49593. The code does not separately report the implant placement as an additional hernia-repair service.
What documentation supports the 3–10 cm level?
Document the total length of the hernia defect or defects and the operative findings that establish reducibility and initial-repair status. The recorded defect size should support the selected size range.
How does the 0-day global period affect same-day care?
Same-day preoperative and postoperative care is included in the procedure. For other procedures performed in the same session, CMS pays the highest-valued procedure in full and applies the standard multiple-procedure reduction to the others.
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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