No office rate
Both describe reducible femoral hernia repair; 49550 is for an initial repair, while this code is for a recurrence after prior repair.
On this page
CMS RVU26D · Effective 2026-10-01
49555 Femoral hernia repair Medicare reimbursement rates in Ohio
Reports operative repair of a recurrent femoral hernia when the hernia is reducible, rather than an initial or nonreducible femoral hernia. Compare 49555 office and facility rates across CMS payment localities in Ohio.
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 49555 in Ohio?
Ohio 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
$567.17
1 of 1 localities have a supported rate.
Payment area: Ohio
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.
Hernia surgery
About 49555: Recurrent reducible femoral hernia repair
Reports operative repair of a recurrent femoral hernia when the hernia is reducible, rather than an initial or nonreducible femoral hernia.
This service repairs a femoral hernia that has returned after an earlier repair and can be reduced. A surgeon treats the defect in an operative setting, addressing the hernia contents and repairing the weakened area. The femoral location distinguishes this service from repair of an inguinal hernia, even when the clinical presentation is similar.
Report the code when the operative record supports both a prior femoral hernia repair and a recurrent, reducible hernia. Use the nonreducible recurrent femoral hernia code when the hernia is documented as incarcerated or strangulated. Medicare assigns a 90-day global period, including the day-before preoperative visit and related postoperative care. For multiple procedures in one session, the highest-valued procedure is paid in full and other procedures are subject to the standard 50% reduction. Bilateral reporting with modifier 50 is paid at 150%. Assistant-at-surgery payment may be made; co-surgeon payment requires supporting documentation, and team surgery is not permitted.
CMS billing rules for 49555
- 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 RVU9.16 · 52%
- Practice expense (office) RVU5.85 · 33%
- Malpractice RVU2.46 · 14%
67
Medicare services in 2024 · #5174 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.
49555 compared with similar codes
Office rates for Ohio, from the same CMS release.
No office rate
This code is for a recurrent, reducible femoral hernia. 49553 describes an initial femoral hernia repair when the hernia is incarcerated or strangulated.
No office rate
Both describe repair of a recurrent femoral hernia. Use 49557 when the hernia is incarcerated or strangulated rather than reducible.
No office rate
49520 describes recurrent reducible inguinal hernia repair. Choose the femoral code when the defect is in the femoral region.
Compare 49555 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
Ohio →
Office / nonfacility
Unavailable
Facility
$567.17
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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 49555 in Ohio.
PPRRVU2026_Oct_nonQPP.csv
5,835
- Code
- 49555
- Physician work
- 9.16
- Practice expense
- 5.85
- Malpractice
- 2.46
GPCI2026.csv
85
- Locality
- Ohio
- Physician work
- 1.000
- Practice expense
- 0.913
- Malpractice
- 1.008
| Component | RVU | Locality factor | Adjusted |
|---|---|---|---|
| Physician work | 9.16 | × 1.000 | 9.1600 |
| Practice expense | 5.85 | × 0.913 | 5.3411 |
| Malpractice | 2.46 | × 1.008 | 2.4797 |
| Total RVUs | 16.9807 | ||
| Conversion factor | × 33.4009 | ||
Facility rate, Ohio$567.17
Explore RVUs, geographic factors and the full formula
Facility
| Component | RVU | Local GPCI |
|---|---|---|
| Work | 9.16 | 1 |
| Practice expense | 5.85 | 0.913 |
| Malpractice | 2.46 | 1.008 |
(9.16 × 1 + 5.85 × 0.913 + 2.46 × 1.008) × $33.4009 = $567.17
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.
49555 billing questions
How does this differ from an initial femoral hernia repair?
This code is for a femoral hernia that has recurred after a prior repair. Use the initial-repair code when there has been no earlier repair of that femoral hernia.
When should the nonreducible recurrent femoral hernia code be used?
Use the nonreducible recurrent code when the operative documentation describes the recurrent femoral hernia as incarcerated or strangulated, rather than reducible.
What documentation supports reporting this code?
Document the femoral location, the history of prior repair, and the reducible status of the recurrent hernia, along with the operative repair performed.
How is bilateral repair reported?
Report modifier 50 for bilateral repair. CMS pays the bilateral procedure at 150%.
How do multiple-procedure and assistant-surgery rules affect payment?
When performed with other procedures in the same session, the highest-valued procedure is paid in full and the others are subject to the standard 50% reduction. Assistant-at-surgery payment may be made; co-surgeon payment requires supporting documentation.
What care is included in the global period?
The 90-day global period includes the day-before preoperative visit and 90 days of related postoperative care.
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.
5,83249540,,Repair lumbar hernia,A,,10.47,6.10,NA,6.10,,2.70,19.27,19.27,0,090,0.09,0.81,0.10,2,1,2,1,0,9,,33.4009,09,0,99,0.00,0.00,0.00
5,83349550,,Rpr rem hernia init reduce,A,,8.77,5.65,NA,5.65,,2.30,16.72,16.72,0,090,0.09,0.81,0.10,2,1,2,1,0,9,,33.4009,09,0,99,0.00,0.00,0.00
5,83449553,,Rpr fem hernia init blocked,A,,9.67,6.04,NA,6.04,,2.52,18.23,18.23,0,090,0.09,0.81,0.10,2,1,2,1,0,9,,33.4009,09,0,99,0.00,0.00,0.00
5,83549555,,Rerepair fem hernia reduce,A,,9.16,5.85,NA,5.85,,2.46,17.47,17.47,0,090,0.09,0.81,0.10,2,1,2,1,0,9,,33.4009,09,0,99,0.00,0.00,0.00
5,83649557,,Rerepair fem hernia blocked,A,,11.33,6.45,NA,6.45,,2.95,20.73,20.73,0,090,0.09,0.81,0.10,2,1,2,1,0,9,,33.4009,09,0,99,0.00,0.00,0.00
5,83749591,,Rpr aa hrn 1st < 3 cm rdc,A,,5.81,2.15,NA,2.15,,1.49,9.45,9.45,0,000,0.00,0.00,0.00,2,0,2,1,0,9,,33.4009,09,0,99,0.00,0.00,0.00
5,83849592,,Rpr aa hrn 1st < 3 ncr/strn,A,,8.25,2.67,NA,2.67,,2.16,13.08,13.08,0,000,0.00,0.00,0.00,2,0,2,1,0,9,,33.4009,09,0,99,0.00,0.00,0.00
8213282,NY,99,REST OF NEW YORK,1.000,0.950,0.703
8311502,NC,00,NORTH CAROLINA,1.000,0.933,0.639
8403302,ND,01,NORTH DAKOTA**,1.000,1.000,0.406
8515202,OH,00,OHIO,1.000,0.913,1.008
8604312,OK,00,OKLAHOMA,1.000,0.893,0.777
8702302,OR,01,PORTLAND,1.016,1.111,0.744
8802302,OR,99,REST OF OREGON,1.000,0.996,0.703