No office rate
Both are for recurrent femoral hernias. Choose 49557 for an incarcerated or strangulated recurrence and 49555 for a reducible recurrence.
On this page
CMS RVU26D · Effective 2026-10-01
49557 Femoral hernia repair Medicare reimbursement rates in Ohio
Reports operative repair of a previously repaired femoral hernia when the recurrent hernia is incarcerated or strangulated. Compare 49557 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 49557 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
$674.45
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 49557: Recurrent incarcerated femoral hernia repair
Reports operative repair of a previously repaired femoral hernia when the recurrent hernia is incarcerated or strangulated.
49557 applies when a femoral hernia has returned after prior repair and the recurrent hernia is incarcerated or strangulated. A surgeon repairs the femoral defect, typically in an operating room. The operative report should establish the femoral site, prior repair, and the incarceration or strangulation that makes the recurrent hernia nonreducible or threatens its blood supply.
Select this code rather than recurrent reducible femoral hernia repair when the documentation supports incarceration or strangulation; an initial femoral repair is a different service. The day-before preoperative visit and 90 days of related postoperative care are included in the 90-day global period. For multiple procedures in one session, the highest-valued procedure is paid in full and others at 50%. 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 49557
- 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 RVU11.33 · 55%
- Practice expense (office) RVU6.45 · 31%
- Malpractice RVU2.95 · 14%
144
Medicare services in 2024 · #4597 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.
49557 compared with similar codes
Office rates for Ohio, from the same CMS release.
No office rate
This code is for a recurrent femoral hernia with incarceration or strangulation; 49553 is for an initial repair with those findings.
No office rate
Both concern recurrent hernias that are incarcerated or strangulated, but 49521 is for an inguinal hernia and 49557 is for a femoral hernia.
Compare 49557 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
$674.45
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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 49557 in Ohio.
PPRRVU2026_Oct_nonQPP.csv
5,836
- Code
- 49557
- Physician work
- 11.33
- Practice expense
- 6.45
- Malpractice
- 2.95
GPCI2026.csv
85
- Locality
- Ohio
- Physician work
- 1.000
- Practice expense
- 0.913
- Malpractice
- 1.008
| Component | RVU | Locality factor | Adjusted |
|---|---|---|---|
| Physician work | 11.33 | × 1.000 | 11.3300 |
| Practice expense | 6.45 | × 0.913 | 5.8889 |
| Malpractice | 2.95 | × 1.008 | 2.9736 |
| Total RVUs | 20.1925 | ||
| Conversion factor | × 33.4009 | ||
Facility rate, Ohio$674.45
Explore RVUs, geographic factors and the full formula
Facility
| Component | RVU | Local GPCI |
|---|---|---|
| Work | 11.33 | 1 |
| Practice expense | 6.45 | 0.913 |
| Malpractice | 2.95 | 1.008 |
(11.33 × 1 + 6.45 × 0.913 + 2.95 × 1.008) × $33.4009 = $674.45
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.
49557 billing questions
How is this different from 49555?
Both describe repair of a recurrent femoral hernia. Use 49557 when the recurrent hernia is incarcerated or strangulated; 49555 is for a reducible recurrence.
How is this different from 49553?
49553 describes an initial femoral hernia repair when the hernia is incarcerated or strangulated. 49557 is for a femoral hernia that has recurred after a prior repair.
What documentation supports reporting 49557?
The operative record should identify the femoral hernia, establish that it is recurrent, and document incarceration or strangulation. A history of prior repair alone does not establish the nonreducible status.
Does the 90-day global include postoperative care?
Yes. The day-before preoperative visit and 90 days of related postoperative care are included in the global period.
How does Medicare handle bilateral repair and multiple procedures?
Bilateral reporting with modifier 50 is paid at 150%. For multiple procedures in the same session, Medicare pays the highest-valued procedure in full and the others at 50%.
Can an assistant or co-surgeon be reported?
Assistant-at-surgery payment may be made. Co-surgeon payment requires supporting documentation, and 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.
5,83349550,,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
5,83949593,,Rpr aa hrn 1st 3-10 rdc,A,,10.00,3.11,NA,3.11,,2.61,15.72,15.72,0,000,0.00,0.00,0.00,2,0,2,1,0,9,,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