Billing code 49618: Abdominal hernia repairMedicare rate & RVUs in Oklahoma
Repair a recurrent anterior abdominal hernia with a total defect length over 10 cm when the hernia is incarcerated or strangulated.
CMS doesn’t publish an office rate for 49618 in Oklahoma.
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 49618 covers
This code represents operative repair of a recurrent anterior abdominal wall hernia when the total length of the defect or defects is greater than 10 cm and the hernia is incarcerated or strangulated. General and acute care surgeons commonly perform the repair in a hospital operating room, using an open, laparoscopic, or robotic approach. Mesh or another prosthesis may be implanted as part of the repair.
Choose the code from the operative findings: the hernia must be recurrent, the total defect length must exceed 10 cm, and the hernia must be incarcerated or strangulated. Documentation should establish the prior repair, defect measurement, and clinical status, along with the repair performed. Mesh placement is included in the hernia repair. 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.
49618 in Oklahoma
| Payment locality | Office | Facility |
|---|---|---|
| Oklahoma | Unavailable | $1,067.48 |
How the 49618 rate is calculated
Each of 49618’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 · 49618
RVUs × geographic indexes × conversion factor
Work22.10
22.10 RVUs× 1.000 GPCI
Practice expense6.09
6.09 RVUs× 1.000 GPCI
Malpractice5.69
5.69 RVUs× 1.000 GPCI
Adjusted RVUs
33.8800
Conversion factor
$33.4009
Medicare rate
$1,131.62
Every GPCI starts at 1.000, the national rate. Enter a ZIP or drag a slider.
Payment rules and modifiers for 49618
The CMS indicators that decide how 49618 is paid alongside other services.
CMS payment indicators · 49618
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
49618 without 51 · national facility
$1,131.62
Abdominal hernia repair
49618-51 · Second procedure: 50%
$565.81
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%).
49618 compared with similar codes
Compare codes · National
4 codes, side by side
How to choose
- 49617Abdominal hernia repair
- Both are for recurrent defects over 10 cm. 49617 applies when the hernia is reducible; 49618 applies when it is incarcerated or strangulated.
- 49616Hernia repair
- Both describe recurrent incarcerated or strangulated hernias, but 49616 is for a total defect length of 3 to 10 cm; 49618 is for over 10 cm.
- 49596Abdominal hernia repair
- This code is for an initial anterior abdominal hernia over 10 cm that is incarcerated or strangulated. Use 49618 when the hernia is recurrent.
49618 billing questions
How does this code differ from 49617?
Both describe repair of a recurrent anterior abdominal hernia with a total defect length over 10 cm. Use 49618 when the hernia is incarcerated or strangulated; 49617 is for a reducible hernia.
Is mesh separately reportable with this repair?
Mesh or another prosthesis placed as part of the hernia repair is included in the code. The repair should not be split into separate hernia-repair and mesh-placement charges.
What documentation supports the size level?
Document the total length of the defect or defects and the operative findings supporting that the hernia is recurrent and incarcerated or strangulated.
Should modifier 50 be appended for more than one defect?
No. CMS identifies modifier 50 as inappropriate for this code; multiple defects are considered in the total defect length used to select the code.
How are other procedures in the same session paid?
Under the standard multiple-procedure reduction, the highest-valued procedure is paid in full and other procedures are subject to a 50% reduction. The code has a 0-day global period, which includes same-day preoperative and 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 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
Fee sheets
Put 49618 and the rest of your codes on one sheet
Build a fee sheet from your own code list at your locality, put your payer contracts beside Medicare, and see what changed each quarter.
Build my fee sheetOr price your code list free →