Billing code 39540: Diaphragm hernia repairMedicare rate & RVUs in Oregon
Repair a chronic diaphragmatic hernia caused by trauma, typically by reducing herniated abdominal contents and closing the diaphragmatic defect.
CMS doesn’t publish an office rate for 39540 in Oregon.
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 39540 covers
This operation repairs a diaphragmatic hernia that developed after trauma and is treated in the chronic phase. The surgeon exposes the diaphragm through an appropriate operative approach, returns displaced abdominal contents to the abdomen, and closes the defect. It is generally performed by a thoracic or general surgeon in a hospital operating room. The distinguishing feature is the chronic traumatic origin; an acute traumatic hernia and a nontraumatic hernia are reported with different codes.
Report the service when the operative documentation supports repair of a chronic, trauma-related diaphragmatic hernia. The 90-day global period includes the day-before preoperative visit and related postoperative care during that period. When multiple procedures are performed 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. An assistant at surgery may be paid; 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 39540 pays more and less in Oregon
| Payment locality | Office | Facility |
|---|---|---|
| Portland | Unavailable | $819.81 |
| Rest Of Oregon | Unavailable | $781.62 |
How the 39540 rate is calculated
Each of 39540’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 · 39540
RVUs × geographic indexes × conversion factor
Swap in your local Medicare rate.
Work 14.21Practice expense 6.68Malpractice 3.61
All indexes start at 1.000 (the national rate). Enter a ZIP or drag a slider.
Payment rules and modifiers for 39540
39540 has a 90-day global period: related visits in that window are included in the surgery payment.
CMS payment indicators · 39540
Diaphragm 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) | 0.09/0.84/0.07 | Share of the payment for pre-op, the procedure itself, and post-op care. |
Global surgery period · 39540
Diaphragm 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
39540 without 51 · national facility
$818.32
Diaphragm hernia repair
39540-51 · Second procedure: 50%
$409.16
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%).
39540 compared with similar codes
Compare codes
39540 vs 39503 vs 39541 vs 39501 vs 43281: national Medicare rates
Swap in your local Medicare rate.
How to choose
- 39503Diaphragm hernia repair
- Use 39503 for acute traumatic diaphragmatic hernia repair; 39540 identifies repair of a chronic traumatic hernia.
- 39541Diaphragm repair
- Use 39541 when the diaphragmatic hernia is nontraumatic. A chronic traumatic cause supports 39540.
- 39501Diaphragm repair
- 39501 describes repair of a diaphragm laceration. It is not the hernia-repair code for a chronic traumatic diaphragmatic hernia.
- 43281Hernia repair
- 43281 is for laparoscopic repair of a paraesophageal hernia. 39540 is for repair of a chronic traumatic diaphragmatic hernia.
39540 billing questions
How is 39540 distinguished from 39503?
39540 is for repair of a chronic traumatic diaphragmatic hernia. Use 39503 for repair of an acute traumatic diaphragmatic hernia.
When is 39541 a better fit?
39541 describes repair of a nontraumatic diaphragmatic hernia. The documented cause of the hernia distinguishes it from the chronic traumatic hernia reported with 39540.
Can modifier 50 be reported?
No. Modifier 50 is inappropriate for this diaphragmatic hernia repair.
What postoperative care is included?
The 90-day global period includes the day-before preoperative visit and related postoperative care for 90 days.
Can an assistant or co-surgeon be reported?
Assistant-at-surgery payment may be available. Co-surgeon payment requires supporting documentation; 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 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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