No office rate
Use 49505 for an initial, reducible inguinal hernia in a patient age five or older; 49507 requires incarceration or strangulation.
On this page
CMS RVU26D · Effective 2026-10-01
49507 Inguinal hernia repair Medicare reimbursement rates in Pennsylvania
Open repair of an initial inguinal hernia in a patient age five or older when the hernia is incarcerated or strangulated. Compare 49507 office and facility rates across CMS payment localities in Pennsylvania.
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 49507 in Pennsylvania?
Pennsylvania has 2 payment localities in this comparison. Use the service location to choose the applicable amount. These are the supported base rates for the 2 payment areas shown below, using the same CMS release.
Office / nonfacility
No supported rate
Facility setting
$547.92–$596.42
2 of 2 localities have a supported rate.
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 49507: Initial incarcerated inguinal hernia repair
Open repair of an initial inguinal hernia in a patient age five or older when the hernia is incarcerated or strangulated.
This code describes open repair of an initial inguinal hernia in a patient age five or older when the hernia is incarcerated or strangulated. Incarceration means the hernia contents cannot be returned to the abdomen; strangulation involves compromised blood supply and may require urgent surgery. General surgeons commonly perform the repair in a hospital operating room or ambulatory surgery center. The operative report should identify the inguinal hernia, the patient’s age, and the incarcerated or strangulated status.
Choose this code instead of the reducible-hernia code when the operative documentation supports incarceration or strangulation. Use a recurrent-repair code when the hernia is at a previously repaired site. CMS assigns a 90-day global period, including the day-before preoperative visit and 90 days of related postoperative care. 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 services may be paid; co-surgeon payment requires supporting documentation, and team surgery is not permitted.
CMS billing rules for 49507
- 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 RVU8.86 · 52%
- Practice expense (office) RVU5.83 · 34%
- Malpractice RVU2.32 · 14%
9.5K
Medicare services in 2024 · #1494 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.
49507 compared with similar codes
Office rates for Pennsylvania, from the same CMS release.
No office rate
Both codes address an initial incarcerated or strangulated inguinal hernia, but 49501 is for a younger patient and 49507 is for age five or older.
No office rate
Use 49520 for a recurrent, reducible inguinal hernia. 49507 is for an initial incarcerated or strangulated hernia.
No office rate
Use 49521 for a recurrent incarcerated or strangulated inguinal hernia; 49507 is for an initial repair.
Compare 49507 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.
2 of 2 payment localities
Metropolitan Philadelphia →
Office / nonfacility
Unavailable
Facility
$596.42
Rest Of Pennsylvania →
Office / nonfacility
Unavailable
Facility
$547.92
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49507 billing questions
How does 49507 differ from 49505?
49507 is for an initial inguinal hernia documented as incarcerated or strangulated in a patient age five or older. 49505 is the corresponding code when the hernia is reducible.
Does 49507 apply to a recurrent hernia?
No. Use the recurrent-repair code that matches the hernia’s status when the same site has been repaired before.
Can mesh be reported separately?
Mesh placement is part of the inguinal hernia repair service; there is no separate mesh add-on for this repair.
How is a bilateral repair reported?
Report modifier 50 for the bilateral procedure. CMS pays this code at 150% under its bilateral rule.
What documentation supports 49507?
Document that this is an initial inguinal hernia repair, the patient’s age, and the incarcerated or strangulated status. The operative note should support the condition treated.
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.
5,82549500,,Rpr ing hernia init reduce,A,,5.69,5.15,NA,5.15,,1.51,12.35,12.35,0,090,0.09,0.81,0.10,2,1,2,1,0,9,,33.4009,09,0,99,0.00,0.00,0.00
5,82649501,,Rpr ing hernia init blocked,A,,9.13,5.99,NA,5.99,,2.44,17.56,17.56,0,090,0.09,0.81,0.10,2,1,2,1,0,9,,33.4009,09,0,99,0.00,0.00,0.00
5,82749505,,Prp i/hern init reduc >5 yr,A,,7.76,5.40,NA,5.40,,2.05,15.21,15.21,0,090,0.09,0.81,0.10,2,1,2,1,0,9,,33.4009,09,0,99,0.00,0.00,0.00
5,82849507,,Prp i/hern init block >5 yr,A,,8.86,5.83,NA,5.83,,2.32,17.01,17.01,0,090,0.09,0.81,0.10,2,1,2,1,0,9,,33.4009,09,0,99,0.00,0.00,0.00
5,82949520,,Rerepair ing hernia reduce,A,,9.74,5.91,NA,5.91,,2.56,18.21,18.21,0,090,0.09,0.81,0.10,2,1,2,1,0,9,,33.4009,09,0,99,0.00,0.00,0.00
5,83049521,,Rerepair ing hernia blocked,A,,11.19,6.40,NA,6.40,,2.92,20.51,20.51,0,090,0.09,0.81,0.10,2,1,2,1,0,9,,33.4009,09,0,99,0.00,0.00,0.00
5,83149525,,Repair ing hernia sliding,A,,8.71,5.61,NA,5.61,,2.28,16.60,16.60,0,090,0.09,0.81,0.10,2,1,2,1,0,9,,33.4009,09,0,99,0.00,0.00,0.00