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CMS RVU26D · Effective 2026-10-01

49593 Abdominal hernia repair Medicare reimbursement rates in Rhode Island

Reports initial repair of a reducible anterior abdominal hernia when the total defect length is 3–10 cm, regardless of surgical approach. Compare 49593 office and facility rates across CMS payment localities in Rhode Island.

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 49593 in Rhode Island?

Rhode Island 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

$525.42

1 of 1 localities have a supported rate.

Payment area: Rhode Island

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.

Find 49593 in your payment locality →

Hernia surgery

About 49593: Initial reducible abdominal hernia repair

Reports initial repair of a reducible anterior abdominal hernia when the total defect length is 3–10 cm, regardless of surgical approach.

Code 49593 describes initial repair of an anterior abdominal hernia, such as a ventral, incisional, umbilical, or epigastric hernia. A surgeon may perform the operation open, laparoscopically, or robotically; the approach does not change code selection. Mesh or another prosthesis may be used as part of the repair and is included in this service.

Select the code when the hernia is reducible and the total length of the defect or defects is 3–10 cm. The operative report should support the hernia site, initial-repair status, reducibility, and measured defect length. 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.

CMS billing rules for 49593

Global period
Minor procedure with a 0-day global period: same-day preoperative and postoperative care is 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 adjustment does not apply; the descriptor or anatomy makes modifier 50 inappropriate.
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 RVU10.00 · 64%
  • Practice expense (office) RVU3.11 · 20%
  • Malpractice RVU2.61 · 17%

18.4K

Medicare services in 2024 · #1181 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.

49593 compared with similar codes

Office rates for Rhode Island, from the same CMS release.

49591

Hernia repair

Initial, under 3 cm, reducible

No office rate

Both are for initial, reducible anterior abdominal hernia repairs. Use 49591 when the total defect length is under 3 cm; use 49593 for 3–10 cm.

49594

Hernia repair

Initial, 3–10 cm, incarcerated

No office rate

This is the 3–10 cm counterpart for an incarcerated or strangulated hernia. Code 49593 is for a reducible hernia in that size range.

49595

Abdominal hernia repair

Initial, over 10 cm, reducible

No office rate

Both are for initial, reducible repairs, but 49595 applies when the total defect length is greater than 10 cm.

49592

Abdominal hernia repair

Incarcerated or strangulated, under 3 cm

No office rate

This code covers an initial hernia repair under 3 cm when the hernia is incarcerated or strangulated; 49593 is for a 3–10 cm reducible hernia.

Compare 49593 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

Office and facility base rates · shared scale starting at $0

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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 49593 in Rhode Island.

PPRRVU2026_Oct_nonQPP.csv

5,839

Code
49593
Physician work
10.00
Practice expense
3.11
Malpractice
2.61

GPCI2026.csv

92

Locality
Rhode Island
Physician work
1.019
Practice expense
1.033
Malpractice
0.892
Facility calculation for 49593 in Rhode Island
ComponentRVULocality factorAdjusted
Physician work10.00× 1.01910.1900
Practice expense3.11× 1.0333.2126
Malpractice2.61× 0.8922.3281
Total RVUs15.7307
Conversion factor× 33.4009

Facility rate, Rhode Island$525.42

Explore RVUs, geographic factors and the full formula

Facility

Facility calculation inputs
ComponentRVULocal GPCI
Work101.019
Practice expense3.111.033
Malpractice2.610.892

(10 × 1.019 + 3.11 × 1.033 + 2.61 × 0.892) × $33.4009 = $525.42

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.

49593 billing questions

How does 49593 differ from 49594?

Both describe an initial anterior abdominal hernia repair for a total defect length of 3–10 cm. Report 49593 for a reducible hernia and 49594 for an incarcerated or strangulated hernia.

Does the surgical approach determine whether to report 49593?

No. The code covers open, laparoscopic, and robotic approaches; select it based on initial status, reducibility, and total defect length.

Can mesh placement be billed separately?

Mesh or another prosthesis used in the repair is included in 49593. The code does not separately report the implant placement as an additional hernia-repair service.

What documentation supports the 3–10 cm level?

Document the total length of the hernia defect or defects and the operative findings that establish reducibility and initial-repair status. The recorded defect size should support the selected size range.

How does the 0-day global period affect same-day care?

Same-day preoperative and postoperative care is included in the procedure. For other procedures performed in the same session, CMS pays the highest-valued procedure in full and applies the standard multiple-procedure reduction to the others.

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.

RVUs for 49593PPRRVU2026_Oct_nonQPP.csv, line 5,839 (RVU26D)
Geographic factors for Rhode IslandGPCI2026.csv, line 92 (RVU26D)
Open CMS sourceHow this rate is calculatedBuild a fee sheet