No office rate
Both describe initial femoral hernia repair. Choose 49553 when the hernia is documented as incarcerated or strangulated rather than reducible.
On this page
CMS RVU26D · Effective 2026-10-01
49550 Femoral hernia repair Medicare reimbursement rates in Utah
Open repair of an initial, reducible femoral hernia, selected when the operative findings identify a femoral defect rather than an inguinal hernia. Compare 49550 office and facility rates across CMS payment localities in Utah.
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 49550 in Utah?
Utah 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
$539.30
1 of 1 localities have a supported rate.
Payment area: Utah
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 49550: Initial reducible femoral hernia repair
Open repair of an initial, reducible femoral hernia, selected when the operative findings identify a femoral defect rather than an inguinal hernia.
This code describes open surgery to repair a femoral hernia that can be reduced and has not been repaired previously. The defect is in the groin at the femoral canal, below the inguinal ligament. A surgeon returns the hernia contents and repairs the defect. General surgeons commonly perform this operation in a hospital or ambulatory surgery setting.
Choose the code from the documented anatomic site, whether the hernia is initial or recurrent, and whether it is reducible. The operative report should support the femoral location, reducibility, laterality, and repair performed. The service has 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 the others at 50%. Bilateral reporting with modifier 50 is paid at 150%. An assistant at surgery may be paid; co-surgeons require supporting documentation, and team surgery is not permitted.
CMS billing rules for 49550
- 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 RVU8.77 · 52%
- Practice expense (office) RVU5.65 · 34%
- Malpractice RVU2.30 · 14%
835
Medicare services in 2024 · #3112 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.
49550 compared with similar codes
Office rates for Utah, from the same CMS release.
No office rate
This code is for an initial reducible femoral hernia; 49555 is for a recurrent reducible femoral hernia.
No office rate
49500 describes an initial reducible inguinal hernia. Use this code when the operative documentation locates the defect in the femoral canal.
No office rate
49557 is for a recurrent femoral hernia documented as incarcerated or strangulated; this code is for an initial reducible femoral hernia.
Compare 49550 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
Utah →
Office / nonfacility
Unavailable
Facility
$539.30
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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 49550 in Utah.
PPRRVU2026_Oct_nonQPP.csv
5,833
- Code
- 49550
- Physician work
- 8.77
- Practice expense
- 5.65
- Malpractice
- 2.30
GPCI2026.csv
104
- Locality
- Utah
- Physician work
- 1.000
- Practice expense
- 0.940
- Malpractice
- 0.898
| Component | RVU | Locality factor | Adjusted |
|---|---|---|---|
| Physician work | 8.77 | × 1.000 | 8.7700 |
| Practice expense | 5.65 | × 0.940 | 5.3110 |
| Malpractice | 2.30 | × 0.898 | 2.0654 |
| Total RVUs | 16.1464 | ||
| Conversion factor | × 33.4009 | ||
Facility rate, Utah$539.30
Explore RVUs, geographic factors and the full formula
Facility
| Component | RVU | Local GPCI |
|---|---|---|
| Work | 8.77 | 1 |
| Practice expense | 5.65 | 0.94 |
| Malpractice | 2.3 | 0.898 |
(8.77 × 1 + 5.65 × 0.94 + 2.3 × 0.898) × $33.4009 = $539.30
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.
49550 billing questions
How does this differ from an inguinal hernia repair?
Select this code when the operative documentation identifies a femoral defect at the femoral canal. An inguinal hernia has a different anatomic site, even though both present in the groin.
When is the incarcerated femoral hernia code used instead?
Use 49553 for an initial femoral hernia documented as incarcerated or strangulated. This code is for an initial hernia that is reducible.
Can modifier 50 be reported for bilateral repair?
Yes. CMS pays this bilateral procedure reported with modifier 50 at 150%.
What postoperative care is included?
The 90-day global period includes the day-before preoperative visit and 90 days of related postoperative care.
How are multiple procedures in the same session paid?
The highest-valued procedure is paid in full, and other procedures subject to the standard multiple procedure reduction are paid at 50%.
Can an assistant or co-surgeon be reported?
An assistant at surgery may be paid. Co-surgeons are paid only with 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 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.
5,83049521,,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
5,83249540,,Repair lumbar hernia,A,,10.47,6.10,NA,6.10,,2.70,19.27,19.27,0,090,0.09,0.81,0.10,2,1,2,1,0,9,,33.4009,09,0,99,0.00,0.00,0.00
5,83349550,,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
10104412,TX,15,GALVESTON,1.008,0.993,0.828
10204412,TX,18,HOUSTON,1.008,0.993,1.376
10304412,TX,99,REST OF TEXAS,1.000,0.949,0.903
10403502,UT,09,UTAH,1.000,0.940,0.898
10514512,VT,50,VERMONT,1.000,0.990,0.506
10611302,VA,00,VIRGINIA,1.000,0.983,0.706
10709202,VI,50,VIRGIN ISLANDS,1.000,1.011,0.985