Billing code 49557: Femoral hernia repairMedicare rate & RVUs in Utah
Reports operative repair of a previously repaired femoral hernia when the recurrent hernia is incarcerated or strangulated.
CMS doesn’t publish an office rate for 49557 in Utah.
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 49557 covers
49557 applies when a femoral hernia has returned after prior repair and the recurrent hernia is incarcerated or strangulated. A surgeon repairs the femoral defect, typically in an operating room. The operative report should establish the femoral site, prior repair, and the incarceration or strangulation that makes the recurrent hernia nonreducible or threatens its blood supply.
Select this code rather than recurrent reducible femoral hernia repair when the documentation supports incarceration or strangulation; an initial femoral repair is a different service. The day-before preoperative visit and 90 days of related postoperative care are included in the 90-day global period. 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 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.
49557 in Utah
| Payment locality | Office | Facility |
|---|---|---|
| Utah | Unavailable | $669.42 |
How the 49557 rate is calculated
Each of 49557’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 · 49557
RVUs × geographic indexes × conversion factor
Swap in your local Medicare rate.
Work 11.33Practice expense 6.45Malpractice 2.95
All indexes start at 1.000 (the national rate). Enter a ZIP or drag a slider.
Payment rules and modifiers for 49557
49557 has a 90-day global period: related visits in that window are included in the surgery payment.
CMS payment indicators · 49557
Femoral 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) | 1 | Bilateral with modifier 50 pays 150% of the fee schedule amount. |
| 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) | 0.09/0.81/0.10 | Share of the payment for pre-op, the procedure itself, and post-op care. |
Global surgery period · 49557
Femoral 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 50 · payment effect
With and without the modifier
49557 without 50 · national facility
$692.40
Femoral hernia repair
49557-50 · Bilateral: 150%
$1,038.60
Both sides on one line with modifier 50 are paid at 150% of the fee schedule amount (subject to multiple-procedure rules with other procedures).
49557 compared with similar codes
Compare codes
49557 vs 49555 vs 49553 vs 49521: national Medicare rates
Swap in your local Medicare rate.
How to choose
- 49555Femoral hernia repair
- Both are for recurrent femoral hernias. Choose 49557 for an incarcerated or strangulated recurrence and 49555 for a reducible recurrence.
- 49553Femoral hernia repair
- This code is for a recurrent femoral hernia with incarceration or strangulation; 49553 is for an initial repair with those findings.
- 49521Inguinal hernia repair
- Both concern recurrent hernias that are incarcerated or strangulated, but 49521 is for an inguinal hernia and 49557 is for a femoral hernia.
49557 billing questions
How is this different from 49555?
Both describe repair of a recurrent femoral hernia. Use 49557 when the recurrent hernia is incarcerated or strangulated; 49555 is for a reducible recurrence.
How is this different from 49553?
49553 describes an initial femoral hernia repair when the hernia is incarcerated or strangulated. 49557 is for a femoral hernia that has recurred after a prior repair.
What documentation supports reporting 49557?
The operative record should identify the femoral hernia, establish that it is recurrent, and document incarceration or strangulation. A history of prior repair alone does not establish the nonreducible status.
Does the 90-day global include postoperative care?
Yes. The day-before preoperative visit and 90 days of related postoperative care are included in the global period.
How does Medicare handle bilateral repair and multiple procedures?
Bilateral reporting with modifier 50 is paid at 150%. For multiple procedures in the same session, Medicare pays the highest-valued procedure in full and the others at 50%.
Can an assistant or co-surgeon be reported?
Assistant-at-surgery payment may be made. Co-surgeon payment requires supporting documentation, and 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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