No office rate
This code is for traumatic diaphragmatic hernia repair through a thoracic or abdominal approach. Choose 39501 when the operative target is a diaphragmatic laceration.
On this page
CMS RVU26D · Effective 2026-10-01
39501 Diaphragm repair Medicare reimbursement rates in Virginia
Report 39501 for operative repair of a diaphragmatic tear, commonly encountered during surgery for penetrating or blunt thoracoabdominal trauma. Compare 39501 office and facility rates across CMS payment localities in Virginia.
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 39501 in Virginia?
Virginia 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
$773.32–$890.51
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.
Thoracic surgery
About 39501: Diaphragm laceration repair
Report 39501 for operative repair of a diaphragmatic tear, commonly encountered during surgery for penetrating or blunt thoracoabdominal trauma.
Code 39501 describes operative closure of a tear in the diaphragm, often an acute injury found during exploration for penetrating or blunt thoracoabdominal trauma. A trauma or general surgeon may repair the defect through an abdominal or chest operation, usually in a hospital facility. The code is for laceration repair, rather than repair of a diaphragmatic hernia.
Select the code when the operative report documents a diaphragmatic laceration and its repair. This major surgery has a 90-day global period, including the day-before preoperative visit and 90 days of related postoperative care. 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. Report the repair once; modifier 50 is not appropriate. An assistant at surgery may be paid, co-surgeon payment requires supporting documentation, and team surgery is not permitted.
CMS billing rules for 39501
- 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 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 RVU13.63 · 56%
- Practice expense (office) RVU7.31 · 30%
- Malpractice RVU3.31 · 14%
294
Medicare services in 2024 · #4004 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.
39501 compared with similar codes
Office rates for Virginia, from the same CMS release.
No office rate
This code is for traumatic diaphragmatic hernia repair through a thoracoabdominal approach. A laceration repair is reported with 39501.
No office rate
This code describes diaphragm resection with simple closure. Use 39501 when the documented service repairs a laceration rather than resecting diaphragm.
Compare 39501 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
Dc + Md/Va Suburbs →
Office / nonfacility
Unavailable
Facility
$890.51
Virginia →
Office / nonfacility
Unavailable
Facility
$773.32
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39501 billing questions
How does 39501 differ from traumatic diaphragmatic hernia repair?
Use 39501 for repair of a diaphragmatic laceration. Codes 39540 and 39541 describe repair of a traumatic diaphragmatic hernia, with the approach distinguishing those codes.
What documentation supports 39501?
The operative report should identify the diaphragmatic tear and document that it was repaired. It should distinguish a laceration from a diaphragmatic hernia or a procedure that resects diaphragm.
Are related postoperative visits included?
Yes. The 90-day global period includes the day-before preoperative visit and 90 days of related postoperative care.
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.
How are other procedures in the same session paid?
The highest-valued procedure is paid in full; other procedures are subject to the standard multiple procedure reduction. Modifier 50 is not appropriate for this diaphragm repair.
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.
4,77839401,,Mediastinoscpy w/medstnl bx,A,,5.30,2.14,NA,2.14,,1.32,8.76,8.76,0,000,0.00,0.00,0.00,2,0,1,0,0,9,,33.4009,09,0,99,0.00,0.00,0.00
4,77939402,,Mediastinoscpy w/lmph nod bx,A,,7.07,2.48,NA,2.48,,1.76,11.31,11.31,0,000,0.00,0.00,0.00,2,0,1,0,0,9,,33.4009,09,0,99,0.00,0.00,0.00
4,78039499,,Unlisted px mediastinum,C,,0.00,0.00,,0.00,,0.00,0.00,0.00,0,YYY,0.00,0.00,0.00,2,0,2,1,1,9,,33.4009,09,0,99,0.00,0.00,0.00
4,78139501,,Repair diaphragm laceration,A,,13.63,7.31,NA,7.31,,3.31,24.25,24.25,0,090,0.09,0.84,0.07,2,0,2,1,0,9,,33.4009,09,0,99,0.00,0.00,0.00
4,78239503,,Repair of diaphragm hernia,A,,106.19,27.29,NA,27.29,,26.77,160.25,160.25,0,090,0.09,0.84,0.07,2,0,2,1,0,9,,33.4009,09,0,99,0.00,0.00,0.00
4,78339540,,Repair of diaphragm hernia,A,,14.21,6.68,NA,6.68,,3.61,24.50,24.50,0,090,0.09,0.84,0.07,2,0,2,1,0,9,,33.4009,09,0,99,0.00,0.00,0.00
4,78439541,,Repair of diaphragm hernia,A,,15.36,7.25,NA,7.25,,3.98,26.59,26.59,0,090,0.09,0.84,0.07,2,0,2,1,0,9,,33.4009,09,0,99,0.00,0.00,0.00