No office rate
Both describe laparoscopic inguinal hernia repair; use 49651 for recurrent hernias and 49650 for initial repairs.
On this page
CMS RVU26D · Effective 2026-10-01
49650 Inguinal hernia repair Medicare reimbursement rates in Virginia
Reports laparoscopic repair of an initial inguinal hernia, typically performed by a surgeon to reduce the hernia and reinforce the repair. Compare 49650 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 49650 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
$405.42–$470.48
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 repair
About 49650: Laparoscopic initial inguinal hernia repair
Reports laparoscopic repair of an initial inguinal hernia, typically performed by a surgeon to reduce the hernia and reinforce the repair.
A surgeon repairs an initial inguinal hernia through small abdominal incisions using a laparoscope and surgical instruments. The surgeon reduces the hernia and repairs the defect, commonly reinforcing the area with mesh. This approach is performed in hospital operating rooms and ambulatory surgery centers; transabdominal preperitoneal and totally extraperitoneal approaches are common. Mesh placement is part of the repair rather than a separate service under this code.
Report this code for laparoscopic repair of an initial, not recurrent, inguinal hernia. The operative report should support the laparoscopic approach, hernia site, and whether the repair is initial or recurrent. For bilateral repair in the same session, CMS pays 150% when modifier 50 is reported. When other procedures are performed in the same session, the highest-valued procedure is paid in full and other procedures are subject to the standard multiple procedure reduction. The code has a 90-day global period, including the day-before preoperative visit and 90 days of related postoperative care. Assistant-at-surgery payment may be available; co-surgeon payment requires supporting documentation, and team surgery is not permitted.
CMS billing rules for 49650
- 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 RVU6.20 · 49%
- Practice expense (office) RVU4.87 · 38%
- Malpractice RVU1.63 · 13%
81.5K
Medicare services in 2024 · #624 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.
49650 compared with similar codes
Office rates for Virginia, from the same CMS release.
No office rate
This is an open repair of an initial inguinal hernia. Use 49650 when the repair is performed laparoscopically.
No office rate
This is an open repair of an incarcerated or strangulated initial inguinal hernia; 49650 identifies laparoscopic initial repair.
Compare 49650 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
$470.48
Virginia →
Office / nonfacility
Unavailable
Facility
$405.42
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49650 billing questions
When should 49651 be reported instead?
Report 49651 for laparoscopic repair of a recurrent inguinal hernia. Code 49650 is for an initial repair.
Is mesh separately reported with 49650?
Mesh used to reinforce the laparoscopic inguinal repair is included in the repair service; do not report it as a separate mesh service.
How is bilateral repair reported?
For repair of both sides in the same session, report modifier 50. CMS pays the bilateral procedure 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.
Can an assistant or co-surgeon be reported?
Assistant-at-surgery payment may be available. Co-surgeon payment requires supporting documentation; CMS does not permit team surgery for this code.
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.
5,85449621,,Rpr parastomal hernia rdc,A,,13.36,3.94,NA,3.94,,3.16,20.46,20.46,0,000,0.00,0.00,0.00,2,0,2,1,0,9,,33.4009,09,0,99,0.00,0.00,0.00
5,85549622,,Rpr parastomal hrna ncr/strn,A,,16.63,4.71,NA,4.71,,4.10,25.44,25.44,0,000,0.00,0.00,0.00,2,0,2,1,0,9,,33.4009,09,0,99,0.00,0.00,0.00
5,85649623,,Rmvl ninfct mesh hernia rpr,A,,3.66,0.90,NA,0.90,,0.95,5.51,5.51,0,ZZZ,0.00,0.00,0.00,0,0,2,1,0,9,,33.4009,09,0,99,0.00,0.00,0.00
5,85749650,,Lap ing hernia repair init,A,,6.20,4.87,NA,4.87,,1.63,12.70,12.70,0,090,0.09,0.81,0.10,2,1,2,1,0,9,,33.4009,09,0,99,0.00,0.00,0.00
5,85849651,,Lap ing hernia repair recur,A,,8.17,6.15,NA,6.15,,2.15,16.47,16.47,0,090,0.09,0.81,0.10,2,1,2,1,0,9,,33.4009,09,0,99,0.00,0.00,0.00
5,85949659,,Unlstd laps px hrnap hrnrphy,C,,0.00,0.00,,0.00,,0.00,0.00,0.00,0,YYY,0.00,0.00,0.00,2,1,2,1,1,9,,33.4009,09,0,99,0.00,0.00,0.00
5,86049900,,Repair of abdominal wall,A,,12.10,8.82,NA,8.82,,3.04,23.96,23.96,0,090,0.09,0.81,0.10,2,0,2,1,0,9,,33.4009,09,0,99,0.00,0.00,0.00