No office rate
49505 describes an initial, reducible inguinal hernia in a patient age five or older. Choose 49525 when the operative findings establish a sliding hernia.
On this page
CMS RVU26D · Effective 2026-10-01
49525 Inguinal hernia repair Medicare reimbursement rates in Washington
Report this code for operative repair of a sliding inguinal hernia, where an organ forms part of the hernia sac. Compare 49525 office and facility rates across CMS payment localities in Washington.
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 49525 in Washington?
Washington 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
$549.97–$597.60
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.
General surgery
About 49525: Sliding inguinal hernia repair
Report this code for operative repair of a sliding inguinal hernia, where an organ forms part of the hernia sac.
A sliding inguinal hernia has an organ wall, commonly colon or bladder, forming part of the hernia sac. A surgeon repairs the hernia through an open operation, carefully identifying and managing the organ that contributes to the sac. These repairs are generally performed in an operating room, most often by a general surgeon.
Select this code when the operative findings establish sliding anatomy, rather than choosing an ordinary inguinal hernia code based only on reducibility or recurrence. The operative report should identify the side, the organ or tissue forming part of the sac when known, and the repair performed. CMS assigns 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 others at 50%. Bilateral repair with modifier 50 is paid at 150%. Assistant-at-surgery payment may be available; co-surgeon payment requires supporting documentation, and team-surgery payment is not permitted.
CMS billing rules for 49525
- 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 RVU8.71 · 52%
- Practice expense (office) RVU5.61 · 34%
- Malpractice RVU2.28 · 14%
1.1K
Medicare services in 2024 · #2899 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.
49525 compared with similar codes
Office rates for Washington, from the same CMS release.
No office rate
49507 is for an initial incarcerated or strangulated inguinal hernia in a patient age five or older. Sliding anatomy is the defining feature for 49525.
No office rate
49520 describes repair of a recurrent, reducible inguinal hernia. Use 49525 when the hernia is documented as sliding rather than coding by recurrence and reducibility alone.
No office rate
49521 is for a recurrent incarcerated or strangulated inguinal hernia. 49525 identifies the sliding anatomy of the hernia.
Compare 49525 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
Rest Of Washington →
Office / nonfacility
Unavailable
Facility
$549.97
Seattle (King Cnty) →
Office / nonfacility
Unavailable
Facility
$597.60
Need rates for a whole code list?
Fee-sheet and API access are in early access. Tell us which codes and locations your team needs.
49525 billing questions
How is 49525 distinguished from an ordinary inguinal hernia repair?
Use 49525 when the operative findings establish that an organ wall forms part of the hernia sac. Ordinary inguinal hernia codes are selected using their applicable age, recurrence, and reducibility criteria.
What operative documentation supports 49525?
Document the sliding anatomy and the operative findings showing the organ or tissue that contributes to the sac. Record the side and the repair performed.
Can 49525 be reported for bilateral repair?
Yes. CMS pays bilateral procedures reported with modifier 50 at 150%.
How does the 90-day global period affect postoperative billing?
The global period includes the day-before preoperative visit and 90 days of related postoperative care. Those included services are part of the surgical global package.
Can an assistant or co-surgeon be paid for this operation?
Assistant-at-surgery payment may be available. Co-surgeon payment requires supporting documentation; team-surgery payment is not permitted.
What happens when another procedure is performed in the same session?
Under the standard multiple procedure reduction, the highest-valued procedure is paid in full and the other procedures are paid at 50%.
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.
5,82849507,,Prp i/hern init block >5 yr,A,,8.86,5.83,NA,5.83,,2.32,17.01,17.01,0,090,0.09,0.81,0.10,2,1,2,1,0,9,,33.4009,09,0,99,0.00,0.00,0.00
5,82949520,,Rerepair ing hernia reduce,A,,9.74,5.91,NA,5.91,,2.56,18.21,18.21,0,090,0.09,0.81,0.10,2,1,2,1,0,9,,33.4009,09,0,99,0.00,0.00,0.00
5,83049521,,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