$508.09
Use for qualifying subcutaneous soft-tissue tumor excision of the abdominal wall. This code is for removal of the umbilicus itself.
On this page
CMS RVU26D · Effective 2026-10-01
49250 Umbilical excision Medicare reimbursement rates in Wyoming
Reports surgical removal of the umbilicus for localized disease or as a distinct operative service, rather than routine umbilical hernia repair. Compare 49250 office and facility rates across CMS payment localities in Wyoming.
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 49250 in Wyoming?
Wyoming 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
$549.91
1 of 1 localities have a supported rate.
Payment area: Wyoming**
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.
General surgery
About 49250: Surgical excision of the umbilicus
Reports surgical removal of the umbilicus for localized disease or as a distinct operative service, rather than routine umbilical hernia repair.
This code describes removal of the navel itself by a surgeon, commonly during an open abdominal operation or to treat disease centered in the umbilicus. The procedure may be performed by a general, gynecologic, or oncologic surgeon. The operative note should identify the condition prompting removal and document that the umbilicus was excised, not merely used as an access point or affected incidentally during another procedure.
The code is designated a separate procedure, so report it separately when the excision is distinct rather than integral to a more extensive operation. Documentation should make the operative work and its relationship to other procedures clear. Medicare assigns a 90-day global period, including the day-before preoperative visit and 90 days of related postoperative care. When multiple procedures occur in one session, the highest-valued procedure is paid in full and other procedures are subject to the standard 50% reduction. Modifier 50 is inappropriate for excision of this single anatomic structure. Medicare does not pay an assistant at surgery for this code; co-surgeon payment requires supporting documentation, and team surgery is not permitted.
CMS billing rules for 49250
- 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
- Statutory restriction: assistant at surgery is not paid.
- Co-surgeons
- Co-surgeons paid only with supporting documentation.
- Team surgery
- Team surgery not permitted.
Where the value comes from
- Work RVU8.78 · 52%
- Practice expense (office) RVU6.13 · 36%
- Malpractice RVU2.10 · 12%
135
Medicare services in 2024 · #4638 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.
49250 compared with similar codes
Office rates for Wyoming, from the same CMS release.
No office rate
This code describes qualifying deeper abdominal-wall soft-tissue tumor excision; it does not describe removal of the navel.
No office rate
Use for the specified initial reducible anterior abdominal hernia repair. It does not describe excision of the umbilicus.
Compare 49250 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
Wyoming** →
Office / nonfacility
Unavailable
Facility
$549.91
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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 49250 in Wyoming**.
PPRRVU2026_Oct_nonQPP.csv
5,781
- Code
- 49250
- Physician work
- 8.78
- Practice expense
- 6.13
- Malpractice
- 2.10
GPCI2026.csv
112
- Locality
- Wyoming**
- Physician work
- 1.000
- Practice expense
- 1.000
- Malpractice
- 0.740
| Component | RVU | Locality factor | Adjusted |
|---|---|---|---|
| Physician work | 8.78 | × 1.000 | 8.7800 |
| Practice expense | 6.13 | × 1.000 | 6.1300 |
| Malpractice | 2.10 | × 0.740 | 1.5540 |
| Total RVUs | 16.4640 | ||
| Conversion factor | × 33.4009 | ||
Facility rate, Wyoming**$549.91
Explore RVUs, geographic factors and the full formula
Facility
| Component | RVU | Local GPCI |
|---|---|---|
| Work | 8.78 | 1 |
| Practice expense | 6.13 | 1 |
| Malpractice | 2.1 | 0.74 |
(8.78 × 1 + 6.13 × 1 + 2.1 × 0.74) × $33.4009 = $549.91
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.
49250 billing questions
When is this code appropriate instead of an umbilical hernia repair code?
Use this code for surgical removal of the umbilicus itself. A hernia repair code describes repair of the defect and is not a substitute when the navel is excised.
Can it be reported with another abdominal procedure?
It is designated a separate procedure, so do not separately report it when the excision is integral to a more extensive operation. The operative note should show when it represents distinct work.
Should modifier 50 be used?
No. The service concerns the single umbilicus, so modifier 50 is inappropriate.
What postoperative care is included?
Medicare assigns a 90-day global period. It includes the day-before preoperative visit and 90 days of related postoperative care.
How are other procedures in the same session paid?
The highest-valued procedure is paid in full, and other procedures are subject to the standard multiple procedure reduction. Medicare does not pay an assistant at 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.
5,77849189,,Opn exc/dst ntra-abd 20.1-30,A,,39.00,16.29,NA,16.29,,9.00,64.29,64.29,0,090,0.09,0.81,0.10,2,0,2,1,0,9,,33.4009,09,0,99,0.00,0.00,0.00
5,77949190,,Opn exc/dstr ntra-abd >30 cm,A,,48.75,19.26,NA,19.26,,11.04,79.05,79.05,0,090,0.09,0.81,0.10,2,0,2,1,0,9,,33.4009,09,0,99,0.00,0.00,0.00
5,78049215,,Excise sacral spine tumor,A,,36.86,15.04,NA,15.04,,8.08,59.98,59.98,0,090,0.09,0.81,0.10,2,0,2,1,0,9,,33.4009,09,0,99,0.00,0.00,0.00
5,78149250,,Excision of umbilicus,A,,8.78,6.13,NA,6.13,,2.10,17.01,17.01,0,090,0.09,0.81,0.10,2,0,1,1,0,9,,33.4009,09,0,99,0.00,0.00,0.00
5,78249255,,Removal of omentum,A,,12.25,7.40,NA,7.40,,2.86,22.51,22.51,0,090,0.09,0.81,0.10,2,0,2,1,0,9,,33.4009,09,0,99,0.00,0.00,0.00
5,78349320,,Diag laparo separate proc,A,,5.01,3.23,NA,3.23,,1.23,9.47,9.47,0,010,0.10,0.80,0.10,2,0,2,0,0,9,,33.4009,09,0,99,0.00,0.00,0.00
5,78449321,,Laparoscopy biopsy,A,,5.30,3.30,NA,3.30,,1.26,9.86,9.86,0,010,0.10,0.80,0.10,3,0,2,2,0,9,49320,33.4009,09,0,99,0.00,0.00,0.00
10902402,WA,99,REST OF WASHINGTON,1.013,1.053,0.761
11011402,WV,16,WEST VIRGINIA,1.000,0.869,1.431
11106302,WI,00,WISCONSIN,1.000,0.958,0.308
11203602,WY,21,WYOMING**,1.000,1.000,0.740
113"MAC Assignments as of November 22, 2023",,,,,,
114,,,,,,
115*Work GPCI reflects a 1.5 floor in Alaska established by the MIPPA.,,,,,,