No office rate
49621 reports the parastomal hernia repair itself. Add 49623 only when noninfected mesh or another prosthesis is also removed during that repair.
On this page
CMS RVU26D · Effective 2026-10-01
49623 Mesh removal Medicare reimbursement rates in Wyoming
Reports removal of noninfected mesh or another prosthesis during a hernia repair, in addition to the primary repair code. Compare 49623 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 49623 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
$175.79
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.
Hernia surgery
About 49623: Noninfected mesh removal during hernia repair
Reports removal of noninfected mesh or another prosthesis during a hernia repair, in addition to the primary repair code.
This add-on describes removing noninfected mesh or another prosthesis during a hernia repair, regardless of the surgical approach. A surgeon may encounter prior mesh during an open or laparoscopic repair of a recurrent abdominal, parastomal, or inguinal hernia. The work must involve removal of the prosthesis; simply working around existing mesh as part of the repair does not establish that removal was performed.
Report 49623 with the qualifying primary hernia repair, not as a standalone service. The operative note should identify the prosthesis as noninfected and document its removal during the repair. CMS classifies the code as an add-on and places its payment within the primary procedure’s global period. The primary code identifies the hernia repair; 49623 represents the additional prosthesis-removal work.
CMS billing rules for 49623
- Global period
- Add-on code: billed only together with a primary procedure and paid within that procedure's global period.
Where the value comes from
- Work RVU3.66 · 66%
- Practice expense (office) RVU0.90 · 16%
- Malpractice RVU0.95 · 17%
1.9K
Medicare services in 2024 · #2521 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.
49623 compared with similar codes
Office rates for Wyoming, from the same CMS release.
No office rate
49650 reports an initial laparoscopic inguinal hernia repair. It is a primary procedure, while 49623 reports qualifying prosthesis removal performed during a hernia repair.
No office rate
49651 reports a recurrent laparoscopic inguinal hernia repair. It does not by itself represent mesh removal; 49623 is the add-on for qualifying removal.
Compare 49623 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
$175.79
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.
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 49623 in Wyoming**.
PPRRVU2026_Oct_nonQPP.csv
5,856
- Code
- 49623
- Physician work
- 3.66
- Practice expense
- 0.90
- Malpractice
- 0.95
GPCI2026.csv
112
- Locality
- Wyoming**
- Physician work
- 1.000
- Practice expense
- 1.000
- Malpractice
- 0.740
| Component | RVU | Locality factor | Adjusted |
|---|---|---|---|
| Physician work | 3.66 | × 1.000 | 3.6600 |
| Practice expense | 0.90 | × 1.000 | 0.9000 |
| Malpractice | 0.95 | × 0.740 | 0.7030 |
| Total RVUs | 5.2630 | ||
| Conversion factor | × 33.4009 | ||
Facility rate, Wyoming**$175.79
Explore RVUs, geographic factors and the full formula
Facility
| Component | RVU | Local GPCI |
|---|---|---|
| Work | 3.66 | 1 |
| Practice expense | 0.9 | 1 |
| Malpractice | 0.95 | 0.74 |
(3.66 × 1 + 0.9 × 1 + 0.95 × 0.74) × $33.4009 = $175.79
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.
49623 billing questions
Can 49623 be reported by itself?
No. It is an add-on code and must be reported with a qualifying primary hernia repair.
Does the surgeon need to remove mesh, or is dissection around it enough?
The code is for removal of noninfected mesh or another prosthesis. The operative note should document that the prosthesis was removed, not merely encountered or left in place.
Can 49623 be used when the mesh is infected?
No. This code describes removal of a noninfected prosthesis.
Does the surgical approach determine whether 49623 applies?
No. The code covers qualifying prosthesis removal during hernia repair by any approach.
What should the operative note say?
Document the noninfected prosthesis, its removal, and the hernia repair performed during the same operation. The primary repair code must also be reported.
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.
5,85349618,,Rpr aa hrn rcr > 10 ncr/strn,A,,22.10,6.09,NA,6.09,,5.69,33.88,33.88,0,000,0.00,0.00,0.00,2,0,2,1,0,9,,33.4009,09,0,99,0.00,0.00,0.00
5,85449621,,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
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.,,,,,,