Common surgery & pain management

49505 - RVUs & Medicare payment (2026)

Open repair of inguinal hernia, initial.

Component	Non-facility	Facility
Work RVU	7.76	7.76
Practice expense RVU	5.40	5.40
Malpractice RVU	2.05	2.05
Total RVUs	15.21	15.21
National payment (CF $33.4009)	$508.03	$508.03
Qualifying APM payment (CF $33.5675)	$510.56	$510.56

How 49505 payment varies by locality

Medicare adjusts payment with geographic practice cost indices, so the same code pays differently across the 109 fee schedule localities. In 2026, non-facility payment for 49505 ranges from $449.39 in Arkansas (AR) to $620.12 in Miami (FL); calculate 49505 for your locality.

Miami (FL) $620.12 Alaska (AK) $618.60 NYC Suburbs/Long Island (NY) $617.39 Chicago (IL) $599.41 Manhattan (NY) $593.96 Queens (NY) $587.71 San Jose-Sunnyvale-Santa Clara (CA) $584.49 San Jose-Sunnyvale-Santa Clara (CA) $574.97 National average $508.03 … 97 more localities between … Wisconsin (WI) $453.07 Nebraska (NE) $451.55 Iowa (IA) $451.41 Arkansas (AR) $449.39

Non-facility payment for 49505 in the 2026 fee schedule ($33.4009 conversion factor), before sequestration. Gray bar = national average.

Global period: 090

90-day global period: routine pre- and post-operative care within 90 days is included in the payment.

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Frequently asked questions

How much does Medicare pay for 49505 in 2026?

The national non-facility payment is $508.03 and the facility payment is $508.03, using the standard $33.4009 conversion factor. Actual amounts vary by Medicare locality; use the RVU calculator for your area.

What is the work RVU for 49505?

The 2026 work RVU for 49505 is 7.76. Total RVUs are 15.21 in the non-facility setting and 15.21 in the facility setting.

Why are the facility and non-facility amounts different?

Only the practice expense component changes by setting. In an office (non-facility) the practice bears the overhead, so the PE RVU is higher; in a hospital or ASC the facility bills its own overhead separately.

Source: CMS Physician Fee Schedule relative value file (rvu26c.zip, retrieved 2026-07-11). Service description is an original plain-English summary, not CPT descriptor text. CPT® is a registered trademark of the American Medical Association. Amounts are estimates before sequestration and claim-level adjustments.