49650 Medicare Reimbursement Rate (2026)
Current CMS pricing and breakdown for Lap ing hernia repair init.
⚠️ This is a National Estimate
Your actual reimbursement depends on your specific Zip Code and GPCI adjustments (e.g., New York vs. Texas).
Code Description
Lap ing hernia repair init
Local Estimate Demo
Pick a demo zip (or type yours) and choose the setting. Then jump into MedFeeSchedule's Medicare Physician Fee Schedule Lookup Tool to calculate your locality-adjusted estimate.
How is this calculated?
Here’s the transparent math behind the estimate for CPT code 49650. For locality-adjusted results, use MedFeeSchedule's Medicare Physician Fee Schedule Lookup Tool.
RVU-based Physician Fee Schedule estimate (Office)
- Medicare uses RVUs (Work + Practice Expense + Malpractice) to estimate payment.
- Office (Non-Facility) estimate: Total RVUs (12.70) × Conversion Factor (33.40) ≈ $424.18.
- Locality adjustments (GPCI) can change the final rate. Use MedFeeSchedule's Medicare Physician Fee Schedule Lookup Tool for your zip.
Reimbursement Summary
For 2026, the estimated National Average Medicare payment for 49650 is $424.18 in a non-facility (office) setting and $424.18 in a facility (hospital/outpatient) setting. Your actual reimbursement depends on locality adjustments.
This code’s RVU components (Work, Practice Expense, and Malpractice) combine to approximately 12.70 total RVUs in the office setting and 12.70 total RVUs in the facility setting.
Description: Lap ing hernia repair init. For locality-adjusted estimates, use MedFeeSchedule's Medicare Physician Fee Schedule Lookup Tool.
Facility vs. Non-Facility (Office) Payment
Medicare often publishes two payment rates for the same code: a **non-facility** rate (typically used when the service is performed in a private office where the clinician bears more overhead) and a **facility** rate (typically used when performed in a hospital or facility where the facility bills separately for its costs).
Because the practice expense portion of RVUs differs by setting, the non-facility and facility payment amounts can be different. For locality-adjusted estimates in 2026, use MedFeeSchedule's Medicare Physician Fee Schedule Lookup Tool.
2026 Breakdown
| Component | Office (Non-Fac) | Facility (Hosp) |
|---|---|---|
| Work RVU | 6.2 | 6.2 |
| Practice Expense (PE) | 4.87 | 4.87 |
| Malpractice (MP) | 1.63 | 1.63 |
| Total RVUs | 12.70 | 12.70 |
Historical Medicare Reimbursement
| Year | Non-Facility Rate | Facility Rate | Year-over-Year % Change |
|---|---|---|---|
| 2026 | Coming Soon (Pro) | Coming Soon (Pro) | Coming Soon |
| 2025 | Coming Soon (Pro) | Coming Soon (Pro) | Coming Soon |
| 2024 | Coming Soon (Pro) | Coming Soon (Pro) | Coming Soon |
| 2023 | Coming Soon (Pro) | Coming Soon (Pro) | Coming Soon |
Historical trends and quarterly breakouts are launching as part of Pro. This preview shows where multi-year analytics will appear once the full dataset is available.
Pro includes historical graphs, deeper year ranges, and export tools. Learn more and join early access.
View Pro Plan (Coming Soon)Learn How This Reimbursement Is Calculated
Medicare reimbursement is determined by RVUs, geographic adjustments, and the annual conversion factor.
Frequently Asked Questions
What is the 2026 Medicare rate for 49650?
The 2026 National Average Medicare reimbursement rate for 49650 (Physician Service) is $424.18. This rate is effective as of January 1, 2026.
What is the description for code 49650?
Lap ing hernia repair init
Why do facility and non-facility payments differ for 49650?
For many physician services, Medicare publishes different practice-expense RVUs by setting. In general, non-facility rates apply when services are performed in a private office, while facility rates apply when performed in a hospital or facility where the facility bills separately.
How can I find my local Medicare rate for 49650?
Use MedFeeSchedule's Medicare Physician Fee Schedule Lookup Tool on the homepage to estimate your locality-adjusted reimbursement. Medicare payment can vary based on geographic adjustments (GPCI), place of service, and claim specifics.
Is 49650 covered by Medicare?
Coverage depends on medical necessity, setting, and Medicare policy. Some codes may be bundled, contractor-priced, or restricted. Verify final coverage guidance through CMS or your local MAC when applicable.