HERNIA REPAIR Procedures and Related CPT and ICD-9 Procedure Codes


49560 Repair initial incisional or ventral hernia; reducible $760.86 0154 Hernia/Hydrocele Procedures $2,675.43 $1,466.02

49561 Repair initial incisional or ventral hernia; incarcerated or strangulated $961.44 0154 Hernia/Hydrocele Procedures $2,675.43 $1,466.02

49565 Repair recurrent incisional or ventral hernia; reducible $793.04 0154 Hernia/Hydrocele Procedures $2,675.43 $1,466.02

49566 Repair recurrent incisional or ventral hernia; incarcerated or strangulated $969.67 0154 Hernia/Hydrocele Procedures $2,675.43 $1,466.02

+495681 Implantation of mesh or other prosthesis for open incisional or ventral hernia repair or mesh for closure of debridement for necrotizing soft tissue infection (List separately in addition to code for the incisional or ventral hernia repair) $277.46 NA NA Packaged into Payment for Other Services Packaged Service/Item

49652 Laparoscopy, surgical, repair, ventral, umbilical, spigelian or epigastric hernia (includes mesh insertion, when performed); reducible $768.37 0132 Level III Laparoscopy $5,479.13 $3,002.32

49653 Laparoscopy, surgical, repair, ventral, umbilical, spigelian or epigastric hernia (includes mesh insertion, when performed);  incarcerated or strangulated $958.94 0132 Level III Laparoscopy $5,479.13 $3,002.32

49654 Laparoscopy, surgical, repair, incisional hernia (includes mesh insertion, when performed); reducible $873.49 0132 Level III Laparoscopy $5,479.13 $3,002.32

49655 Laparoscopy, surgical, repair, incisional hernia (includes mesh insertion, when performed); incarcerated or strangulated $1,067.28 0132 Level III Laparoscopy $5,479.13 $3,002.32

49656 Laparoscopy, surgical, repair, recurrent incisional hernia (includes mesh insertion, when performed); reducible $949.29 0132 Level III  Laparoscopy $5,479.13 $3,002.32

49657 Laparoscopy, surgical, repair, recurrent incisional hernia (includes mesh insertion, when performed); incarcerated or strangulated $1,364.76 0132 Level III Laparoscopy $5,479.13 $3,002.32


Hernia Repair

11008 Removal of mesh in abdominal wall for infection

49500 Repair initial inguinal hernia, age 6 months to younger than 5 years, with or without hydrocelectomy; reducible

49501 Repair initial inguinal hernia, age 6 months to younger than 5 years, with or without hydrocelectomy; incarcerated or strangulated

49505 Repair initial inguinal hernia, age 5 years or older; reducible

49507 Repair initial inguinal hernia, age 5 years or older; incarcerated or strangulated

49520 Repair recurrent inguinal hernia, any age; reducible

49525 Repair inguinal hernia, sliding, any age

49560 Repair initial incisional or ventral hernia; reducible

49561 Repair initial incisional or ventral hernia; incarcerated or strangulated

49565 Repair recurrent incisional or ventral hernia; reducible

49566 Repair recurrent incisional or ventral hernia; incarcerated or strangulated

49568 Implantation of mesh or other prosthesis for incisional or ventral hernia repair or mesh for closure of debridement for necrotizing soft tissue infection (List separately in addition to code for the incisional or ventral hernia repair)

49580 Repair umbilical hernia, younger than age 5 years; reducible

49582 Repair umbilical hernia, younger than age 5 years; incarcerated or strangulated

49585 Repair umbilical hernia, age 5 years or older; reducible

49587 Repair umbilical hernia, age 5 years or older; incarcerated or strangulated

49650 Laparoscopy, surgical; repair initial inguinal hernia

49651 Laparoscopy, surgical; repair recurrent inguinal hernia

49652 Laparoscopy, surgical, repair, ventral, umbilical, spigelian or epigastric hernia (includes mesh insertion, when performed); reducible

49653 Laparoscopy, surgical, repair, ventral, umbilical, spigelian or epigastric hernia (includes mesh insertion, when performed); incarcerated or strangulated

49654 Laparoscopy, surgical, repair, incisional hernia (includes mesh insertion, when performed); reducible

49655 Laparoscopy, surgical, repair, incisional hernia (includes mesh insertion, when performed); incarcerated or strangulated

49656 Laparoscopy, surgical, repair, recurrent incisional hernia (includes mesh insertion, when performed); reducible

49657 Laparoscopy, surgical, repair, recurrent incisional hernia (includes mesh insertion, when performed); incarcerated or strangulated

49659* Unlisted lap procedure, hernioplasty, hernioorrhaphy, herniotomy

Parastomal Hernia Repair

44346 Revision of colostomy; with repair of paracolostomy hernia (separate procedure)

Hiatal Hernia Repair 39540 Repair, diaphragmatic hernia (other than neonatal), traumatic; chronic

39541 Repair, diaphragmatic hernia (other than neonatal), traumatic; chronic


CPT Code CPT Description ICD -9 Procedure



49495 Repair initial inguinal hernia, under age 6 months, with or without
hydrocelectomy; reducible
5300



49496 incarcerated or strangulated 5300



49500 Repair initial inguinal hernia, age 6 months to under 5 years, with
or without hydrocelectomy; reducible
5300



49501 incarcerated or strangulated 5300



49505 Repair initial inguinal hernia, age 5 years or over; reducible 5300



49507 incarcerated or strangulated 5300



49520 Repair recurrent inguinal hernia, any age; reducible 5300



49521 incarcerated or strangulated 5300



49525 Repair inguinal hernia; sliding, any age 5300



49540 Repair lumbar hernia 539



49550 Repair initial femoral hernia, any age; reducible 5329



49553 incarcerated or strangulated 5329



49555 Repair recurrent femoral hernia; reducible 5329



49557 incarcerated or strangulated 5329



49560 Repair initial incisional or ventral hernia; reducible 5351



49561 incarcerated or strangulated 5351



49565 Repair recurrent incisional or ventral hernia; reducible 5351



49566 incarcerated or strangulated 5351



49568 Implantation of mesh or other prosthesis for incisional or ventral
hernia repair (List separately in addition to code for the incisional
or ventral hernia repair)
5351
(49565)



49570 Repair epigastric hernia (e.g. Preperitoneal fat); reducible
(separate procedure)
5359



49572 incarcerated or strangulated 5359



49580 Repair umbilical hernia, under age 5 years; reducible 5359



49582 incarcerated or strangulated 5359



49585 Repair umbilical hernia, age 5 years or over; reducible 5349



49587 incarcerated or strangulated 5349



49590 Repair spigelian hernia 5359



49600 Repair of small omphalocele, with primary closure 5349



49605 Repair of large omphalocele or gastroschisis; with or without
prosthesis
5341



49606 with removal of prosthesis, final reduction and closure, in
operating room
5341



49610 Repair of omphalocele (Gross type operation); first stage 5349



49611 second stage 5349


Facility ICD-9-CM Procedure Codes & Descriptors

34.81 Excision of lesion or tissue of diaphragm 163-165, 515-517
42.7 Esophagomyotomy 133-134, 326-328, 820-822, 826-828, 907-909, 957
44.67 Laparoscopic procedures for creation of esophagogastric 326-328, 907-909, 957, 987-989 sphincteric competence
46.1 [series] Colostomy 329-331, 907-909, 957
46.2 [series] Ileostomy 329-331, 907-909, 957
46.40 [series] Revision of intestinal stoma 347-349, 907-909, 957
46.5 [series] Closure of intestinal stoma 344-346, 907-909, 957
53.00 Unilateral repair of inguinal hernia, not otherwise specified 350-352, 987-989
53.01 Other and open repair of direct inguinal hernia 350-352, 987-989
53.03 Other and open repair of direct inguinal hernia with graft or prosthesis 350-352, 987-989
53.04 Other and open repair of indirect inguinal hernia with graft or prosthesis 350-352, 987-989
53.05 Unilateral repair of inguinal hernia with graft or prosthesis, not otherwise specified 350-352, 987-989
53.14 Other and open bilateral repair of direct inguinal hernia with graft or prosthesis 350-352, 987-989
53.15 Other and open bilateral repair of indirect inguinal hernia with graft or prosthesis 350-352, 987-989
53.16 Other and open bilateral repair of inguinal hernia, one direct and one indirect, 350-352, 987-989 with graft or prosthesis
53.17 Bilateral inguinal hernia repair with graft or prosthesis, not otherwise specified 350-352, 987-989
53.71 Laparoscopic repair of diaphragmatic hernia, abdominal approach 163-165, 326-328, 907-909, 957
53.72 Other and open repair of diaphragmatic hernia, abdominal approach 163-165, 326-328, 907-909, 957
53.75 Repair of diaphragmatic hernia, abdominal approach, not otherwise specified 163-165, 326-328, 907-909, 957
53.83 Laparoscopic repair of diaphragmatic hernia, with thoracic approach 163-165, 326-328, 907-909, 957
53.84 Other and open repair of diaphragmatic hernia, with thoracic approach 163-165, 326-328, 907-909, 957 MS-DRG
53.41 Repair of hernia with graft or prosthesis 353-355, 987-989
53.59 Repair of other hernia of anterior abdominal wall 353-355
53.61 Other open incisional hernia repair with graft or prosthesis 353-355, 907-909, 957
53.62 Laparoscopic incisional hernia repair with graft or prosthesis 353-355, 907-909, 957
53.63 Other laparoscopic repair of other hernia of anterior abdominal wall with 353-355 graft or prosthesis

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