Laparoscopy, surgical; repair initial inguinal hernia, age 5 years or older; reducible

CPT 49650 is the billing code for "Laparoscopy, surgical; repair initial inguinal hernia, age 5 years or older; reducible". For laparoscopic repair of initial reducible inguinal hernia in patients age 5 years or older

Medicare pays approximately $427.62 for CPT 49650 (national average). Actual payment varies by geographic location due to GPCI adjustments. Hospital and commercial insurance rates are typically 2-4x higher than Medicare rates.

CPT 49650 has a total RVU of 23.75, broken down as: Work RVU 10.50, Practice Expense RVU 12.20, and Malpractice RVU 1.05. RVUs (Relative Value Units) determine Medicare reimbursement rates.

Key documentation requirements for CPT 49650 include: Indication for laparoscopic hernia repair; Hernia type (direct vs indirect); Laparoscopic approach used (TEP vs TAPP); Mesh placement documented. Missing or incomplete documentation is a leading cause of claim denials for this code.

Bundling considerations for CPT 49650: Includes laparoscopic hernia repair. Includes mesh placement Use an NCCI bundling checker to verify specific code combinations before billing.

Common modifiers for CPT 49650 include: 50 (Bilateral procedure when both sides performed same session), 51 (Multiple procedures performed same session), 22 (Increased procedural services for difficult cases). Modifiers indicate special circumstances and can affect reimbursement or prevent claim denials.

The typical time requirement for CPT 49650 is 60-90 minutes typical operative time. Time-based codes require documentation of the actual time spent providing the service.