Laparoscopy, surgical, repair, ventral, umbilical, spigelian or epigastric hernia; reducible
Relative Value Units (RVUs)
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Clinical Information
When to Use
For laparoscopic repair of reducible ventral, umbilical, spigelian, or epigastric hernia
Common Scenarios
Documentation Requirements
- Indication for laparoscopic hernia repair
- Hernia type and location
- Laparoscopic approach used
- Mesh placement documented
- Any complications
Coding Guidelines
Common Modifiers
Bundling Rules
- Includes laparoscopic hernia repair
- Includes mesh placement
- Diagnostic laparoscopy bundled
- Multiple hernias repaired bundled
- Conversion to open coded separately
Exclusions
- 49560 (open ventral hernia repair)
- 49585 (open umbilical hernia repair)
- 49650 (laparoscopic inguinal hernia repair)
- 49651 (laparoscopic recurrent inguinal hernia repair)
Coding Notes
Clinical scenarios
- Indication for laparoscopic hernia repair
- Hernia type and location
- Laparoscopic approach used
- Indication for laparoscopic hernia repair
- Hernia type and location
- Laparoscopic approach used
- Indication for laparoscopic hernia repair
- Hernia type and location
- Laparoscopic approach used
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Code Details
Medicare Pricing
Pricing data not available for this code.
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Ask a QuestionFrequently Asked Questions
CPT 49652 is the billing code for "Laparoscopy, surgical, repair, ventral, umbilical, spigelian or epigastric hernia; reducible". For laparoscopic repair of reducible ventral, umbilical, spigelian, or epigastric hernia
CPT 49652 has a total RVU of 25.32, broken down as: Work RVU 11.20, Practice Expense RVU 13.00, and Malpractice RVU 1.12. RVUs (Relative Value Units) determine Medicare reimbursement rates.
Key documentation requirements for CPT 49652 include: Indication for laparoscopic hernia repair; Hernia type and location; Laparoscopic approach used; Mesh placement documented. Missing or incomplete documentation is a leading cause of claim denials for this code.
Bundling considerations for CPT 49652: Includes laparoscopic hernia repair. Includes mesh placement Use an NCCI bundling checker to verify specific code combinations before billing.
Common modifiers for CPT 49652 include: 51 (Multiple procedures performed same session), 22 (Increased procedural services for difficult cases), 59 (Distinct procedural service if performed separately). Modifiers indicate special circumstances and can affect reimbursement or prevent claim denials.
The typical time requirement for CPT 49652 is 60-90 minutes typical operative time. Time-based codes require documentation of the actual time spent providing the service.