How much does Medicare pay for CPT 49507?

Medicare allowed an average of $735.60 per service and paid $581.59 of that, the balance being the patient's coinsurance and deductible (2024 data). Providers submitted an average of $3866.72, which is what they billed rather than what they received — Medicare pays its fee schedule regardless of the charge.

What is CPT code 49507?

Repair of trapped groin hernia (5 years or older). It was billed 1,027 times to 1,018 Medicare beneficiaries by 52 providers in 2024.

Which specialty bills 49507 most?

General Surgery, with 746 services from 38 clinicians. Next are Ambulatory Surgical Center, Physician Assistant, Surgical Oncology.

CPT 49507

Repair of trapped groin hernia (5 years or older)

$735.60Medicare-allowed amount per service, averaged across 1,027 services

Providers submitted

$3866.72

Asking price, not received

Medicare allowed

$735.60

The fee schedule figure

Medicare paid

$581.59

Balance is patient coinsurance

Providers submitted an average of $3866.72 for this code and Medicare allowed $735.60 — 5.3× less. That gap is normal and means nothing on its own: Medicare pays its fee schedule regardless of what is billed, so the submitted figure describes a hospital chargemaster, not a price anyone paid. Of the allowed amount Medicare paid $581.59 (79%); the rest is the patient’s coinsurance and deductible.

Services: 1,027
Beneficiaries: 1,018
Providers billing it: 52
Total allowed: $755,461

What Medicare pays for CPT 49507

Across 1,027 services billed by 52 providers to 1,018 beneficiaries, Medicare allowed an average of $735.60 per service. The allowed amount is the figure that matters: it is what Medicare and the patient together owe, set by the fee schedule and adjusted for local practice costs. What a provider chose to submit has no bearing on it.

Who bills 49507

Specialty	Services	Beneficiaries	Avg allowed	Providers
General Surgery	746	741	$608.38	38
Ambulatory Surgical Center	177	173	$1566.01	9
Physician Assistant	72	72	$88.51	3
Surgical Oncology	20	20	$572.86	1
Orthopedic Surgery	12	12	$549.83	1

49507 reimbursement by state

Two different numbers. Allowed is what Medicare actually allowed in that state, which includes the local practice-cost adjustment. Standardized strips that geographic adjustment out of the payment, so it is the column to use when comparing states — a difference there reflects how the code was billed, not what it costs to run a practice locally.

State	Services	Allowed	Standardized pmt	Providers
New Jersey	222	$858.62	$633.62	7
California	214	$687.67	$511.93	13
New York	177	$649.18	$426.27	8
Florida	132	$802.55	$657.30	7
Maryland	79	$618.97	$464.88	5
Washington	60	$891.86	$678.99	3
Illinois	31	$665.86	$456.70	2
Tennessee	29	$528.49	$452.43	1
South Carolina	18	$582.63	$488.67	1
Georgia	15	$293.73	$231.12	1
Delaware	14	$1607.88	$1225.97	1
Texas	12	$563.28	$461.85	1
Missouri	12	$642.46	$501.76	1
Virginia	12	$549.83	$454.51	1

Related codes

49505Repair of groin hernia (5 years or older)$660.91
49594Initial repair of entrapped hernia of abdomen$802.78
49591Initial repair of sliding hernia of abdomen$463.16
49593Initial repair of sliding hernia of abdomen$538.47

Billing this code is not the same as earning it

An allowed amount is revenue to a practice, not income to a clinician. It funds staff, premises, equipment and supplies before anyone is paid. What clinicians actually earn is published separately by the Department of Labor, and what industry pays them is published separately again by CMS — this site carries both.

What doctors are paid →·Look up a clinician →·All procedure codes →

Where this comes from. CMS Medicare Physician & Other Practitioners, by Provider and Service, 2024. It covers fee-for-service Original Medicare Part B only — not Medicare Advantage, not Medicaid, and not commercial insurance, which typically pays more for the same code.

How it is averaged. CMS publishes one average per provider per code. Every figure here is re-weighted by the number of services, so a clinician who billed the code 4,000 times counts 4,000 times more than one who billed it twice. CMS also suppresses any provider-code pair with fewer than 11 beneficiaries, so low-volume practice is missing from these totals by design.