How much does Medicare pay for CPT 49593?

Medicare allowed an average of $538.47 per service and paid $425.33 of that, the balance being the patient's coinsurance and deductible (2024 data). Providers submitted an average of $2881.38, which is what they billed rather than what they received — Medicare pays its fee schedule regardless of the charge.

What is CPT code 49593?

Initial repair of sliding hernia of abdomen, 3-10 cm in length. It was billed 1,358 times to 1,346 Medicare beneficiaries by 90 providers in 2024.

Which specialty bills 49593 most?

General Surgery, with 1,026 services from 68 clinicians. Next are Physician Assistant, Ambulatory Surgical Center, Colorectal Surgery (Proctology).

CPT 49593

Initial repair of sliding hernia of abdomen, 3-10 cm in length

$538.47Medicare-allowed amount per service, averaged across 1,358 services

Providers submitted

$2881.38

Asking price, not received

Medicare allowed

$538.47

The fee schedule figure

Medicare paid

$425.33

Balance is patient coinsurance

Providers submitted an average of $2881.38 for this code and Medicare allowed $538.47 — 5.4× 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 $425.33 (79%); the rest is the patient’s coinsurance and deductible.

Services: 1,358
Beneficiaries: 1,346
Providers billing it: 90
Total allowed: $731,242

What Medicare pays for CPT 49593

Across 1,358 services billed by 90 providers to 1,346 beneficiaries, Medicare allowed an average of $538.47 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 49593

Specialty	Services	Beneficiaries	Avg allowed	Providers
General Surgery	1,026	1,019	$536.15	68
Physician Assistant	164	162	$66.88	11
Ambulatory Surgical Center	95	95	$1564.49	7
Colorectal Surgery (Proctology)	35	32	$248.97	1
Nurse Practitioner	14	14	$77.69	1
Critical Care (Intensivists)	13	13	$436.76	1
General Practice	11	11	$552.00	1

49593 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
Florida	286	$501.42	$373.39	17
California	143	$688.74	$499.47	11
New York	111	$588.83	$378.41	6
Texas	110	$546.40	$443.24	8
Maryland	81	$455.92	$346.81	5
North Carolina	80	$195.66	$169.70	4
Arizona	59	$534.52	$426.03	4
New Jersey	59	$297.09	$206.97	4
Virginia	57	$516.31	$403.61	3
Georgia	52	$503.88	$390.22	4
Ohio	48	$958.21	$799.67	3
Oklahoma	37	$486.74	$426.49	2
Pennsylvania	33	$385.80	$294.63	3
Colorado	26	$1011.20	$814.61	2
Kansas	26	$909.96	$749.22	2
Massachusetts	23	$559.95	$428.25	2
South Carolina	22	$524.00	$426.23	2
Tennessee	17	$560.83	$430.11	1
Michigan	14	$603.34	$393.22	1
Oregon	14	$528.42	$454.52	1
Connecticut	13	$436.76	$302.65	1
Louisiana	13	$534.10	$408.72	1
Mississippi	12	$529.70	$446.35	1
Nevada	11	$522.10	$425.90	1
Missouri	11	$491.91	$430.32	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
49507Repair of trapped groin hernia (5 years or older)$735.60

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.