How much does Medicare pay for CPT 49650?

Medicare allowed an average of $593.41 per service and paid $467.62 of that, the balance being the patient's coinsurance and deductible (2024 data). Providers submitted an average of $2954.43, which is what they billed rather than what they received — Medicare pays its fee schedule regardless of the charge.

What is CPT code 49650?

Repair of groin hernia using an endoscope. It was billed 46,163 times to 44,977 Medicare beneficiaries by 2,269 providers in 2024.

Does 49650 pay differently in an office than a hospital?

Yes. The allowed amount averaged $426.56 in an office setting and $594.41 in a facility. The office rate is generally higher because the practice supplies the room, staff and equipment out of that single payment; in a hospital those are billed separately by the facility.

Which specialty bills 49650 most?

General Surgery, with 34,554 services from 1,754 clinicians. Next are Physician Assistant, Ambulatory Surgical Center, Nurse Practitioner.

CPT 49650

Repair of groin hernia using an endoscope

$593.41Medicare-allowed amount per service, averaged across 46,163 services

Providers submitted

$2954.43

Asking price, not received

Medicare allowed

$593.41

The fee schedule figure

Medicare paid

$467.62

Balance is patient coinsurance

Providers submitted an average of $2954.43 for this code and Medicare allowed $593.41 — 5.0× 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 $467.62 (79%); the rest is the patient’s coinsurance and deductible.

Office pays differently to hospital

Office / non-facility: $426.56
Hospital / facility: $594.41

The facility rate is higher for this code, which is unusual and generally means the service depends on equipment or staffing a hospital carries. 276 services were billed in an office setting and 45,887 in a facility.

Services: 46,163
Beneficiaries: 44,977
Providers billing it: 2,269
Total allowed: $27,393,586

What Medicare pays for CPT 49650

Across 46,163 services billed by 2,269 providers to 44,977 beneficiaries, Medicare allowed an average of $593.41 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 49650

Specialty	Services	Beneficiaries	Avg allowed	Providers
General Surgery	34,554	34,480	$468.75	1,754
Physician Assistant	5,426	5,424	$66.67	288
Ambulatory Surgical Center	4,378	3,274	$2373.01	130
Nurse Practitioner	996	993	$62.87	53
Colorectal Surgery (Proctology)	264	263	$521.77	15
Surgical Oncology	156	155	$456.73	7
General Practice	136	135	$465.14	7
Vascular Surgery	96	96	$463.78	6
Critical Care (Intensivists)	58	58	$515.33	3
Plastic and Reconstructive Surgery	23	23	$474.33	1
Otolaryngology	18	18	$80.17	1
Hospitalist	16	16	$520.87	1
Family Practice	15	15	$457.37	1
Urology	14	14	$237.62	1
Internal Medicine	13	13	$413.72	1

49650 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
California	5,825	$802.59	$549.96	229
Florida	5,145	$537.05	$415.09	231
Texas	3,010	$641.68	$521.00	161
New York	2,700	$558.40	$375.16	118
Arizona	2,333	$635.18	$513.35	99
Illinois	1,965	$654.16	$491.66	94
Pennsylvania	1,782	$454.82	$356.49	97
Virginia	1,444	$510.12	$389.91	77
New Jersey	1,361	$492.80	$360.86	67
Maryland	1,355	$638.58	$499.65	49
North Carolina	1,222	$631.06	$521.79	66
Georgia	1,173	$423.34	$333.01	61
South Carolina	1,131	$487.02	$406.64	57
Ohio	1,118	$646.31	$530.18	62
Colorado	1,108	$708.10	$561.23	56
Washington	1,099	$712.65	$545.17	58
Missouri	1,059	$504.97	$413.60	55
Massachusetts	914	$579.44	$444.77	47
Tennessee	716	$502.70	$429.00	43
Michigan	658	$654.26	$514.44	37
Oklahoma	573	$368.64	$302.77	29
Indiana	514	$693.68	$580.50	32
Nevada	508	$429.79	$341.41	27
Utah	496	$509.95	$415.87	30
Kansas	484	$690.73	$583.16	25
Connecticut	461	$445.63	$318.97	25
Wisconsin	454	$562.81	$476.97	30
Mississippi	437	$425.77	$364.44	26
New Mexico	394	$412.26	$332.17	18
Oregon	390	$751.03	$566.53	26
New Hampshire	357	$573.89	$453.25	18
Kentucky	335	$517.21	$417.77	20
Nebraska	328	$636.24	$530.93	17
Idaho	325	$425.63	$358.69	18
Delaware	321	$355.80	$280.11	13
Alabama	320	$350.85	$304.03	20
Louisiana	314	$488.64	$411.58	17
Iowa	302	$628.39	$535.56	19
Arkansas	266	$439.69	$385.35	18
Minnesota	249	$546.07	$441.97	16
Montana	241	$594.08	$474.88	13
Alaska	234	$932.38	$615.76	11
District of Columbia	234	$339.24	$240.99	5
Wyoming	116	$629.19	$517.41	7
West Virginia	108	$423.48	$327.09	7
Rhode Island	64	$494.61	$388.41	5
Hawaii	55	$292.82	$225.52	3
Maine	47	$487.53	$380.37	2
South Dakota	46	$371.09	$318.83	4
North Dakota	36	$429.21	$363.29	2
Vermont	36	$446.49	$373.89	2

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.