2025 CPT code 49492
(Active) Effective Date: N/A Revision Date: N/A Surgery - Hernia repair Surgery Feed
Repair of initial inguinal hernia in a preterm infant (less than 37 weeks gestation), performed from birth to 50 weeks postconception, with or without hydrocelectomy; incarcerated or strangulated.
Modifiers 50 (bilateral procedure) may be appropriate.Other modifiers may apply based on specific circumstances; consult payer guidelines.
Medical necessity for hernia repair in preterm infants is determined by the presence of incarceration or strangulation, or the risk thereof.Preoperative and postoperative assessment should support the decision to proceed with surgery.
The surgeon is responsible for performing the hernia repair, including any necessary hydrocelectomy. Pre-operative assessment, intra-operative management, and post-operative care are also within the surgeon’s responsibility.
In simple words: This code covers surgery to fix a hernia (a bulge in the groin) in a baby born prematurely. The surgery can happen anytime from birth until 50 weeks after conception. If needed, the surgeon might also remove fluid from the scrotum.
This CPT code encompasses the surgical repair of an incarcerated or strangulated inguinal hernia in a preterm infant born before 37 weeks of gestation.The procedure is performed anytime between birth and 50 weeks postconception.The repair may include hydrocelectomy (excision of a scrotal fluid collection) if present. The procedure involves an incision at the hernia site, exposure of the inguinal canal, dissection of scar tissue, removal of hernia sac contents, reduction of the hernia to the fascial defect, inspection of the scrotum for hydrocele (and its excision if present), repair of the hernia defect with absorbable sutures, and reconstruction of the inguinal canal.Hemostasis (control of bleeding) is ensured before closure.
Example 1: A premature infant (32 weeks gestation) presents with an incarcerated right inguinal hernia at 2 weeks of age. The surgeon performs an open repair with hydrocelectomy., A 48-week-old preterm infant (born at 34 weeks) presents with a strangulated left inguinal hernia. The surgeon performs an open repair and finds a portion of the bowel has become necrotic, necessitating a bowel resection (reported with an additional CPT code)., A premature infant born at 35 weeks presents with a reducible right inguinal hernia at 10 weeks of age.The surgeon performs a prophylactic repair.
Operative report detailing the procedure, including the hernia type (inguinal), whether incarcerated or strangulated, any associated hydrocele, and the surgical technique. Preoperative and postoperative diagnoses, imaging studies (if any), and pathology reports (if applicable) are also required.
** Postconception age is calculated as gestational age at birth plus the infant's age in weeks at the time of surgery.Always refer to the most current CPT manual for the most up-to-date coding guidelines and definitions.
- Revenue Code: P1G (Major Procedure - Other)
- RVU: Information not available in source.Consult official RVU databases for current values.
- Global Days: Information not available in source.Global surgical days vary by payer and may be 0, 10, or 90 days post-op.Consult payer guidelines.
- Payment Status: Active
- Modifier TC rule: Not applicable.This is a complete procedure code.
- Fee Schedule: Historical fee schedule data is not available in provided sources. Consult an appropriate fee schedule database for historical data.
- Specialties:Pediatric Surgery, General Surgery
- Place of Service:Inpatient Hospital, Outpatient Hospital, Ambulatory Surgical Center