2025 CPT code 49521
(Active) Effective Date: N/A Revision Date: N/A Surgery - Hernia repair Surgery Feed
Repair of a recurrent inguinal hernia, any age; incarcerated or strangulated.
Modifiers may be applicable to this code, such as modifier 50 for bilateral procedures (excluding codes 49591-49622) and other modifiers as clinically indicated (e.g., for anesthesia, assistant surgeon).
Medical necessity is established by the presence of a symptomatic recurrent inguinal hernia that is incarcerated or strangulated, representing an acute surgical emergency requiring prompt intervention to prevent bowel necrosis or other complications. Documentation should support the clinical indications for the procedure.
The surgeon is responsible for pre-operative evaluation, surgical procedure including incision, dissection, reduction, mesh placement, hemostasis and wound closure.Post-operative care may be included or billed separately depending on the billing practices.
In simple words: This surgery fixes a recurring hernia in the groin area.The hernia is either trapped or has its blood supply cut off. The surgeon makes a cut, repairs the hernia, and uses mesh to prevent it from happening again.
This procedure involves the surgical repair of a recurrent inguinal hernia that is incarcerated (trapped) or strangulated (blood supply cut off).The surgeon makes an incision at the site of the previous scar, carefully dissecting around the hernia sac to avoid injury to the incarcerated or strangulated bowel.The hernia sac is opened to assess its contents, and any compromised tissue is addressed (e.g., intestinal resection, if necessary—this would be billed separately).The hernia sac is then reduced and repositioned, and mesh is placed over the defect to prevent recurrence. The incision is closed after hemostasis is achieved.
Example 1: A 60-year-old male patient presents with a recurrent right inguinal hernia that is incarcerated. The patient underwent a previous inguinal hernia repair 5 years prior. During the procedure, the surgeon finds compromised bowel requiring resection. This is coded with 49521 and the appropriate bowel resection code., A 75-year-old female patient has a strangulated recurrent left inguinal hernia.The surgeon performs the repair with mesh placement. This is coded with 49521., A 45-year-old male patient with a recurrent bilateral inguinal hernia, incarcerated on the right and strangulated on the left. Requires mesh placement on both sides.This is coded 49521 x 2 with modifier 50 on one code.If additional procedures were necessary for any strangulated organs, they would be billed separately.
Preoperative diagnosis, operative report detailing the hernia repair procedure (including assessment of bowel viability, mesh type and placement, and closure details), pathology report (if applicable), and any relevant imaging studies.
** This code is for recurrent inguinal hernias. Initial repairs are coded differently.Always consult the most current CPT codebook and guidelines for accurate coding.
- Revenue Code: P1G (Major Procedure - Other)
- Payment Status: Active
- Modifier TC rule: The Technical Component (TC) modifier may apply depending on the specific circumstances of the procedure and billing practices.
- Specialties:General Surgery
- Place of Service:Inpatient Hospital, Ambulatory Surgical Center, Outpatient Hospital