2025 CPT code 49591
(Active) Effective Date: N/A Surgery - Surgical Procedures on the Abdomen, Peritoneum, and Omentum Surgery Feed
Repair of anterior abdominal hernia(s) (e.g., epigastric, incisional, ventral, umbilical, spigelian), any approach (e.g., open, laparoscopic, robotic), initial, including implantation of mesh or other prosthesis when performed; total length of defect(s) less than 3 cm, reducible.
Modifiers may be applicable, such as 59 (distinct procedural service) if other procedures are performed at the same time as the hernia repair.
Medical necessity for 49591 must be established based on the patient's symptoms, clinical findings, and the impact of the hernia on their daily activities.
The physician prepares the patient and performs the hernia repair. This may involve open, laparoscopic, or robotic techniques to dissect, remove adhesions, reduce the hernia sac, and repair the defect. Mesh or other prosthesis may be implanted to reinforce the abdominal wall.
- Surgery
- Surgical Procedures on the Digestive System; Surgical Procedures on the Abdomen, Peritoneum, and Omentum; Repair Procedures on the Abdomen, Peritoneum, and Omentum; Hernioplasty, Herniorrhaphy, Herniotomy Procedures; Hernia Open Procedures
In simple words: This procedure fixes a hernia in the abdominal area. The doctor pushes the hernia back into place and may use a mesh to strengthen the area.The hernia is less than 3 cm and hasn't been repaired before.
This code describes the initial repair of one or more anterior abdominal hernias, including epigastric, incisional, ventral, umbilical, or spigelian hernias.The repair can be performed using any approach (open, laparoscopic, or robotic) and may include the implantation of mesh or another prosthesis. The total length of all defects repaired, measured before opening the hernia defect(s), is less than 3 cm, and the hernias are reducible (can be pushed back into place).
Example 1: A patient presents with a 2 cm reducible umbilical hernia.The surgeon performs a laparoscopic repair using mesh., A patient has two small reducible incisional hernias totaling 2.5 cm in length. The surgeon performs an open repair with mesh implantation., A patient with a 1 cm epigastric hernia undergoes robotic repair without mesh.
Documentation should include the type of hernia, location, size, reducibility, approach used for repair, use of mesh or other prosthesis, and any complications.
** This code has a 0-day global period. Subsequent procedures and services performed starting the day after the operation need to be separately reported.
- Revenue Code: P5E (AMBULATORY PROCEDURES - OTHER)
- Global Days: 0 days
- Payment Status: Active
- Specialties:General surgery
- Place of Service:Ambulatory Surgical Center, Hospital - Inpatient, Hospital - Outpatient