2025 CPT code 49623
(Active) Effective Date: N/A Revision Date: N/A Deletion Date: N/A Surgery - Hernia Open Procedures Surgery Feed
Removal of non-infected mesh or prosthesis during anterior abdominal or parastomal hernia repair.
Modifiers may apply depending on the circumstances of the procedure (e.g., 22, 51, 52, 80, 81).Refer to the CPT manual for more detail.
Removal of non-infected mesh or prosthesis is medically necessary when it is determined to be interfering with the hernia repair or causing complications, even in the absence of infection.Documentation must support the clinical need for removal.
The surgeon's responsibilities include preparing the patient, administering anesthesia (if applicable), performing the removal of the mesh or prosthesis (using open, laparoscopic, or robotic techniques), hemostasis, and closing the incision(s).
In simple words: This code is used when a doctor removes a piece of mesh or other material that was previously placed to repair a hernia in the abdomen, near the intestines, or near a surgically created opening in the intestines. This removal happens at the same time as a hernia repair and only if the mesh is not infected.It is added to the code for the main hernia repair procedure.
This add-on code reports the removal of previously implanted, non-infected mesh or prosthesis during the same session as an initial or recurrent anterior abdominal hernia repair or parastomal hernia repair.The approach may be open, laparoscopic, or robotic.The code is reported in addition to the primary procedure code (49591-49596, 49613-49618, or 49621-49622).
Example 1: A patient presents for a recurrent anterior abdominal hernia repair. During the procedure, the surgeon finds the previous mesh is non-infected but requires removal. Code 49623 is added to the code for the hernia repair., A patient undergoes a laparoscopic parastomal hernia repair.Non-infected mesh from a previous repair is removed during the procedure.Code 49623 is added to the code for the laparoscopic parastomal hernia repair., A patient has an open repair of an initial anterior abdominal hernia.A significant portion of the previously placed mesh is found to be causing complications but is not infected and is removed.Code 49623 is reported with the open hernia repair code.
* Operative report detailing the removal of the non-infected mesh or prosthesis.* Preoperative diagnosis indicating the need for hernia repair.* Documentation of the approach used (open, laparoscopic, robotic).* Confirmation that the mesh or prosthesis removed was non-infected.* Documentation of the type of mesh or prosthesis removed.
** This code should only be used when the mesh or prosthesis is not infected.For removal of infected mesh, use CPT code 11008.The cost of the mesh is typically included in the payment for the hernia repair.
- Revenue Code: P5E (Ambulatory Procedures - Other)
- RVU: This information is not provided in the source but can be found in the Medicare Physician Fee Schedule (MPFS) and varies by location and other factors.
- Global Days: The global period is dependent on the primary procedure code used in conjunction with 49623.Refer to the global surgery guidelines for the specific primary procedure code.
- Payment Status: Active
- Modifier TC rule: A Technical Component (TC) modifier is not applicable to this add-on code.
- Fee Schedule: This information is not included in the source and is subject to change; check the Medicare Physician Fee Schedule (MPFS) for the most recent data.
- Specialties:General Surgery
- Place of Service:Office, Ambulatory Surgical Center, Hospital (Inpatient and Outpatient)