What do doctors typically charge for Initial Repair of Entrapped Hernia of Abdomen?

The nationwide median physician charge for Initial Repair of Entrapped Hernia of Abdomen (CPT 49592) is $1528.50. Doctor billed charges vary based on geographic region, setting, and overhead.

What is the standard insurance baseline for CPT 49592?

The standard insurance baseline reimbursement rate is $432.93. This represents the customary allowable amount established across standard fee schedules.

Home/Procedures/Initial Repair of Entrapped Hernia of Abdomen

CPT 49592Medical Service

Initial Repair of Entrapped Hernia of Abdomen

Initial repair of entrapped hernia of abdomen, less than 3 cm in length. Clinical pricing breakdown and utilization metrics across 40 practicing doctors nationwide.

$1528.50

Peer Median Charge

Gross billed rate

$432.93

Standard Baseline

Customary allowable

3.5x

National Markup

Charge vs baseline

Active Physicians

Billing this code

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Understanding This Medical Fee

Gross Charge vs Negotiated Payment: The median physician charge for this service is $1528.50. However, insured patients almost never pay this full amount directly. Insurers negotiate rates down toward the $432.93 baseline.

Self-Pay & Uninsured Guidance: If you are paying without insurance or out-of-network, request a prompt-pay cash discount. Most medical practices are willing to settle self-pay bills near the customary baseline rate rather than the full gross charge.

Key Questions for Your Doctor's Billing Office:

"Does Dr. [Name] participate in my specific insurance plan network?"
"What is the total self-pay or cash rate for code 49592 if paid upfront?"
"Are there separate facility, anesthesia, or pathology fees associated with this procedure?"