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 49594) is $2184.92. Doctor billed charges vary based on geographic region, setting, and overhead.

What is the standard insurance baseline for CPT 49594?

The standard insurance baseline reimbursement rate is $703.22. This represents the customary allowable amount established across standard fee schedules.

Home/Procedures/Initial Repair of Entrapped Hernia of Abdomen

CPT 49594Medical Service

Initial Repair of Entrapped Hernia of Abdomen

Initial repair of entrapped hernia of abdomen, 3-10 cm in length. Clinical pricing breakdown and utilization metrics across 110 practicing doctors nationwide.

$2184.92

Peer Median Charge

Gross billed rate

$703.22

Standard Baseline

Customary allowable

3.1x

National Markup

Charge vs baseline

110

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 $2184.92. However, insured patients almost never pay this full amount directly. Insurers negotiate rates down toward the $703.22 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 49594 if paid upfront?"
"Are there separate facility, anesthesia, or pathology fees associated with this procedure?"