CPT 49900
Global 090 ActiveRepair of abdominal wall
CPT 49900 Billing & Documentation Guide
CPT code 49900 (Repair of abdominal wall) is classified under Surgery (Digestive) with a global period indicator of 090. The 2026 Medicare Physician Fee Schedule assigns a work RVU of 12.1, a non-facility practice expense RVU of 8.82, and a malpractice RVU of 3.04, a total non-facility RVU of 23.96 and facility RVU of 23.96. With the current conversion factor of $33.4009, the national average non-facility reimbursement is approximately $806.77, though rates vary from $709.5 to $975.92 based on MAC locality and Geographic Practice Cost Indices (GPCIs).
When billing 49900, ensure documentation supports medical necessity and the specific components required for the code's level of service. For E/M codes, document MDM (medical decision-making) elements: problems addressed, data reviewed, and risk. For procedural codes, document the indication, technique, and any complications. Always verify NCCI edits before bundling 49900 with related codes; this code has 10 PTP bundling relationships on file (see table below).
Payment Status & Global Period
Active code (paid under MPFS)
90-day global period (major surgery: 1 day pre-op + procedure + 90 days post-op)
MUE Limit (Medically Unlikely Edits)
Submitting more than 1 units of 49900 for the same patient on the same date triggers automatic line denial unless an appropriate modifier and supporting documentation justify the higher quantity.
RVU Breakdown, CPT 49900
| Component | Non-Facility | Facility |
|---|---|---|
| Work RVU | 12.1 | 12.1 |
| Practice Expense RVU | 8.82 | 8.82 |
| Malpractice RVU | 3.04 | 3.04 |
| Total RVU | 23.96 | 23.96 |
| Conversion Factor | $33.4009 | |
2026 Medicare Reimbursement by State, CPT 49900
State-level averages across all MAC localities. Non-facility rates typically apply to office-based services; facility rates apply to hospital outpatient / inpatient.
| State | Non-Facility | Facility | Range (Non-Fac) | Localities |
|---|---|---|---|---|
| California | $822.29 | $822.29 | $788.32 - $927.84 | 29 |
| Florida | $897.39 | $897.39 | $838.4 - $967.62 | 3 |
| Georgia | $807.29 | $807.29 | $787.96 - $826.62 | 2 |
| Illinois | $884.26 | $884.26 | $831.82 - $936.08 | 4 |
| Michigan | $823.69 | $823.69 | $787.75 - $859.63 | 2 |
| North Carolina | $743.89 | $743.89 | $743.89 - $743.89 | 1 |
| New York | $890.01 | $890.01 | $755.4 - $968.85 | 5 |
| Ohio | $775.47 | $775.47 | $775.47 - $775.47 | 1 |
| Pennsylvania | $804.89 | $804.89 | $770.54 - $839.24 | 2 |
| Texas | $790.72 | $790.72 | $766.56 - $839.64 | 8 |
Source: CMS PFSRVU 2026 · Updated 2026-04-01. Full locality-level detail available for all 53 states, contact us for custom reports.
NCCI Bundling Edits, CPT 49900
Procedure-to-procedure (PTP) edits. If you bill any of these codes with 49900 on the same date of service, review the modifier indicator and payer policy before submission.
| Partner Code | Relationship | Modifier Allowed | Rationale |
|---|---|---|---|
| 0213T | Column 1 (primary), can be billed with modifier | No | Misuse of Column Two code with Column One code |
| 0216T | Column 1 (primary), can be billed with modifier | No | Misuse of Column Two code with Column One code |
| 0228T | Column 1 (primary), can be billed with modifier | No | Standards of medical/surgical practice |
| 0230T | Column 1 (primary), can be billed with modifier | No | Standards of medical/surgical practice |
| 0596T | Column 1 (primary), can be billed with modifier | Yes | Standards of medical/surgical practice |
| 0597T | Column 1 (primary), can be billed with modifier | Yes | Standards of medical/surgical practice |
| 0708T | Column 1 (primary), can be billed with modifier | Yes | Standards of medical/surgical practice |
| 0709T | Column 1 (primary), can be billed with modifier | Yes | Standards of medical/surgical practice |
| 0903T | Column 1 (primary), can be billed with modifier | Yes | Misuse of Column Two code with Column One code |
| 0904T | Column 1 (primary), can be billed with modifier | Yes | Misuse of Column Two code with Column One code |
Frequently Asked Questions, CPT 49900
What does CPT code 49900 mean? +
CPT code 49900 represents: Repair of abdominal wall. It's in the Surgery (Digestive) category with a global period of 090.
What is the Medicare reimbursement for CPT 49900? +
The 2026 Medicare national average non-facility payment for CPT 49900 is $806.77. Rates range from $709.5 to $975.92 across 53 states depending on MAC locality and GPCIs.
What modifiers can I use with CPT 49900? +
Surgery codes commonly use modifier 22 (increased procedural services), 50 (bilateral), 51 (multiple procedures), 52 (reduced services), 58/78/79 (staged, unplanned return, unrelated within global), 62 (co-surgeons), 80/82 (assistant surgeon), and 59 or the X{EPSU} subset for distinct procedural service.
What bundling edits apply to CPT 49900? +
This code has 10 NCCI PTP bundling relationships. See the NCCI Bundling section below for full list.
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Reviewed by the PayerReady Medical Coding Team
Verified against the CMS 2026 code set on June 2, 2026.
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