How Much Does Prp I/hern Init Reduc >5 Year Cost?
Also known as: Prp i/hern init reduc >5 yr (CPT 49505)
Surgical repair of an inguinal hernia (groin hernia) using an open approach.
The total estimated cost of Prp I/hern Init Reduc >5 Year (CPT 49505) is $1,707 to $3,201, including hospital fees, anesthesia, and supplies. The surgeon's Medicare fee alone is $508.
Total Estimated Cost of Care
This estimate includes hospital facility fees, anesthesia, and supplies .
Patient Guide: Prp I/hern Init Reduc >5 Year
What you need to know before your appointment
What to Expect
Under general or spinal anesthesia, the surgeon makes an incision in your groin, pushes the hernia contents back into place, and reinforces the abdominal wall with mesh. Most patients go home the same day.
How Long Does It Take?
45-60 minutes
Common Reasons Doctors Order This
Inguinal hernia causing a bulge in the groin, hernia pain, hernia at risk of strangulation
How to Prepare
Fast after midnight. Wear loose, comfortable pants. Arrange a ride home and help for a few days. Avoid lifting more than 10 pounds for 4-6 weeks.
Procedures Commonly Done Together
These procedures are frequently performed alongside Prp i/hern init reduc >5 yr
How to Reduce Your Cost for Prp i/hern init reduc >5 yr
Practical tips that can save you hundreds or thousands of dollars
- 1 Ask about cash-pay discounts
Many hospitals and clinics offer 20-40% discounts for self-pay patients. Always ask before scheduling.
- 2 Compare facility vs. office setting costs
Some procedures cost significantly less in an office setting than a hospital. Ask your provider about options.
- 3 Shop around — costs vary significantly
Costs can vary 2-3x between providers in the same city. Get quotes from multiple facilities.
How is the Price Calculated?
Medicare calculates procedure payments using Relative Value Units (RVUs). Each procedure has three components multiplied by a conversion factor ($33.40 in 2026) and adjusted by geographic cost indices.
Payment = Total RVU (15.21) x CF ($33.40) = $508
Related Procedures
Similar procedures in the same category or body system
People Also Ask
Common questions people search for about this procedure
Is hernia surgery usually covered by insurance?
Is hernia surgery worth it?
What is the 6 2 rule for hernia?
reducible herniae: the '6–2' rule: – birth–6 wks > surgery within 2 d.
How much does hernia surgery cost out of pocket?
Frequently Asked Questions
How much does Prp i/hern init reduc >5 yr cost?
The Medicare facility rate for Prp i/hern init reduc >5 yr is $508. Commercial insurance rates typically range from 150% to 250% of Medicare (varies by plan).
How much does Prp i/hern init reduc >5 yr cost without insurance?
Without insurance, the cost of Prp i/hern init reduc >5 yr can range from 150% of Medicare to 500% of Medicare depending on the facility. Many hospitals and clinics offer self-pay discounts of 20-40% off their chargemaster price. Always ask about cash pricing before your visit.
Does insurance cover Prp i/hern init reduc >5 yr?
Most commercial health insurance plans and Medicare cover Prp i/hern init reduc >5 yr when ordered by a physician for a medically necessary reason. Your out-of-pocket cost depends on your plan's deductible, copay/coinsurance structure, and whether you use an in-network provider. Check with your insurance company before scheduling to confirm coverage and get a cost estimate.
Why does the cost vary so much by location?
Medicare adjusts payments using Geographic Practice Cost Indices (GPCIs) that reflect local differences in physician work costs, practice expenses, and malpractice insurance. Manhattan, San Francisco, and other high-cost areas pay significantly more than rural regions. Commercial insurers follow similar geographic patterns.