How Much Does an Open Inguinal Hernia Repair Cost in California?
Prp i/hern init reduc >5 yr
$4,166Hospital outpatient total2026 Medicare, physician + facilityUnder 2026 Medicare rates, an open inguinal hernia repair costs about $4,166 in total at a hospital outpatient department or about $2,252 at an ambulatory surgery center, counting both the physician and the facility (national rates). The physician's own fee in California averages $519, from $498 to $584 across 29 Medicare localities.
- ✓Your ZIP's wage-adjusted hospital and surgery center rates
- ✓Five nearby hospitals by name, with CMS star ratings
- ✓The add-on codes that typically land on the bill
- ✓A word-for-word script for asking for a good-faith estimate
- ✓A private link you can reopen and share
- ✓Everything in the Premium report
- ✓15 nearby hospitals instead of five
- ✓Filled good-faith-estimate request letter
- ✓Bill-negotiation letter
- ✓Printable PDF download
California Medicare physician rate (2026)
+2.2% vs nationalAverage of 29 localities. Office range $497.98–$584.49.
What the whole procedure costs
The rate above is the physician’s fee on its own. The facility bills separately, and for most procedures the facility is the larger half of the bill. These are 2026 national Medicare amounts.
Choosing a surgery center over a hospital saves about $1,914 on the Medicare allowed amount for open inguinal hernia repair. Ask whether your procedure can be done at an ambulatory surgery center.
Medicare pays the hospital a single comprehensive amount for this procedure, covering the facility's share of the encounter including implants and supplies. Medicare allowed amounts are not what an uninsured patient is charged, and not a quote. Private plans typically allow more.
Your ZIP in California
A ZIP-level lookup matters more in California than in any other state; compare your area, whether that is the Bay Area, Los Angeles, San Diego, Sacramento, the Central Valley, or the rural north.
What open inguinal hernia repair costs at hospitals near you
Everything above is a national average. The hospital you pick in California moves the bill more than anything else you control.
Rates for your ZIP, 5 named hospitals with CMS ratings, the add-on codes, and the scheduler script.
For example 90001.
One-off payment, no account and no subscription. You get a private link and an email. No medical records and no insurance card, ever.
What these numbers are
Every figure on this page is a 2026 Medicare allowed amount: the physician line comes from the Physician Fee Schedule adjusted by geographic practice-cost indices, and the facility totals come from the CMS hospital outpatient (OPPS) and ambulatory surgery center rates. None of them is a hospital chargemaster price, your insurer's contracted rate, or a quote. Anesthesia, pathology, imaging reads and follow-up care are billed under their own codes when they apply, and an inpatient stay is paid a different way again.
National vs California
Where California ranks for this CPT
CPT 49505 by California locality
| Locality | Office |
|---|---|
| san jose-sunnyvale-santa clara (san benito cnty) | $584.49 |
| san jose-sunnyvale-santa clara (santa clara cnty) | $574.97 |
| san francisco-oakland-berkeley (marin cnty) | $569.56 |
| san francisco-oakland-berkeley (san francisco/san mateo/alameda/contra costa cnty) | $567.23 |
| napa | $548.02 |
| vallejo | $544.67 |
| los angeles-long beach-anaheim (los angeles/orange cnty) | $528.65 |
| santa rosa-petaluma | $525.16 |
| oxnard-thousand oaks-ventura | $522.30 |
| santa cruz-watsonville | $520.48 |
| riverside-san bernardino-ontario | $519.94 |
| san diego-chula vista-carlsbad | $519.79 |
| sacramento-roseville-folsom | $514.99 |
| santa maria-santa barbara | $513.45 |
| salinas | $512.97 |
| san luis obispo-paso robles | $505.73 |
| bakersfield | $503.49 |
| el centro | $498.32 |
| chico | $497.98 |
| fresno | $497.98 |
| hanford-corcoran | $497.98 |
| madera | $497.98 |
| merced | $497.98 |
| modesto | $497.98 |
| redding | $497.98 |
| stockton | $497.98 |
| visalia | $497.98 |
| yuba city | $497.98 |
| rest of california | $497.98 |
PE GPCI ranges from 1.096 to 1.442 in California. That index is why the same CPT is not one price statewide.
Open Inguinal Hernia Repair and how California is priced
California is the most finely divided state in the Medicare fee schedule, with roughly thirty payment localities drawn around metropolitan statistical areas after CMS reformed the state's locality map. The San Francisco Bay Area carries some of the highest geographic adjustments in the nation, with San Francisco, San Jose, and the East Bay each priced separately, while Los Angeles, Orange County, San Diego, and Sacramento have their own localities at somewhat lower levels. Rural and inland counties fall into lower-cost localities, so the same procedure can carry meaningfully different Medicare-approved amounts within a single day's drive. No other state shows this much in-state variation on the fee schedule itself.
California's markets differ sharply: the Bay Area combines high wages with heavily consolidated hospital systems, Los Angeles offers enormous choice across a sprawling region, and the Central Valley and far north face genuine access shortages. Where you are treated within the state matters more here than almost anywhere else in the country. Academic medical centers in the Bay Area, Los Angeles, San Diego, and Sacramento handle much of the complex referral care.
This procedure: Open inguinal hernia repair fixes a groin hernia through a single incision a few inches long over the bulge. The surgeon pushes the bulging tissue back into place and reinforces the weak spot in the abdominal wall, usually with a piece of surgical mesh. It is one of the most common operations in the United States, it can often be done under local anesthesia with sedation rather than general anesthesia, and most patients go home the same day.
What Is Open Inguinal Hernia Repair?
Open inguinal hernia repair fixes a groin hernia through a single incision a few inches long over the bulge. The surgeon pushes the bulging tissue back into place and reinforces the weak spot in the abdominal wall, usually with a piece of surgical mesh. It is one of the most common operations in the United States, it can often be done under local anesthesia with sedation rather than general anesthesia, and most patients go home the same day.
What Affects the Cost
- –The type of anesthesia matters: local anesthesia with sedation is usually billed for less than general anesthesia.
- –Repairing both sides in the same operation is billed with a bilateral modifier and raises the surgeon's fee, although it costs less than two separate operations.
- –A hernia that is trapped (incarcerated) or has lost its blood supply (strangulated) uses a different, higher-paying code and can need emergency admission.
- –Surgery centers usually charge a much lower facility fee than hospital outpatient departments for the same repair.
- –The mesh is part of the facility payment rather than billed by the surgeon.
Questions to Ask Before Booking
- 1.Will this be an open or a laparoscopic repair, and why that approach for me?
- 2.Can it be done under local anesthesia with sedation?
- 3.Is the surgery booked at a surgery center or a hospital, and what is the facility fee at each?
- 4.If you find a hernia on the other side, will you repair it, and how is that billed?
- 5.Which follow-up visits are included in the surgeon's fee?
Other featured procedures in California
Open Inguinal Hernia Repair in other states
Open Inguinal Hernia Repair in California: questions
Under 2026 Medicare rates, an open inguinal hernia repair costs about $4,166 in total at a hospital outpatient department or about $2,252 at an ambulatory surgery center, counting both the physician and the facility (national rates). The physician's own fee in California averages $519, from $498 to $584 across 29 Medicare localities. Enter a ZIP for the exact California locality.
Yes. CMS splits California into 29 payment localities. For this CPT the office physician fee spans $86.51 from the lowest to highest locality. A ZIP-level lookup matters more in California than in any other state; compare your area, whether that is the Bay Area, Los Angeles, San Diego, Sacramento, the Central Valley, or the rural north.
After the Part B deductible, coinsurance is usually 20% of the allowed amount: about $104 for the office physician line or $104 for the hospital physician line in California. Medigap may cover that 20%. This is not the hospital facility fee.
No. $519.03 is only the physician's share. Adding Medicare's facility payment brings the total to about $4,166 in a hospital outpatient department, or about $2,252 at an ambulatory surgery center. Anesthesia, pathology and other codes billed the same day are extra. California ranks #40 of 51 states on the physician line (2% above the national office rate of $508.03).