CPT49505

How Much Does an Open Inguinal Hernia Repair Cost in Connecticut?

Prp i/hern init reduc >5 yr

$4,166Hospital outpatient total2026 Medicare, physician + facility

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 Connecticut averages $541.

Hospital payments are wage-adjusted by locality, so the ZIP changes the numbers. For example 06001.
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Connecticut Medicare physician rate (2026)

+6.6% vs national

Single statewide locality.

Connecticut (Hospital)
$541.48
Facility physician fee
Private plan est.
$704–$1,083
~130–200% of Medicare
Cash / self-pay est.
$433–$812
~80–150% of Medicare

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.

Surgery center, total
$2,252
$508 physician + $1,744 facility
Physician fee alone
$508
Only 12% of the hospital total

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 Connecticut

Look up your ZIP code for local detail across Connecticut, including the New Haven and Hartford areas, Fairfield County and Stamford, and the quieter eastern and northwestern corners.

What open inguinal hernia repair costs at hospitals near you

Everything above is a national average. The hospital you pick in Connecticut moves the bill more than anything else you control.

Locked

Rates for your ZIP, 5 named hospitals with CMS ratings, the add-on codes, and the scheduler script.

For example 06001.

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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 Connecticut

National office$508.03
National hospital (physician)$508.03
Connecticut vs national7% above the national office rate of $508.03

Where Connecticut ranks for this CPT

Rank (lowest physician fee first)#45 of 51
Lowest stateArkansas ($449.39)
Highest stateAlaska ($618.60)

Open Inguinal Hernia Repair and how Connecticut is priced

Despite sitting between two of the priciest metros in America, Connecticut is priced as one statewide Medicare locality, with geographic indices well above the national average. Every town from Stamford to Storrs shares the same adjustments, which are pushed up by the state's high wages, rents, and insurance costs. The uniform locality means Fairfield County's proximity to New York does not add a further Medicare premium beyond the statewide level. In practice Connecticut's Medicare-approved amounts rank among the higher states outside the biggest coastal cities.

Connecticut's hospital market has consolidated around a few large systems, and a major academic medical center in New Haven draws complex cases from across the state. Residents of Fairfield County routinely cross into New York for care, while some in the north lean toward Springfield or Boston providers. High commercial prices in the state make Medicare rates and transparent cash pricing especially useful comparison points here.

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?

Open Inguinal Hernia Repair in Connecticut: 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 Connecticut averages $541. Connecticut is a single Medicare locality, so the physician rate is the same statewide.

Not on the physician fee schedule. Connecticut uses one locality, so the Medicare physician rate is the same from one end of the state to the other. What still changes is site of service (office vs hospital) and any facility fee the hospital bills on its own claim.

After the Part B deductible, coinsurance is usually 20% of the allowed amount: about $108 for the office physician line or $108 for the hospital physician line in Connecticut. Medigap may cover that 20%. This is not the hospital facility fee.

No. $541.48 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. Connecticut ranks #45 of 51 states on the physician line (7% above the national office rate of $508.03).

Data source: 2026 Medicare Physician Fee Schedule (CMS PPRRVU26B, released March 2026). Conversion factor: $33.4009. Prices shown are Medicare allowed amounts for the physician service and may not match what you are billed. Private insurance and self-pay ranges, when shown, are labeled estimates (typical multiples of Medicare), not quotes. This site is an independent cost tool, not medical advice.