CPT49505

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

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 Indiana averages $460.

Hospital payments are wage-adjusted by locality, so the ZIP changes the numbers. For example 46001.
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Indiana Medicare physician rate (2026)

-9.5% vs national

Single statewide locality.

Indiana (Hospital)
$459.67
Facility physician fee
Private plan est.
$598–$919
~130–200% of Medicare
Cash / self-pay est.
$368–$690
~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 Indiana

Look up your ZIP for Indiana figures, whether in Indianapolis, Fort Wayne, Evansville, South Bend, the Region near Chicago, or the rural counties along the Ohio River.

What open inguinal hernia repair costs at hospitals near you

Everything above is a national average. The hospital you pick in Indiana 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 46001.

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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 Indiana

National office$508.03
National hospital (physician)$508.03
Indiana vs national10% below the national office rate of $508.03

Where Indiana ranks for this CPT

Rank (lowest physician fee first)#8 of 51
Lowest stateArkansas ($449.39)
Highest stateAlaska ($618.60)

Open Inguinal Hernia Repair and how Indiana is priced

Indiana's Medicare physician rates come from a single statewide locality with indices a bit under the national average, placing it in the moderate band of Midwest pricing. Indianapolis, Fort Wayne, Evansville, and the smallest rural counties all share identical geographic adjustments. Northwest Indiana sits inside the Chicago metropolitan area but is still priced under Indiana's statewide locality rather than Chicago's, which creates a visible pricing seam at the state line. For most Hoosiers the statewide fee schedule is a dependable guide to Medicare-approved amounts.

Indianapolis dominates the state's health care landscape, hosting its academic medical center and the headquarters of its largest systems, while regional hubs in Fort Wayne, Evansville, and South Bend cover their surrounding counties. Indiana's hospital prices for commercially insured patients have drawn national attention for running high relative to the region, which makes Medicare benchmarks a valuable reference for anyone paying cash. Rural southern Indiana often looks to Louisville or Cincinnati across the river.

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 Indiana: 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 Indiana averages $460. Indiana is a single Medicare locality, so the physician rate is the same statewide.

Not on the physician fee schedule. Indiana 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 $92 for the office physician line or $92 for the hospital physician line in Indiana. Medigap may cover that 20%. This is not the hospital facility fee.

No. $459.67 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. Indiana ranks #8 of 51 states on the physician line (10% below 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.