How Much Does an Open Inguinal Hernia Repair Cost in Rhode Island?
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 Rhode Island averages $512.
- ✓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
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- ✓15 nearby hospitals instead of five
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Rhode Island Medicare physician rate (2026)
+0.7% vs nationalSingle statewide locality.
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 Rhode Island
Enter a ZIP code for your part of Rhode Island, whether Providence and Pawtucket, Warwick and Cranston, Newport, or the South County shore towns.
What open inguinal hernia repair costs at hospitals near you
Everything above is a national average. The hospital you pick in Rhode Island 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 02801.
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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 Rhode Island
Where Rhode Island ranks for this CPT
Open Inguinal Hernia Repair and how Rhode Island is priced
Rhode Island, the smallest state, is unsurprisingly a single payment locality, with geographic adjustments above the national average in line with southern New England's cost structure. Providence and the shoreline towns publish identical Medicare-approved amounts, and no point in the state is more than an hour from its main hospitals. The compact geography makes locality subdivision pointless. Pricing here reads as a slightly discounted echo of neighboring Boston's market.
Providence dominates Rhode Island care, with the state's teaching hospitals and academic affiliation concentrated there, and consolidation has left a small number of systems running most beds. Many Rhode Islanders, particularly in the northeast corner, use Boston hospitals for complex or specialized procedures, accepting metro Boston pricing when they do. South County residents have fewer local options and often travel to Providence.
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 Rhode Island
Open Inguinal Hernia Repair in other states
Open Inguinal Hernia Repair in Rhode Island: 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 Rhode Island averages $512. Rhode Island is a single Medicare locality, so the physician rate is the same statewide.
Not on the physician fee schedule. Rhode Island 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 $102 for the office physician line or $102 for the hospital physician line in Rhode Island. Medigap may cover that 20%. This is not the hospital facility fee.
No. $511.51 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. Rhode Island ranks #36 of 51 states on the physician line (within 2% of the national office rate of $508.03).