How Much Does an Open Inguinal Hernia Repair Cost in Texas?
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 Texas averages $502, from $487 to $535 across 8 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
Texas Medicare physician rate (2026)
-1.2% vs nationalAverage of 8 localities. Office range $486.93–$534.58.
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 Texas
With so many Texas localities, check your exact ZIP: Houston, Dallas-Fort Worth, Austin, the Galveston and Beaumont coast, San Antonio, El Paso, the Valley, and rural West Texas can all price differently.
What open inguinal hernia repair costs at hospitals near you
Everything above is a national average. The hospital you pick in Texas 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 73960.
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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 Texas
Where Texas ranks for this CPT
CPT 49505 by Texas locality
| Locality | Office |
|---|---|
| houston | $534.58 |
| austin | $511.20 |
| dallas | $499.92 |
| fort worth | $499.00 |
| galveston | $497.06 |
| brazoria | $493.41 |
| rest of texas | $492.19 |
| beaumont | $486.93 |
PE GPCI ranges from 0.910 to 1.058 in Texas. That index is why the same CPT is not one price statewide.
Open Inguinal Hernia Repair and how Texas is priced
Texas is carved into grouped metro localities rather than priced statewide: Houston, Dallas, Fort Worth, Austin, Galveston, Beaumont, and Brazoria each carry their own locality, and the enormous remainder of the state shares rest-of-state pricing. The big-city localities approve higher amounts than rural Texas, with Houston and Dallas at the top of the state's range. Uniquely, several smaller Gulf Coast areas kept their own localities from an earlier era, which is why Galveston and Beaumont are priced separately from Houston. San Antonio and El Paso, despite their size, fall under rest-of-state factors.
Texas contains several of the largest medical complexes in the world, most famously in Houston, plus deep hospital markets in Dallas-Fort Worth, San Antonio, and Austin. At the other extreme, West Texas and the Panhandle include counties with no physician at all, and rural hospital closures have hit Texas harder than almost any state. Border communities from El Paso to the Rio Grande Valley have distinct markets, and some residents cross into Mexico for lower-cost dental and pharmacy 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 Texas
Open Inguinal Hernia Repair in other states
Open Inguinal Hernia Repair in Texas: 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 Texas averages $502, from $487 to $535 across 8 Medicare localities. Enter a ZIP for the exact Texas locality.
Yes. CMS splits Texas into 8 payment localities. For this CPT the office physician fee spans $47.65 from the lowest to highest locality. With so many Texas localities, check your exact ZIP: Houston, Dallas-Fort Worth, Austin, the Galveston and Beaumont coast, San Antonio, El Paso, the Valley, and rural West Texas can all price differently.
After the Part B deductible, coinsurance is usually 20% of the allowed amount: about $100 for the office physician line or $100 for the hospital physician line in Texas. Medigap may cover that 20%. This is not the hospital facility fee.
No. $501.79 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. Texas ranks #30 of 51 states on the physician line (within 2% of the national office rate of $508.03).