Medicare's national average for an inguinal hernia repair in 2026 is $2,252 at an ambulatory surgery center and $4,165 at a hospital outpatient department — a range of $2,252 to $4,165 for the same procedure code, CPT 49505. Those totals cover the doctor's fee and the facility's fee together. A Medicare patient's own share is $449 at the surgery center and $832 at the hospital.
Medicare describes CPT 49505 as “Repair initial inguinal hernia, age 5 years or older; reducible” — in plain terms, repair of a first-time, reducible inguinal (groin) hernia in a patient aged 5 or older. The figures below are national averages published by CMS; your own region, and above all your own insurance status, will move them.
| Ambulatory surgery center | Hospital outpatient department | |
|---|---|---|
| Total (Medicare-approved amount) | $2,252 | $4,165 |
| Doctor fee | $508 | $508 |
| Facility fee | $1,744 | $3,657 |
| Medicare pays | $1,801 | $3,332 |
| Patient pays (average) | $449 | $832 |
Source: Medicare.gov Procedure Price Lookup, CPT 49505, retrieved July 29, 2026. CMS states these are national averages based on Medicare’s 2026 payments and copayments; the underlying dataset is the CMS 2026 Hospital Outpatient PPS annual policy file. Figures are rounded by CMS and are not intended to reconcile to the dollar.
The most useful thing in that table is what does not change. The doctor’s fee is $508 in both settings. What moves is the facility fee: $1,744 at a surgery center against $3,657 at a hospital outpatient department — 2.1× as much. Because the professional fee is fixed, the whole 1.8× difference in the total is the building.
Medicare.gov's own note on this procedure says the figures include facility and doctor fees, but that “you may need more than one doctor and additional costs may apply.” In practice the extra bill is usually anesthesia, and sometimes pathology. Two things from CMS's National Correct Coding Initiative Policy Manual are worth knowing before you pay any of them:
Anesthesia itself is reported from the CPT anesthesia series; the manual notes that codes 00100–01860 are the “Anesthesia for” codes tied to a surgical intervention, and that 99151–99157 describe moderate (conscious) sedation. Which specific code applies depends on the operation, so ask for the anesthesia claim in writing rather than assuming.
Everything above is what Medicare pays. It is not a cash price, it is not what a commercial insurer has negotiated, and it is certainly not a hospital’s list price. Those three numbers can differ from each other by multiples for the identical procedure code at the identical hospital.
We are deliberately not publishing a national “fair cash price” for an inguinal hernia repair. We do not have a current primary-source benchmark for one, and a stale number presented as today’s would be worse than no number. What we can tell you is where the number that actually governs your bill lives: your hospital publishes its own rates for CPT 49505 — the gross charge, the discounted cash price, and the payer-specific negotiated rates — in a machine-readable file. Our hospital price check walks you to it, and this guide shows how to read it once you get there.
If you just want a quick sanity check on the number in front of you, the overcharge estimator compares your charge against typical national ranges. Treat it as a smoke alarm, not a valuation.
CMS describes 49505 as the repair of an initial hernia that is reducible, in a patient aged 5 years or older. A repeat repair of the same hernia, or one that was incarcerated or strangulated, is a different code with a different payment. If any of those describe your case, check that the code on your bill matches your operative report.
If both sides were repaired, that is a different clinical scenario from the single-side procedure Medicare prices here. Ask the billing department to show you how each side was reported.
Per CMS’s NCCI Policy Manual, post-operative pain management by the operating physician “is not separately reportable.”
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