Always confirm costs with your healthcare facility and/or insurance coverage
Hernia surgery is a common procedure performed to repair a weak spot in the abdominal wall where internal tissues push through. The cost varies based on hernia type, surgical approach, patient age, and insurance coverage. Let’s break down the cost of hernia repair for children, adults, men, and women, as well as CPT codes for billing reference.
Average Cost of Hernia Surgery
Cost Factor |
Without Insurance |
With Insurance |
|---|---|---|
Open Hernia Repair |
$4,200 – $6,200 |
$750 – $1,500 |
Laparoscopic Hernia Repair |
$4,000 – $11,000 |
$750 – $2,000 |
Outpatient Surgery Center |
$5,800 – $8,000 |
$750 – $1,500 |
Hospital Surgery (Inpatient) |
$8,500 – $15,000 |
$1,000 – $3,500 |
🔹 Laparoscopic surgery costs more upfront but has a faster recovery time compared to open repair.
🔹 Insurance typically covers hernia repair when medically necessary, but out-of-pocket costs depend on deductibles and copays.
Hernia Surgery Costs by Patient Type
Patient Type |
Average Cost |
|---|---|
Infants & Children |
$2,500 – $5,000 |
Adult Males |
$4,000 – $11,000 |
Adult Females |
$4,500 – $12,000 |
Elderly Patients (Medicare) |
$1,500 – $6,500 (Medicare Copay) |
🔹 Hernia surgery in children tends to cost less due to shorter procedures and lower anesthesia costs.
🔹 Women’s hernia repairs may be more expensive if the surgeon needs to address hidden femoral or umbilical hernias.
Hernia Surgery Costs by Location
Location |
Average Cost Without Insurance |
|---|---|
New York, NY |
$6,500 – $12,000 |
Los Angeles, CA |
$5,800 – $10,500 |
Houston, TX |
$4,500 – $9,000 |
Chicago, IL |
$4,800 – $10,000 |
Miami, FL |
$4,200 – $8,500 |
🔹 Urban hospitals typically charge more, while outpatient centers in suburban or rural areas may offer lower pricing.
CPT Codes for Hernia Repair Surgery
Procedure |
CPT Code |
|---|---|
Initial inguinal hernia repair (age 5+) – Reducible |
49505 |
Initial inguinal hernia repair (age 5+) – Incarcerated/Strangulated |
49507 |
Laparoscopic inguinal hernia repair (initial) |
49650 |
Laparoscopic inguinal hernia repair (recurrent) |
49651 |
Anterior abdominal hernia repair (ventral, incisional, umbilical) |
49591 – 49596 |
Parastomal hernia repair – Reducible |
49621 |
Parastomal hernia repair – Incarcerated/Strangulated |
49622 |
Removal of infected/non-infected mesh |
49623 |
🔹 Surgeons use different codes based on hernia type, repair method, and whether mesh is used.
What Affects the Cost of Hernia Surgery?
Factor |
Impact on Cost |
|---|---|
Hernia Type |
Complex hernias (incisional, femoral, recurrent) cost more to repair |
Surgical Method |
Laparoscopic repair is more expensive than open surgery |
Hospital vs. Surgery Center |
Hospitals charge higher facility fees |
Surgeon’s Fees |
Highly specialized surgeons charge more |
Anesthesia Fees |
General anesthesia increases the cost |
🔹 Hernia surgery at an outpatient surgery center is usually cheaper than hospital-based surgery.
Does Insurance Cover Hernia Surgery?
Insurance Type |
Coverage for Hernia Surgery |
|---|---|
Employer/Private Health Insurance |
Partially or fully covered (deductible & copay apply) |
Medicare (Part B & Part A) |
Covers surgery, but 20% coinsurance applies |
Medicaid (Varies by State) |
Often fully covered for qualifying patients |
Marketplace/ACA Plans |
Covered when medically necessary |
No Insurance |
Must pay full cost ($4,000 – $11,000) |
🔹 Most insurance plans cover hernia surgery when it is medically necessary, but elective repairs may not be covered.
Ways to Reduce the Cost of Hernia Surgery
- Choose an outpatient surgery center – This can save $2,000 – $5,000 compared to hospital-based surgery.
- Ask for a cash-pay discount – Some hospitals offer 20-50% off for self-pay patients.
- Use an FSA or HSA – If insurance doesn’t cover everything, you can use tax-free savings to pay for surgery.
- Check Medicaid eligibility – Low-income patients may qualify for fully covered hernia repair.
- Compare multiple hospitals or clinics – Prices can vary by thousands of dollars depending on the facility.
Final Thoughts
The cost of hernia surgery varies widely, with prices ranging from $4,000 to $11,000 without insurance.
- Children’s hernia repairs cost less ($2,500 – $5,000) compared to adults.
- Laparoscopic hernia repair is more expensive than open surgery but has a faster recovery.
- Insurance typically covers the procedure, but deductibles and copays may apply.
- Outpatient centers and self-pay discounts can help lower costs.
If you’re considering hernia surgery, ask your doctor about different options, compare facility prices, and check insurance coverage to avoid high out-of-pocket costs.
Have you had hernia surgery before? Share your experience in the comments!
For more real-world healthcare pricing insights, visit CostHowMuch.com. 😊
